be complex and needs a multidisciplinary or interdisciplinary approach. “A range of health care professionals can be consulted to reach the proper diagnosis and develop the best treatment plan,” says Dr. Vu. The CAPD position statement calls for collaboration between general dentists, pediatric dentists, oral surgeons, pediatricians, lactation consultants and nurses. “We work together as a team to identify the particular reasons for any breastfeeding problems, and to determine if it’s actually the ankyloglossia causing the issue,” he explains. or trends. “I always remind parents that we’ve seen kids with no tongue-tie who still have feeding problems, and others with very short tongues who can speak very well.” The presence of a physical restriction does not automatically mean there is a problem. “Function first. Anatomy second. That’s the approach we need,” he says. CAPD acknowledges that despite clinical experience, there’s still insufficient long-term research on the outcomes of early surgical intervention for tongue-tie. “We need more research and data,” Dr. Vu says. “As in everything in science and medicine, we have to keep asking: is this really the best treatment? Or will something else be better in the future?” Until then, he encourages clinicians to practice humility and focus on collaboration. “We combined our guidelines with the American Academy of Pediatric Dentistry and other medical pediatrician groups because at the end of the day, we all have the same goal: to help children develop and thrive.” Quick Takeaways for Clinical Practice z Look beyond anatomy.A visible tongue-tie does not guarantee functional impairment. z Ask parents or caregivers about function. Is the baby latching? Is the child speaking clearly? Is oral hygiene an issue? z Refer wisely. Don’t try to manage complex cases in isolation. Connect with a multidisciplinary team. z Get informed consent.Always explain benefits, risks, and alternatives clearly. z Stay impartial. Follow evidence, not prevailing trends or attitudes. Read CAPD’s Position Statement at: bit.ly/4bVHKll First Line, Not Final Word Getting the correct diagnosis is important. It’s not just about tongue size, it’s also related to breastfeeding difficulty, speech problems, swallowing and oral hygiene. All the functionalities can be affected. “If you see a child for the first time and you notice a short tongue, don’t rush. Talk to the parents. Ask questions. What are their concerns? Are they noticing anything that affects feeding or speech?” explains Dr. Vu. Such cases often require referral to a multidisciplinary team, especially in urban areas. “If your clinic is located in a part of Canada where you are able to refer the family to a team of clinicians, try to seek out a pediatrician, lactation nurse, nurse consultant, or a specialist like myself,” says Dr. Vu. A key focus of the CAPD statement is on shared decision-making. “Everything we do has to be with informed consent. The parents or caregivers need to be made aware of the benefits, risks and alternatives,” he says. “Obviously, nothing in life comes without risk, but they should consider if it’s worth the risk to have treatment or not. This will depend on the parents and the health care professional and how comfortable they are with the procedure,” adds Dr. Vu. Dr. Vu also cautions against performing procedures without a full assessment. “We have to make sure that the parents agree on how, or even if, to proceed.” The Future: More Research, Better Protocols Laser frenectomy clinics and online testimonials have led to a rise in demand for tongue-tie release procedures. But Dr. Vu urges clinicians not to succumb to such pressures If you see a child for the first time and you notice a short tongue, don’t rush. Talk to the parents. Ask questions. What are their concerns? Watch an interview with Dr. Vu on CDA Oasis: bit.ly/4s46Ww8 19 Issue 2 | 2026 | Issues and People
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