Kotlow ruler

Stainless steel measuring instrument, developed by OMFT.info to measure the tongue tie according to the Kotlow classification. If the tongue tie is too short or too stiff, it can obstruct moving a low tongue position into a good high tongue rest position. Often the tongue tie will have to be removed or cleaved. Laurence Kotlow, an English pediatrician, has set clear guidelines for when action should be taken. See also the information on the page Tongue ties.

The Kotlow rulers can be used in two ways:

1. To determine the place of attachment (Kotlow's original measurement method):
The distance is measured from the tip of the tongue to the place of attachment of the tongue tie at the bottom of the tongue. A distance > 16 mm is normal (for babies this is: > 10 mm). Anything less is considered mild to severe abnormal:

• 12 -16 mm Kotlow class 1: Mild.
• 8 - 12 mm Kotlow class 2: Moderate.
• 4 - 8mm Kotlow Class 3: Severe.
• 0 - 4 mm Kotlow class 4: Complete.
   

2. To determine the length of the tongue tie (based on insights and experiences from OMFT.info):
The distance from the place of attachment at the bottom of the tongue to the top of the saliva caruncles is measured.
To determine the Kotlow rating in this way, hold the client's tongue back with a slotted probe (the grooved director), a tongue guide or a liper device and slightly tighten the tongue tie. Then you take one of the Kotlow measuring bars, which you then hold parallel to the tongue tie. Place the end of the measuring stick between the thickening that is visible near the bottom of the mouth at the bottom of the tongue tie (the saliva caruncles) and where the top of the tongue tie is attached to the tongue. Find the ruler that fits exactly in between. The relevant ruler indicates which Kotlow classification is involved.

To properly measure the tongue tie with a Kotlow ruler, you need either a grooved director, a tongue guide or a liper device (to hold the tongue back and slightly tighten the tongue tie).