There are several different ways of describing tongue tie. Some are purely positional whereas others are more functional. From the perspective of whether tongue tie may be causing symptoms, the functional grading system is more helpful. Known as TRMR (Tongue Range of Motion Ratio), this is calculated with two measurements: maximal inter-incisal mouth opening (MIO) and mouth opening with tongue tip to maxillary incisive papillae at roof of mouth (MOTTIP).
Grade 1: TRMR more than 80%
Grade 2: TRMR 50-80%
Grade 3: TRMR 50-25%
Grade 4: TRMR less than 25%
More info on tongue tie:
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Video created by Dr. Christopher Chang:
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