PubMed abstract / permitted excerpt

OBJECTIVE: The primary objective of this study was to evaluate demographic trends and financial impacts of ankyloglossia treatments across privately insured pediatric patients in inpatient and outpatient settings. STUDY DESIGN: Retrospective database analysis. SETTING: The Merative™ MarketScan® Commercial Claims and Encounters Database 2010 to 2022. METHODS: Within the MarketScan database, we identified infants (age <1 year) who had diagnoses of ankyloglossia and received surgical treatment for ankyloglossia. Sociodemographic variables included sex and geographic location. Financial variables included copays, deductibles, net payments, and billing provider type. RESULTS: A total of 10,353,534 unique infants were captured within the database. From 2010 to 2022, the annual rate of ankyloglossia diagnosis increased from 0.77% to 4.03%, and the annual rate of surgical treatment of ankyloglossia increased from 0.47% to 1.78%, plateauing after 2018. The percentage of medical claims from dental specialists and nurse practitioners increased from 1.7% to 13.1% and from 0.08% to 5.33%, respectively. A total of $45.8 million was billed for surgical procedures in infants. The cost per infant increased 33% from $350.79 to $467.08. Out-of-pocket costs per infant increased 109% from $56.26 to $117.85. CONCLUSION: We demonstrate increases in the number of claims and associated costs for procedures in the treatment of ankyloglossia. The true medical costs of this condition are likely higher, as we do not capture procedures uncovered by insurance. Despite increased diagnosis of ankyloglossia, there is a surprising plateau in the frequency of frenotomy in recent years, suggesting either market saturation or shifts in treatment away from medical specialties.