Ankyloglossia and Professional Liability: Between Action and Omission

The growing scientific and clinical interest in ankyloglossia has expanded the possibilities for assessment, diagnosis, and treatment, while also raising significant questions concerning the civil liability of healthcare professionals. In a multidisciplinary context, in which different professionals participate in screening, assessment, referral, and treatment, it is essential to define the duty of care, the limits of professional practice, and the legal consequences arising from both intervention and omission.

This presentation will examine civil liability in the assessment and management of ankyloglossia through two central dimensions: **action and omission**. It will address the legally relevant elements for establishing professional liability, including duty of care, professional conduct, fault, damage, and causation, with particular attention to negligent, reckless, or technically deficient conduct. An adverse clinical outcome, in itself, does not necessarily establish civil liability; professional conduct must be assessed in light of the specific circumstances of the case and the applicable standards of care.

Regarding action, the presentation will discuss situations such as diagnosis without adequate clinical grounds, overdiagnosis, unjustified indication of frenotomy or frenectomy, inappropriate use of assessment tools, interventions performed without appropriate professional training or competence, and technical failures in the performance of procedures. The duty to provide adequate information and the role of informed consent will also be examined, particularly regarding treatment indications, therapeutic alternatives, expected benefits, risks, limitations, and potential complications.

Regarding omission, the presentation will address circumstances in which clinically relevant signs are not recognized, investigated, documented, or appropriately referred, as well as potentially avoidable delays in assessment or diagnosis, failure to make an interdisciplinary referral, and deficiencies in follow-up care. Particular emphasis will be placed on the principle that a legally relevant omission requires both a duty to act and a causal relationship between the omission and the alleged harm.

The presentation will further distinguish between an adverse outcome, an inherent complication of a procedure, and legally compensable harm, while examining the relevance of clinical protocols, scientific evidence, and professional scope of practice in determining whether the conduct met the applicable standard of care.

Special attention will be given to clinical records and documentation as essential evidence of clinical findings, professional reasoning, therapeutic decisions, referrals, information provided to patients or their legal representatives, and follow-up care.

The Brazilian experience, including legislation concerning lingual frenulum assessment in newborns, will serve as a reference point for a broader international discussion. The presentation aims to demonstrate that legal protection is closely connected to technically competent, evidence-based, appropriately informed and documented professional practice, guided by the duty of care and patient safety.