Thank you, Anne.  I haven't had trouble deciding whether to refer to an ENT or not, but I am trying to get a feel for how others are approaching getting moms help for ptt in particular.  
My question arises because in two days, I saw two babies who needed the frenulum addressed, and we seem to be seeing it here in larger numbers than some of the literature might expect.  Thank goodness we have doctors here who are familiar with it and will treat it.  And last year I invited a wonderful ENT to come to speak on the matter to help get the word out there.
My concern is that I have one contact out of state who is needing to drive 3 hours for a frenotomy, and sadly you and I (and we all!) know of situations where a mother and baby have been referred to an ENT (or pediatric dentist) and she decided to see someone else instead, someone who doesn't really understand the mechanics of breastfeeding, and the frenulum hasn't been clipped.  I am thinking that it might be helpful to attend the appt. with the mother and baby and show the dr. what is going in with breastfeeding and explain what should be going on, but it is an added expense for a mother to bring an LC to an appt.   I am wondering if anyone has any thoughts on whether it would be helpful to have the tool (they're not expensive, by the way), not because LC's need help identifying the tongue tie, but so that an LC could, for example,  take a picture of the ptt for the mother to bring with her to an appt.
Also, does anyone have feelings against this?
Maria Paciullo, NY

p.s.  Yes, I highly recommend Catherine Watson Genna's version and purchased both the original and revised.  It was probably a photograph from her materials that made me think of purchasing a grooved tongue director!  Thank you, Cathy!      JHL Feb. 2012 also had an interesting article on how different experts approach tongue tie.
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