This review attempted to identify evidence to address a broadly defined research question. Attempts were made to minimise bias and errors in the selection of studies, but it was not clear if such measures were taken for other processes. The diversity of the included studies suggests that a narrative synthesis was appropriate, but few details of the included studies were given.
The authors' conclusions follow from the results found, but this evidence might be biased due to small samples, selected participant groups, subjective outcome measures, lack of blinding, and the absence of comparators. The discussion section of the review appeared to suggest that the largest (and highest quality) randomised study found no significant effect on LATCH score, but this study did not appear in the summary tables, nor in the narrative synthesis of results.
Given the limitations of the primary evidence and the lack of clarity in some aspects of reporting, the authors' conclusions on the efficacy of tongue-tie division were appropriately cautious, but may be overly positive.