Tongue thrust, also known as a reverse or immature swallow, describes an atypical swallowing pattern. The tongue pushes too far forward in the mouth, often pressing against or protruding between the front teeth during swallowing, speech, or at rest. This continuous forward pressure, instead of the tongue resting properly against the roof of the mouth, can interfere with normal oral function. While common in infants, it typically resolves as a child develops.
Identifying a Tongue Thrust
A primary indicator of tongue thrust is when the tongue is visible between the teeth during rest, speaking, or swallowing. This protrusion can be subtle or quite noticeable. Individuals may also exhibit messy eating habits, with food or liquid escaping the mouth.
Speech difficulties, particularly a lisp involving “s” and “z” sounds, are frequently observed. Mouth breathing, where breathing occurs primarily through the mouth instead of the nose, is another common sign. An open bite, where the upper and lower front teeth do not meet when the mouth is closed, is a frequent dental manifestation.
Contributing factors can include prolonged habits like thumb sucking or pacifier use, which influence tongue positioning. Conditions such as chronic allergies, enlarged tonsils, or adenoids can also lead to mouth breathing, encouraging the tongue to sit lower and forward.
Impacts of Tongue Thrust
The persistent forward pressure of the tongue against the teeth often causes dental issues. This can result in misaligned teeth, such as an open bite where the front teeth do not meet, or protruding upper teeth. The continuous force from the tongue can create gaps between teeth or lead to crowded teeth.
This misalignment can make biting and chewing certain foods difficult. For instance, biting into items like lettuce or lunch meat might be problematic as the food slips through the gap.
Speech impediments are also a common consequence, with a lisp being a frequent concern, especially when producing “s” and “z” sounds. In some cases, tongue thrust can contribute to an elongated facial appearance due to the inability to properly close the mouth. Swallowing difficulties or digestive issues may also arise from improper swallowing mechanics, where the tongue does not effectively push food down the throat.
Myofunctional Therapy Exercises
Myofunctional therapy is an exercise-based treatment that retrains the orofacial muscles for proper resting, swallowing, and speaking positions. These exercises strengthen the tongue, jaw, and facial muscles, promoting balanced and coordinated function.
One common exercise involves placing the tongue tip high on the palate, just behind the upper front teeth. Patients press the tongue firmly upward and then bring it down forcefully to create a clicking or popping sound, repeating this frequently. Another exercise, often called “slurp,” involves placing the tongue as if to click, but instead sucking air back into the throat to pull the tongue backward. Then, swallow while maintaining tongue pressure against the palate without forward thrust.
Strengthening exercises for the tongue and lips are also incorporated. An example includes pushing the tongue firmly against a spoon held in front of the lips for about 10 seconds, repeating multiple times. For lip strength, holding a metal spoon handle between the lips using only lip muscles for 10 seconds, and repeating, can be beneficial. Some exercises also involve placing a small object like an orthodontic rubber band on the tongue tip and practicing swallowing while keeping it on the roof of the mouth with teeth closed and lips apart.
Additional Correction Strategies
Orthodontic appliances can help guide the tongue into a correct position or correct existing dental issues. These appliances, such as tongue cribs or palatal expanders, can be removable or fixed. A fixed appliance typically consists of a metal grate or fence attached to the back molars, acting as a barrier to prevent the tongue from pushing forward. Removable appliances, similar to retainers, can be worn for a specified duration each day and are suitable for less severe habits or for children who can consistently follow instructions.
Addressing underlying medical conditions is also important. Conditions like chronic nasal obstruction, allergies, or enlarged tonsils and adenoids can contribute to mouth breathing, which influences tongue posture. Consulting with healthcare professionals such as orthodontists, speech-language pathologists, or myofunctional therapists is recommended for a comprehensive evaluation and a tailored treatment plan. A multidisciplinary approach may be necessary to address all contributing factors and achieve lasting correction.