Tongue sucking, often called tongue thrust, is a habitual movement pattern where the tongue presses forward against or between the front teeth during activities like swallowing, speaking, or when the mouth is at rest. When this behavior persists past the typical developmental age, it is classified as an orofacial myofunctional disorder. While this forward tongue posture is normal in infants, its continuation into childhood and adulthood can lead to complications. Addressing this habit requires a systematic approach involving at-home behavioral changes and professional interventions.
Understanding the Origins of the Habit
The tongue thrust habit originates in the infantile swallow pattern, a natural reflex necessary for suckling where the tongue moves forward to meet the lips. Most children transition to a mature swallow pattern, where the tongue elevates to the roof of the mouth, by age six. Failure to outgrow this initial reflex establishes the habit.
The habit’s persistence is often compounded by prolonged non-nutritive sucking behaviors, such as extended pacifier or thumb sucking, which encourage a low and forward tongue position. Chronic upper airway obstruction, frequently caused by enlarged tonsils, adenoids, or allergies, also contributes significantly. When nasal breathing is difficult, the jaw drops for mouth breathing, forcing the tongue to rest low to maintain an open airway. The habit can also serve as a psychological coping mechanism, providing comfort or relief during periods of stress or anxiety.
How Tongue Sucking Affects Dental Health and Speech
The constant pressure exerted by the tongue against the teeth during a tongue thrust affects the development and alignment of the jaw and teeth. The human tongue is a powerful muscle, and its repetitive force can shift the teeth over time. This pressure frequently leads to dental malocclusion, specifically an anterior open bite, where the upper and lower front teeth fail to meet when the mouth is closed.
Another common dental consequence is a significant overjet, where the upper front teeth noticeably protrude outward. The imbalance of forces between the tongue pushing out and the cheek and lip muscles pushing in can also negatively influence the growth of the jaw and palate, sometimes resulting in a narrow upper arch.
The habit also directly impacts speech articulation, as the forward tongue position interferes with the precise movements required for certain sounds. This often manifests as a frontal lisp, particularly affecting the clarity of sibilant sounds like “s” and “z,” which rely on the tongue positioning just behind the front teeth. Difficulties may also be observed with sounds like “t,” “d,” and “n” because the tongue is not achieving proper contact with the alveolar ridge.
Behavioral and Home-Based Intervention Strategies
Behavioral modification techniques are the most accessible starting point for addressing the tongue thrust habit and emphasize developing conscious awareness. A core strategy is positive reinforcement, focusing on praising and rewarding moments when the tongue is correctly positioned. Establishing a visual tracking chart, where a sticker is earned for periods without the habit, provides encouraging feedback and celebrates milestones.
Awareness training is paramount, as the habit is often unconscious, particularly during rest or sleep. Placing a small, removable cue, such as a sticker on a mirror or hand, serves as a gentle reminder to check tongue posture. Simple exercises establish the correct tongue resting spot, known as the “N-spot” (the area behind the upper front teeth where the tongue rests when saying ‘n’), which is highly effective for re-education.
To practice the mature swallow pattern, individuals can place a tiny piece of food, like a Cheerio, on the N-spot and then swallow, ensuring the tongue remains elevated and the teeth are lightly together. If the habit is linked to anxiety, finding healthy replacement coping mechanisms can reduce the urge for oral stimulation. Providing a stress ball or offering safe, chewy foods redirects the need for comfort away from the tongue and teeth.
Professional Dental and Orthodontic Treatment Options
When home-based strategies are insufficient, or if the habit has caused noticeable dental or speech issues, professional intervention is necessary. A dentist or orthodontist can assess the severity of any malocclusion and determine if the habit is still active, especially if it persists past age four or five.
Orthodontic treatment often involves fixed or removable habit-breaking appliances to physically block the tongue from forward movement. A tongue crib, a fixed device cemented to the back molars, uses a small wire barrier behind the front teeth to remind the tongue to stay back. The appliance serves as a constant physical cue, preventing the tongue from pushing forward during swallowing.
Simultaneously, a specialist may recommend Orofacial Myofunctional Therapy (OMT), a specialized program of exercises designed to retrain the muscles of the face, jaw, and tongue. OMT focuses on establishing the correct resting posture for the tongue—up against the palate—and normalizing the swallowing pattern. This therapy is considered a long-term solution, addressing underlying muscle memory and function to stabilize subsequent orthodontic correction and prevent relapse.