Tongue thrust is a condition characterized by the tongue pushing forward against or between the teeth during rest, swallowing, or speech. It is also known as an orofacial myofunctional disorder (OMD). While common in infants as a natural reflex, it can persist into childhood and even adulthood if not addressed.
Understanding Tongue Thrust
Tongue thrust occurs when the tongue’s position is not optimal, often protruding forward instead of resting against the roof of the mouth behind the upper front teeth. During swallowing, the tongue may push against the front teeth with significant pressure, up to four pounds per swallow. This consistent pressure, occurring thousands of times a day, can influence tooth alignment and oral structure.
Signs of tongue thrust include the tongue being visible between the teeth during speech or at rest, and difficulty biting food properly. Individuals might also exhibit frequent mouth breathing, inability to close lips completely, or messy eating habits. A “frontal lisp,” where the tongue is positioned against or between the teeth when producing sounds like /s/, /z/, /sh/, /ch/, and /j/, is common.
Common Causes of Tongue Thrust
Several factors can contribute to tongue thrust. Prolonged oral habits, such as thumb or finger sucking, extended pacifier use, or bottle feeding past early childhood, can train the tongue to adopt a forward position. The presence of an object in the mouth during these habits causes the tongue to move downward and forward.
Anatomical factors also play a role, including enlarged tonsils or adenoids, allergies, or nasal obstructions that hinder nasal breathing. When nasal breathing is difficult, the jaw and tongue may move forward to open the airway, leading to a forward resting position. Conditions like tongue-tie (ankyloglossia), a narrow upper jawbone, or poor oral muscle strength can also contribute.
Impact of Untreated Tongue Thrust
If untreated, tongue thrust can lead to various issues, particularly concerning dental health and speech. The constant pressure from the tongue against the teeth can cause dental misalignment, such as an open bite where the upper and lower front teeth do not meet when the mouth is closed. This can also result in teeth flaring out, creating gaps, or contributing to an overbite or underbite.
Untreated tongue thrust can impact overall oral posture and contribute to jaw pain or an elongated facial structure due to persistent mouth breathing.
Professional Treatment for Tongue Thrust
Addressing tongue thrust often involves a multidisciplinary approach. Myofunctional therapy focuses on retraining the muscles of the face, tongue, and mouth. Therapists use customized exercises to improve muscle function, establish proper tongue posture, and correct swallowing patterns. The goal is to achieve a normal oral resting position where lips are closed, and the tongue tip rests against the ridge behind the upper front teeth.
Orthodontic intervention corrects dental issues resulting from tongue thrust. Orthodontists use braces, aligners, or specialized appliances like tongue cribs or palatal bars to realign teeth and discourage forward tongue pressure. These appliances act as a physical reminder, helping retrain the tongue’s position. Orthodontic treatment works with myofunctional therapy to ensure long-term stability and prevent relapse of corrected dental alignment.
Speech therapy, provided by speech-language pathologists, addresses speech impediments like lisping. Therapists teach individuals how to strengthen and correctly position their tongue to produce sounds accurately. A collaborative effort ensures a comprehensive treatment plan.
Complementary Home Strategies
Home strategies support professional guidance in addressing tongue thrust. Exercises and awareness techniques help retrain the tongue and promote proper oral posture. These include practicing specific tongue movements or holding certain positions to build muscle memory and strength. Consistent daily practice is important for long-term benefits.
Breaking detrimental oral habits is a key home strategy. This involves weaning children from prolonged pacifier or bottle use, typically around ages four to five years. For older children and adults, consciously stopping thumb or finger sucking is crucial, as these habits reinforce the forward tongue thrust. Promoting proper oral posture, keeping lips closed and the tongue resting on the roof of the mouth, can be reinforced through awareness and gentle reminders.