Tongue thrusting is an atypical swallowing pattern where the tongue pushes against or between the teeth instead of resting correctly against the roof of the mouth. This myofunctional disorder can persist from childhood into adulthood, potentially affecting oral health, speech, and facial structure. This article explores adult tongue thrusting, its contributing factors, and correction strategies.
Understanding Adult Tongue Thrusting
Tongue thrust, also known as orofacial myofunctional disorder, involves the tongue pushing forward against the front teeth during swallowing, speaking, or at rest. In a typical swallow, the tongue tip rests on the alveolar ridge (the bumpy area behind the upper front teeth), then pushes upwards and backwards in a wave-like motion to propel food or liquid. With a tongue thrust, the tongue presses against the teeth, often protruding between them. This condition can persist or develop in adulthood, affecting an estimated 5% to 15% of older children and adults.
Adults might identify tongue thrusting through several signs:
An open bite, where upper and lower front teeth do not meet when the mouth is closed.
A lisp, particularly affecting “s” and “z” sounds.
Difficulty closing the lips completely.
Consistent mouth breathing.
A persistent sensation of the tongue pushing against the teeth.
An elongated facial appearance due to constant pressure.
Common Causes and Impact
Factors contributing to adult tongue thrusting include prolonged childhood oral habits like thumb sucking or extended pacifier use. Anatomical considerations also play a role, such as enlarged tonsils or adenoids leading to chronic mouth breathing, a restrictive tongue-tie, or existing jaw misalignment. Chronic respiratory issues like allergies or nasal obstruction can similarly encourage mouth breathing, influencing tongue posture and function.
Untreated tongue thrusting impacts dental health, speech, and overall oral function. It often leads to malocclusion, including open bite, overbite, or misaligned teeth, and can complicate orthodontic retention. Individuals might also experience:
Difficulty chewing or swallowing.
Jaw pain associated with temporomandibular joint (TMJ) disorders.
Poor head and neck posture.
Myofunctional Exercises and Techniques
Myofunctional therapy, or Orofacial Myofunctional Therapy (OMT), is a behavioral approach focused on retraining the oral and facial muscles for proper function. This exercise-based treatment aims to correct dysfunctional habits by improving tongue posture, swallowing patterns, and overall oral muscle coordination. Consistency in daily practice is a fundamental aspect for achieving lasting results.
Basic exercises target specific muscle groups to retrain the tongue, lips, and jaw. For proper tongue placement, one common exercise involves placing the tongue tip on the “spot” just behind the upper front teeth on the alveolar ridge, then creating suction to hold the entire tongue to the roof of the mouth. Another technique, the “mint swallow,” involves placing a sugarless mint on the tongue tip at this spot and swallowing as it dissolves, ensuring the tongue remains elevated.
Lip competency exercises aim to strengthen the muscles around the mouth, promoting proper lip seal. Practicing lip seals involves holding a button or a piece of paper between the lips without using teeth, gently pulling to create resistance. Blowing up balloons or whistling can also help strengthen the perioral and cheek muscles.
Correct swallowing exercises retrain the tongue to move in a wave-like motion against the roof of the mouth, rather than pushing forward. One method involves practicing swallowing with the tongue pressing firmly against the palate, ensuring it does not thrust forward. The “slurp” exercise, where the tongue is suctioned to the palate and then released with a popping sound, helps reinforce this movement. Consistent nasal breathing is also emphasized, as it supports proper tongue resting posture and overall airway health.
When to Seek Professional Support
While home exercises can be beneficial, professional intervention is often necessary or highly advantageous for correcting tongue thrusting. A certified myofunctional therapist possesses specialized expertise in diagnosing the specific patterns of tongue thrust and developing personalized treatment plans. They guide individuals through targeted exercises to retrain muscle function and establish proper oral habits.
Professional guidance becomes particularly important when individuals experience persistent issues despite consistent home exercises or face complex dental problems directly linked to the thrust. Significant speech impediments or underlying anatomical issues, such as a severe tongue-tie that might require a frenectomy, also warrant expert assessment. Many adults also find structured, guided therapy beneficial for accountability and to achieve optimal, long-term results.
Myofunctional therapy often involves collaboration with other healthcare professionals to ensure a comprehensive approach, including:
Orthodontists
Speech-language pathologists
Ear, nose, and throat (ENT) specialists
The duration of therapy can vary depending on individual needs and compliance, typically ranging from about 4 to 6 months of active treatment, though some programs may extend to 6 to 12 months. With diligence and proper guidance, correction of tongue thrust is often possible, leading to improved oral health, function, and overall well-being.