Many individuals experience their tongue pushing against their teeth, especially during sleep. This indicates an oral habit that goes unnoticed throughout the day. Understanding this phenomenon is the first step toward addressing potential oral health implications.
What is Tongue Thrusting?
Tongue thrusting, also known as an orofacial myofunctional disorder (OMD), describes an atypical pattern where the tongue exerts pressure against or between the teeth. This can happen during various activities, including rest, swallowing, and speech. In a typical swallow, the tongue presses against the roof of the mouth, but with tongue thrust, it pushes forward.
Why Your Tongue Pushes Your Teeth
Several factors can lead to the development of tongue thrusting. Prolonged habits during childhood, such as thumb or finger sucking and extended pacifier use, can teach the tongue to rest and move forward. Genetic predisposition, such as a family history of specific oral and facial structures, can contribute to a forward tongue position.
Upper airway obstructions (e.g., enlarged tonsils or adenoids, chronic allergies, nasal congestion) can be a factor. When nasal breathing is difficult, the jaw and tongue may move down and forward to open the airway, leading to a forward tongue position. An anterior tongue tie, where the band of tissue beneath the tongue is tight or short, can encourage the tongue to thrust forward during swallowing. Poor oral muscle strength or tone can contribute, as low muscle strength may cause the jaw to drop and the tongue to move forward. Neurological conditions, including cerebral palsy or Down syndrome, can influence muscle control and contribute to tongue thrusting.
How This Affects Your Mouth and Health
Tongue thrusting can lead to various effects on oral health and overall well-being. A common dental consequence is an open bite, where the upper and lower front teeth do not meet when the mouth is closed. This pressure can also cause misaligned teeth or gaps, particularly between the two upper front teeth. These dental issues, known as malocclusion, can affect chewing efficiency and overall oral function.
Beyond dental alignment, tongue thrusting can contribute to speech impediments, such as a lisp, where the tongue is against or between the teeth when producing sounds like /s/, /z/, /sh/, and /j/. Difficulty chewing or swallowing can arise, as abnormal tongue movement affects food handling. Jaw pain, linked to temporomandibular joint (TMJ) issues, can result from misaligned teeth and an improper bite. Tongue thrusting might contribute to sleep-disordered breathing patterns, including snoring or even obstructive sleep apnea, due to altered tongue placement and airway obstruction.
Addressing Tongue Thrusting
Addressing tongue thrusting typically begins with a professional evaluation by a dental professional, orthodontist, or an oral myofunctional therapist. These specialists assess the tongue’s position during rest, swallowing, and speech to accurately diagnose the condition. The primary treatment method for tongue thrusting is orofacial myofunctional therapy (OMT), which focuses on retraining the muscles of the face, jaw, and tongue. This therapy involves a series of exercises designed to improve tongue elevation strength, correct resting posture, and establish proper tongue placement during swallowing.
Myofunctional therapy aims to develop a normal oral resting position where the lips are closed, and the tongue tip rests behind the upper front teeth. Orthodontic treatment may also be necessary to correct any dental issues, such as misaligned teeth or an open bite, that resulted from the tongue thrust. In some instances, orthodontic appliances, such as tongue cribs, can be used to help train the tongue into the correct position. Addressing underlying causes, such as enlarged tonsils or adenoids, may involve consultation with an ear, nose, and throat (ENT) specialist to improve nasal breathing. A collaborative approach involving multiple healthcare professionals can be beneficial for comprehensive care.