What is Tongue Thrusting?

Long Beach, CA – Simply explained, tongue thrusting is the habit of putting the tongue in the wrong position when swallowing. A tongue thruster will place the tongue too far forward, or off to the side.

Every 24 hours, it is estimated that we swallow as many as 2,000 times, and each swallow using about four pounds of pressure. The tongue is one of the strongest muscles in our body, so when that pressure is placed in the wrong place, it then forces the teeth and dental arches out of alignment.

Unfortunately, there isn’t one thing that individually initiates tongue thrusting. There are, however, certain habits or conditions that are associated with tongue thrusting, so it is important to keep an eye on several suspected causes.

Those include:

• Thumb sucking
• Mouth breathing
• Difficulty swallowing
• An overly large tongue
• Muscular, neurological or other physiological abnormalities
• Being tongue tied

There are several variations of tongue thrusting, each of which present with their own unique orthodontic problems.

1- Anterior tongue thrust: An anterior open bite is the most common outcome of tongue thrusting. It is characterized by only the posterior teeth touching with the rest of the bite open, particularly the front teeth. Oftentimes, the patient’s lips do not close properly. A larger than normal tongue can often be present too.
2- Unilateral tongue thrust: Characterized by an open bite of the posterior dentition on either side of the mouth.
3- Bilateral tongue thrust: Characterized by an open bite of the posterior dentition, but the anterior bite will be closed. This is often the most difficult to correct through orthodontic treatment.
4- Closed bite tongue thrust: Characterized by upper and lower teeth anterior teeth that are together while biting, but spaced apart and flared.

Children do exhibit an infantile swallowing pattern from birth, but this type of tongue thrusting shouldn’t persist past the age of four. Most children will outgrow this habit on their own, but if they don’t, this is when we become concerned that it can affect their orthodontic health and speech.

There are many professionals who are qualified to diagnose tongue thrusting. Orthodontists, general dentists, pediatricians and speech therapists will be capable of detecting the issue. The issue often isn’t caught until the child has dental issues or speech problems that need correcting because of the habit.

Tongue thrusting is the cause of misalignment and bite problems in many orthodontic patients. To ensure orthodontic treatment will be successful to correct a patient’s bite, the tongue thrusting habit must also be corrected. If the teeth and bite are corrected but the tongue thrust remains, the patient will almost always experience a relapse of the open bite post-treatment.

There are two main therapies for correcting tongue thrust.

The first is called MyoFunctional Therapy, which involves exercises to re-train the tongue muscles. In order for it to succeed, the patient and parents must be committed to following through on the therapy. When followed correctly, it has the highest percentage of favorable results for orthodontic patients.

Other patients, however, may require the use of a special appliance to help them stop their tongue thrusting habit. A stainless steel tongue thrust appliance fits over the teeth, and has an attachment that prevents the tongue from pushing forward.

If your child displays an open bite, has a slight lisp when speaking, or displays any of the signs listed above, it is best to schedule a consultation with an orthodontist. The sooner the habit can be diagnosed, the sooner therapy can begin and hopefully, the less damage can be done to the child’s bite.