What is a Tongue Thrust?
Basically, it is an abnormal swallowing pattern developed from compensations and or habits such as thumb sucking. There are different types of tongue thrusts. Varieties of thrust include when the tip of the tongue protrudes forward over the front teeth, in other thrusts the tip and/or sides of the tongue push or spread between the teeth. The force of the tongue muscle against the teeth can cause alignment issues, excessive overjet and orthodontic relapse.
Babies have an infantile thrust but as they grow, they develop motor skills and oral muscles through breast feeding, chewing foods (around 6 months) and drinking from real cups (not sippy cups). By age 6-7 we should have matured into an adult swallow pattern.
During a healthy swallow the tip of the tongue elevates to “the spot” on the roof of the mouth located behind the front teeth. The rest of the tongue raises up against the roof of the mouth in a wave like pattern as the swallow progresses. The lips should remain sealed with the teeth lightly touching. The swallow that is ideal is what we in the Orofacial Myofunctional Program call the “silent-swallow,“ you can’t really see it or hear it. The lip muscles, chin and muscles of the neck should be calm and uninvolved.
How can it affect my health?
Airway is always the number one concern, without proper breathing all else suffers. Tongue thrusts are notorious for airway issue. A person with tongue thrust may have airway and digestive issues as well. Imagine that every time a swallow occurs in thrust-swallow pattern a parting of the lips occurs. The air that is sucked in and then swallowed, can cause digestive issues such as reflux, bloating and tummy aches. The airway of the tongue thruster will be more prone to throw off the O2/Co2 balance we addressed earlier. At night- time the favored mouth position will be open due to anterior and or lateral open bite created by the thrust (and possible tongue tie as well) which brings us to issues of snoring, sleep apnea and poor sleep quality resulting in lack of cognitive restoration. Over years of poor sleep quality and gas exchange imbalance can take its toll on the different body systems.
How does a tongue thrust affect my teeth?
The thrust will lead to misalignment of the teeth which makes them harder to maintain clean. As the tongue thrusts forward it can cause narrowing and crowding, it can cause food traps that are hard to keep clean which long term can result in gum disease, decay and or tooth loss.
Open bite or cross bite can form as a result of improper tongue and muscle patterns during swallowing.
The facial muscles can experience soreness, tension, inflammation and dysfunction such as limited opening of the mouth.
The Temporomandibular joint or TMJ can be affected by an open bite. Temporomandibular Disorder or TMD can occur due to lateral shifting of the jaw during chewing.
Tooth eruption can be delayed. Improper swallow can delay teeth from erupting as the tongue pushes forward can interfere with tooth eruption and the alignment as well.
Relapse of orthodontic treatment is frustrating. The tongue is more often than not the culprit.
After years in braces the teeth will shift back if the tongue is not retrained to be in the proper rest position and swallow pattern. Orofacial Myology can help eliminate the tongue thrust pattern.
Causes of Tongue Thrust:
Sippy cups/Digit/habitual sucking
Mouth breathing-associated to low tongue rest posture
Allergies, large adenoids, tonsils, nasal congestion, Natural jaw anatomy, steep jaw angle
Down’s syndrome/muscular/neurological development
Tongue Thrust signs:
Chapped lips or area around lips are red, dry, cracked from frequent licking
Habitual mouth breathing (mouth breathing when not congested or sick)
Open mouth rest posture with lips apart and/or tongue resting against top and or bottom teeth
Swallow requires lower lip to come up/forward to keep food/drink in
Tongue protrudes against top and/or bottom front teeth when articulating /s/,/z/,/t/,/d/,n/,/l/,or /sh/
How do you fix a Tongue Thrust?
An Orofacial Myofunctional program uses functional exercises based on the individuals muscle patterns to establish new neuromuscular behaviors. The “cookie cutter” approach to our program doesn’t work in Orofacial Myology as each person usually has multiple factors contributing to the muscle dysfunction. By assessing and identifying the patient’s unique patterns and behaviors I am able to create a program plan that addresses the factors involved in the OMD.