Heather Gross, M.S., CCC-SLP
If your child has been diagnosed with a tongue thrust by their orthodontist or dentist, they are certainly not alone!
According to the American Speech-Language-Hearing Association, tongue thrusting during swallowing is estimated to be present in 33% to 50% of school-aged children. It appears most often in preschool- and young school-aged children.
As a parent or caregiver, you may have some questions! What causes a tongue thrust? What are the signs of a tongue thrust? And can a tongue thrust be corrected? This article provides an overview of tongue thrust in children and the benefits of treating it with speech therapy.
What is tongue thrust?
A tongue thrust is a “reverse swallow.” To understand tongue thrust, it helps to know what happens during a typical swallow. The tongue tip is placed on the alveolar ridge (the bumpy ridge behind your top front two teeth). You gently bite down, and the tongue pushes up against the hard palate, then pushes back and down to swallow.
With a tongue thrust, the tongue pushes forward during the swallow, instead of backward.
If a tongue thrust is not corrected, children may grow into adulthood with their tongue pushing against their front teeth every time they swallow. This can interfere with the normal growth, development, and function of their orofacial structures, leading to issues with eating, talking, and breathing.
Tongue thrusting is a concern for dentists and orthodontists when it affects occlusion (how the upper teeth and lower teeth come together when you close your mouth). Too much tongue pressure against the teeth may result in a malocclusion, or misalignment, of the teeth. For example, if the tongue consistently rests against the front teeth (and if the upper lip is weak), the front teeth will be pushed forward.
What causes tongue thrust?
Correct swallowing patterns typically develop by the age of 6 or 7 years old. Some children do not automatically develop that swallowing pattern, leaving them with a reverse swallow or tongue thrust.
There are several possible causes of tongue thrust, including but not limited to:
Sucking and chewing habits (such as thumb sucking) beyond 3 years of age
Blocked airways and/or nasal passages (caused by enlarged tonsils, enlarged adenoids, deviated septum, or chronic allergies), resulting in mouth breathing or an open-mouth posture
Poor muscle control
Anything that causes misplacement of the tongue, making it difficult to keep the lips together at rest
Tongue thrust can also be caused by an open mouth posture. This means that the person’s mouth remains open, even when they aren’t speaking, chewing, or swallowing.
What are some signs of a tongue thrust?
Signs of a tongue thrust may include any or all of the following:
Open-mouth resting posture, with the tongue resting on the floor of the mouth
Mouth breathing without allergies or nasal congestion
An open bite (common, but not a definitive factor)
Decreased tone of the facial muscles
A “full” bottom lip or tongue fully out while drinking from an open cup
The person anchors the straw with their tongue when straw drinking
High-arching, narrow palate
Pursed lips while swallowing
Trouble speaking clearly (speech articulation difficulties)
Why is it important to correct a tongue thrust?
When should you worry about a tongue thrust? Tongue thrust can affect a person’s health in many ways.
Persistent pressure on the teeth from the tongue can affect the development and alignment of the teeth. When the tongue pushes against the teeth during swallowing, speech, or at rest, this can lead to malocclusions such as an overbite, underbite, open bite, or crossbite.
A tongue thrust can also cause speech articulation difficulties, or problems pronouncing words clearly. For example, a lisp is a common result of tongue thrust.
When tongue thrusting persists into the teen and adult years, it can even affect jaw alignment.
Other potential health issues related to long-term tongue thrust include:
Snoring
Sleep apnea
Temporomandibular joint syndrome (TMJ)
Mouth breathing
Malnutrition (due to inefficient chewing and breakdown of food)
Social isolation and self-consciousness because of speech articulation problems
What’s involved in tongue thrust treatment?
If you think your child may have a tongue thrust, contact a speech-language pathologist (also known as a speech therapist) for an evaluation. If your child has been diagnosed with a tongue thrust by your orthodontist or dentist, they may have referred you to a speech therapist. The best way to fix a tongue thrust is through speech therapy. A tongue thrust does not have to be permanent!
Your speech therapist will use an evidence-based treatment called myofunctional therapy. This tongue thrust treatment targets the muscles of the face, jaw, tongue, neck, and mouth. The goals of myofunctional therapy are to improve the tongue’s oral resting posture and correct your child’s tongue positioning in speech, chewing, and swallowing.
The goals of therapy are to improve the tongue’s resting posture and correct your child’s tongue positioning in speech, chewing, and swallowing.
Your speech therapist will work to make therapy sessions fun and engaging for your child. They will also provide an at-home exercise program so that you and your child can practice between sessions. It’s important to practice these tongue thrust exercises as directed by your speech therapist. In tongue thrust treatment, we are retraining muscle movements and building new habits. Short, frequent practice reminds the brain to tell the muscles what to do. This is the way to create lasting change!
When you commit to an evidence-based tongue thrust treatment program, and regularly practice at home under the guidance of a speech therapist, you will see results! Treatment for tongue thrust can help prevent long-term speech problems and improve your child’s overall health and well-being. You can schedule a free consultation call with one of our specialists to learn more about tongue thrust treatment.
