What is tongue thrust?

Tongue thrust is defined as a forward placement of the tongue in between the front (anterior) teeth and against the lower lip during the swallowing process. Tongue thrust is present if the tongue is observed thrusting between, and the teeth do not close in centric occlusion during swallowing. It is considered an orofacial myofunctional disorder, a deficit that includes orofacial and oral muscles and can interfere with structural growth, function, or development.  

How tongue thrust affects dental occlusion? 

The tongue is a very powerful muscle and is strong enough to push our teeth out of their natural position, which causes loss of equilibrium. An individual swallows around 2000 times a day. In tongue thrusting, the improper swallowing becomes more apparent when it is persistent for a longer duration of time. It can also lead to open bite and malocclusion, in which only your back teeth touch together when you swallow, and anterior teeth will not touch. In addition, increased overbite, bruxism, unilateral or bilateral crossbite may be observed.  

What are the types of tongue thrusting? 

There are different types of tongue thrusting:  

• Anatomic Type – Persons who have huge tongue might be associated with tongue thrusting habit. 
• Habitual Type – The habit of tongue thrust swallow remains as a habit even after the malocclusion has been corrected. 
• Functional Type – A functional tongue thrust habit happens when the tongue thrust mechanism is an adaptive behaviour developed to achieve the oral seal. 
• Physiological Types – This comprises the normal tongue thrust swallow of infancy.

What causes tongue thrusting? 

• Retained infantile swallowing pattern in children. 
• Bottle feeding of children. 
• Upper respiratory tract infection such as chronic tonsillitis & allergies. 
• Tongue size which is abnormally large (macroglossia). 
• Tongue tie (ankyloglossia). 
• Thumb or fingers sucking habit. 
• Large tonsils. 
• Hereditary factors. 

What can the orthodontist or the speech and language therapist observe in a person having a tongue thrust?  

There are several symptoms that can be used to diagnose a person with tongue thrust: 

1. Extra-oral symptoms:
   • The gap between upper and lower lip is bigger than normal (greater lip separation).
   • The movement of the lower jaw is more erratic during the process of swallowing.
   • Speech disorders such as lisping & sibilant distortions.
   • Problems in the pronunciation of the certain sounds such as “s”, “n”, “t”, “d”, “l”, “th”, “v”, “z.”
   • Anterior facial height is greater than normal.
2. Intra-oral symptoms:
   • The swallowing sequences are jerky and irregular.
   • Increased proclination of upper front teeth.
   • Greater spacing between the teeth.
   • Retroclination or proclination of lower front teeth.
   • Decreased width of upper jaw.
   • Anterior or posterior open bite.
   • Posterior cross bite.
   • A difference in the way you eat, chew, or speak compared to others could indicate a possible neuromuscular condition.
   • The teeth becoming misaligned or gapped. The continuous gradual pressure moves your teeth and may require orthodontic treatment for optimum performance.
3. A difference in the way you eat, chew, or speak compared to others could indicate a possible neuromuscular condition.
4. The teeth becoming misaligned or gapped. The continuous gradual pressure moves your teeth and may require orthodontic treatment for optimum performance.
5. A narrow face and larger tongue may be the cause or result of tongue thrust.

How tongue thrust is treated?  

There are several treatment options for tongue thrust depending on the case: 

• Speech Therapy: The therapist will provide a training of correct swallowing technique and posture of the tongue during the deglutition (swallowing) by various myofunctional exercises. In addition, exercises that retrain and strengthen facial and oral muscles to move differently are also applied. 
  For younger patients also that often hold their tongues in an unhabitual pattern because of thumb sucking, pacifier use, or mouth breathing, changing the tongue’s behavior through exercises and conscious observation can alleviate tongue thrust. The treatment can work in adults as well. 
• Orthodontia: The most common conditions tongue thrust cause tooth misalignment or crookedness. With orthodontic treatment, traditional braces can correct extreme cases of misaligned smiles. In addition, the correction of malocclusion is required if there is an open bite or posterior cross bite. Both fixed and removable dental appliances can be used to restrain the anterior tongue movement during the process of deglutition (swallowing). 

Tongue thrusting exercise to try at home for children:  

1. Place a sugar-free candy, like a lifesaver, on the tip of your tongue. 
2. Press the tip of your tongue against the roof of your mouth. 
3. Make sure that your tongue is pushing against the lifesaver. 
4. Bite your teeth together and keep your lips apart. 
5. Swallow, but be sure to keep your teeth together and lips apart.  

Transforming Smiles with Speech Therapy at Talking Brains Center, Dubai

At Talking Brains Center in Dubai, we’re here to address the impact of tongue thrust on dental health and speech. If you or your child is facing these challenges, our dedicated team offers tailored trilingual speech therapy solutions in Arabic, French and English. By retraining tongue behavior, we’re committed to improving your child’s oral health and boosting confidence. Contact us today to embark on your journey to a brighter, healthier smile.