What is tongue thrusting?
Tongue thrusting is the habit of placing or "thrusting" the tongue against the teeth or between the upper and lower front teeth when swallowing. It is an infantile swallowing pattern that has been retained by an individual.
We swallow between 1,200 to 2,000 times per day. The average force exerted by the tongue against the teeth when swallowing is four pounds. It is this constant pressure exerted by the tongue that forces the teeth out of alignment in a child with a tongue thrust problem.
What causes tongue thrust?
No one specific cause has been identified. However, any one of the following may be a contributing factor:
- Allergies, nasal congestion or obstructions leading to mouth breathing
- An abnormally large tongue
- Large tonsils, adenoids, or frequent sore throats which cause difficulty in swallowing
- Hereditary factors within the family, such as a steep jaw line
- Neurological, muscular, or other physiological abnormalities
- Short lingual frenum (tongue tied)
What are the consequences?
The force of the tongue against the teeth is an important factor in contributing to malocclusions (bad bites). This is manifested by anterior or lateral open bites where the teeth do not meet properly. Many well-treated orthodontic cases have suffered relapse because of the patient's tongue thrust swallowing pattern. If the tongue is allowed to continue pushing against the teeth, it will tip the teeth forward and alter the orthodontic treatment result.
Who diagnoses tongue thrust?
The most difficult problem of all is correctly diagnosing tongue thrust. In many cases, the tongue thrust may not be detected until the child is under orthodontic care.
Diagnosis is usually made when the child exhibits a dental or speech problem that needs correction.
How is a tongue thrust corrected?
Generally a tongue thrust swallowing pattern is handled in one of two ways:
- An appliance is placed by the orthodontist to control the tongue thrust
- Correction by oral habit training. This method involves working with a trained speech therapist to retrain the muscles associated with swallowing by changing the swallowing pattern.
With sincere commitment and cooperation of the child, correction is possible in the majority of cases. At the present time, successful correction of tongue thrust is as follows:
- 70% of the treated cases are successful
- 25% of the treated cases are unsuccessful due to poor cooperation or lack of commitment on the part of the parent or child
- 5% of the treated cases are unsuccessful due to factors that make correction impossible