Tongue thrust, also known as reverse swallow or immature swallow, is a condition where the
tongue pushes against or between the front teeth while swallowing, speaking, or at rest. This
condition can lead to a variety of dental and speech problems if not addressed.
However, by understanding this condition and seeking treatment early on, most people are able to overcome this condition. So, in this article, we’ll break down everything you need to know about tongue thrusts, including the causes, symptoms, and the most effective treatments available.
In this article we will discuss:
What is Tongue Thrust?
Tongue thrust, a common type of orofacial myofunctional disorder (OMD), is a habitual pattern where the tongue protrudes through the anterior teeth during swallowing, speech, and sometimes even when the tongue is at rest.
The tongue's forward posture during swallowing, speaking, and even at rest exerts pressure on the teeth, leading to dental misalignment and speech issues. This condition is most commonly seen in children but can persist into adulthood if not corrected.
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What Are the Most Common Causes of Tongue Thrust?
Understanding the cause behind the tongue thrust is the first step toward effective treatment. Addressing these root causes can significantly improve the outcomes of therapy and interventions. Several factors can contribute to the development of tongue thrust including:
● Thumb Sucking or Pacifier Use
● Nasal Obstruction
● Enlarged Tonsils or Adenoids
● Genetics
● Short Frenulum (Tongue-Tie)
While most of these causes are difficult to control, they can often serve as an early indicator of tongue thrust, allowing proactive parents to seek help early on.
What Are the Symptoms of Tongue Thrust?
Identifying tongue thrust can be challenging at first. However, by keeping an eye out for the
most common symptoms, you can seek timely intervention, potentially preventing long-term
dental and speech issues:
● Open Bite or Protrusion of Front Teeth: This is often a visible sign of tongue thrust.
The pressure exerted by the tongue can push the front teeth forward, creating an open
bite where the upper and lower teeth do not touch when the mouth is closed.
● Lisping or Speech Distortions: The incorrect tongue position can affect speech clarity.
Lisping, characterized by the mispronunciation of sibilant sounds (like 's' and 'z'), is a
common speech distortion caused by tongue thrust.
● Mouth Breathing: Persistent mouth breathing can be both a cause and a symptom of
tongue thrust. Mouth breathing often accompanies tongue thrust due to the obstructed
nasal airway.
● Frequent Open Mouth Posture: The tongue may rest against the teeth even when not
swallowing. An open mouth posture can lead to dry mouth and other oral health issues.
● Difficulty Swallowing Pills: The incorrect swallow pattern can make swallowing pills
challenging. The tongue's forward position disrupts the natural swallowing mechanism.
● Chronic Dry Lips: Mouth breathing and open mouth posture can lead to dry, chapped
lips. This symptom often indicates an underlying issue with tongue posture and
breathing.
While these symptoms don’t always indicate tongue thrust, it’s important to seek timely
evaluation and intervention if you recognize these common signs.
What is the Most Effective Tongue Thurst Treatment?
The most effective tongue thrust treatment involves a multidisciplinary approach, depending on the patient’s situation. Addressing the condition holistically ensures the best outcomes for the patient. This approach may include:
● Speech Therapy
● Orthodontic Treatment
● Myofunctional therapy
● Surgical intervention
Speech Therapy
Speech therapy is the cornerstone of tongue thrust treatment. An SLP will design a
personalized therapy plan to correct the swallowing pattern and improve tongue posture.
Key components of speech therapy include:
● Oral Motor Exercises: Strengthening the muscles of the tongue, lips, and jaw. These
exercises help in building the muscle strength needed for correct tongue positioning.
● Swallowing Techniques: Teaching the correct method of swallowing, ensuring the
tongue stays in the proper position. Techniques such as the "tip and swallow" method
can help re-train the swallowing pattern.
● Habit Reversal: Addressing and eliminating habits like thumb sucking or pacifier use.
Habit reversal training can reduce the risk of perpetuating tongue thrust behaviors.
Speech therapy involves consistent practice and reinforcement of new swallowing and speech patterns. Over time, these new habits can replace the dysfunctional ones, leading to improved oral and dental health.
Orthodontic Treatment
Orthodontic intervention may be necessary to correct any dental misalignment caused by
tongue thrust. Treatment options include:
● Braces: Traditional braces can help align the teeth and correct bite issues. Braces apply
continuous pressure to the teeth, gradually moving them into the correct position.
● Clear Aligners: Invisalign or other clear aligners can be used to gradually move the
teeth into proper position. Clear aligners offer a discreet and flexible option for correcting
dental misalignment.
● Habit Appliances: Devices such as tongue cribs or rakes can be installed to prevent the
tongue from pushing against the teeth. These appliances act as physical barriers,
discouraging the forward movement of the tongue.
Orthodontic treatment can address the structural issues caused by tongue thrust,
complementing the behavioral changes achieved through speech therapy.
Myofunctional Therapy
Myofunctional therapy focuses on retraining the muscles of the face and mouth to function
correctly. This therapy is done by a speech therapist but distinguishes itself in its emphasis on overall facial muscle coordination. Techniques include:
● Breathing Exercises: Encouraging nasal breathing to reduce mouth breathing. Proper
breathing techniques help in maintaining the correct tongue posture.
● Posture Correction: Ensuring proper head and neck posture to facilitate correct tongue
placement. Good posture supports overall muscle balance and function.
● Tongue Exercises: Specific exercises to improve tongue strength and flexibility. These
exercises help in achieving a stable and correct tongue posture.
Myofunctional therapy helps in creating a balanced muscle function, supporting the changes
achieved through other treatments.
Surgical Intervention
In severe cases, surgical intervention may be necessary. For example, this surgery might be
needed to remove a significant anatomical obstruction such as enlarged tonsils or adenoids. Or, if the frenulum is too short, it may be cut to improve tongue movement. Surgery is usually a last resort, considered only when other treatments are insufficient to address the underlying issues.
Getting Started with Speech Therapy for Tongue Thrust
If you or someone you know is struggling with tongue thrust, it’s crucial to seek professional
evaluation as soon as possible. Untreated, tongue thrust can lead to major dental and speech issues. However, if you address this issue early on, you can begin any necessary treatment and mitigate your risk of long-term damage.
To get started on your journey to overcoming tongue thrust, get in touch with our
speech-language pathologists (SLPs) at Better Speech. With online speech therapy at Better
Speech, you’ll gain access to the expertise of over 250 licensed SLPs, ready to help you
conquer this challenge from the comfort of your own home. Get in touch with an expert at Better Speech to schedule a consultation today!
Frequently Asked Questions
Can adults develop tongue thrust, or is it only a condition seen in children?
While tongue thrust is most commonly identified in children, adults can also develop tongue thrust due to certain habits or anatomical changes over time.
Is tongue thrust hereditary?
Can tongue thrust lead to sleep apnea?
Are there any exercises I can do at home to help with tongue thrust?
How long does it take to correct tongue thrust with therapy?
About the Author
Aycen Zambuto
I’m a seasoned educator in speech therapy with over six years of experience helping people navigate challenges in communication. Throughout this time, I’ve found joy in guiding individuals through a variety of therapeutic journeys, from toddlers with apraxia to seniors with dysphonia.
I’m passionate about demystifying this complex world of speech therapy and helping readers around the globe achieve clear and effective communication. When I’m not writing about speech, you’ll often find me reading, traveling or spending time with friends and family.
