Tongue Thrust

What is Tongue Thrust?
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Tongue thrust is a habit of pushing the tongue against or between the front teeth during swallowing and/or speaking, and, sometimes, at rest. Every time a child swallows, his teeth are pushed forward by the pressure of the tongue. This habit can cause problems with dentition, biting, chewing/eating, and speech.

Tongue thrust swallow is normal in infancy, but it usually decreases and disappears as the child grows and begins to eat solid food.   If this does not happen, a trained speech language pathologist (SLP) can help re-train the muscles to a normal swallowing pattern. In a normal swallow, the teeth usually come together, the lips are closed and relaxed, and the tongue is held against the roof of the mouth behind the upper front teeth.


Causes of Tongue Thrust

Tongue thrust can be caused by several  factors:

Allergies, enlarged tonsils and adenoids: Allergies and enlarged adenoids can make it difficult to breath normally through the nose.  When the tonsils are enlarged and the nose is blocked at the same time, the back of the tongue has no room, and has to come forward (otherwise the child can't breathe). The child develops open mouth posture and forward placement of the tongue during speaking, swallowing, and at rest. 

Excessive thumb/finger sucking, prolonged use of bottles and pacifiers  also  encourage forward placement of the tongue and immature swallowing pattern.

Family heredity  is another causes of tongue thrust. 

Consequences of Tongue Thrust

Speech: Some children produce sounds like S, Z, SH, ZH, CH, J incorrectly with the tongue tip protruding between the front teeth.  “Sun” may sound like “thun” and “shoe” – like “thoo”. Also, the sounds T, D, N, and L may be distorted because of weak tongue tip muscles. However, in some cases speech may not suffer at all.

Dentition: The pressure of the tongue against the front teeth may result in malocclusion or misalignment of teeth, such as open bite. Open bite occurs when  the upper and lower front teeth do not come together when the mouth is closed. The result is a gap or opening between the rows of teeth when the jaws are closed.  

Tongue thrust can reverse orthodontic work that has already been done.

Eating:  Tongue thrust swallow may cause messy and noisy eating.  A child may chew food with his/her lips open, take large bites, and swallow before completely chewing the food. This may also cause an upset stomach from swallowing too much air while eating.

How can tongue thrust be corrected?

A speech language pathologist will develop a treatment plan to remediate tongue thrust. The tongue thrust therapy is different from articulation therapy and will include goals such as:
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• decreasing unhealthy oral habits (e.g., thumb sucking)
•  improving swallowing pattern and eliminating open-mouth posture
• improving muscle coordination and strength
• improving articulation skills

For success in this therapy, consistent exercise every day is necessary until the correct swallowing and muscle pattern becomes a habit.