Understanding how incorrect swallowing patterns are linked to breathing, dental development & speech
What is Tongue Thrust?
A tongue thrust is a muscle pattern characterized by the tongue visibly pushing forward or sideways during swallowing or speaking. It may be associated with an "open bite" malocclusion or a lisp. A tongue thrust is often the most recognized symptom of an Orofacial Myofunctional DIsorder.
Is a Tongue Thrust THE PROBLEM or Just a Symptom of a MUCH LARGER ISSUE?
There has been much speculation over the years about the effects of a tongue thrust swallowing pattern on dental occlusion. Historically, it was assumed that a tongue thrust caused malocclusion (crooked teeth) by pushing against the teeth repeatedly during swallowing. However, a tongue thrust has been proven to be insufficient in both force and duration to move teeth.
We now know that a tongue thrust is simply an adaptation to the various causes of much larger, underlying orofacial muscle issues.
Traditional approaches to Tongue Thrust Treatment
In the past, because the focus was on the force of the thrust rather than the Oral Rest Posture, dentists and orthodontists used "habit appliances" such as cribs, takes or spikes to block the tongue from the thrusting during swallowing. These habit appliances made daily tasks such as eating and speaking very difficult for the patient. These appliances also prevented the orofacial muscles and the jaw from resting in the correct place, leading to even poorer Oral Rest Posture. A tongue thrust may "appear" to be resolved by a habit appliance, but in reality, the tongue develops other compensations which are neither healthy nor correct.
Therapy for Orofacial Myofunctional Disorders
To properly address a tongue thrust, we now know that is is imperative that we address the underlying cause. Certified Orofacial Myologists collaborate with other allied health care professionals to address barriers to nasal breathing and correct tongue ties with necessary. Certified Orofacial Myologists are trained to eliminate noxious oral habits such as thumb sucking. Once the cause of the tongue thrust is addressed, your therapist will use a sequential and systematic approach to addressing not just the function of the tongue, but the function and the rest of the posture of all of your oral and facial muscles. If your therapist is also a Speech and Language Pathologist, they will work with you or your child to correct any lisping/articulation problems associated with the tongue thrust.
Why Oral Posture Matthers More than Tongue Thrust
When our orofacial muscles are at rest, our tongue should be resting against the roof of the mouth, our lips should be sealed and our jaws should be closed together with only a few milometers of space between the teeth. This proper Oral Rest Posture leads the way to good dental and airway development and clear speech. If the harmony and equilibrium in our Oral Rest Posture is disturbed, then a tongue thrust is often the most recognized result.
Many things can lead to a change in Oral Rest Posture, resulting in a Tongue Thrust Swallow. Airway issues that lead to chronic mouth breathing such as chronic allergies or enlarges tonsils/adenoids can alter Oral Rest Posture. An untreated tongue tie can prevent the tongue from resting in the proper place. Also, prolonged thumb, pacifier or sippy cup use teaches the tongue to rest in the wrong position, and to thrust while swallowing. In order to properly rehabilitate the incorrect swallowing pattern, it is imperative that the underlying cause be addressed.
Source: International Association of Orofacial Myology