Tongue thrust, formally known as an oromyofunctional disorder (OMD), describes an incorrect pattern of muscle use involving the face, mouth, and tongue. This condition is characterized by the tongue resting or moving too far forward, pressing against or between the teeth during speech and swallowing. The tongue’s proper position should be elevated against the roof of the mouth, or the palate, where it exerts balanced pressure. When this pattern is incorrect, the tongue’s constant, gentle force influences the alignment of the teeth and the function of the oral muscles. This common, treatable condition is corrected through targeted muscle retraining.
Recognizing the Signs of Tongue Thrust
The consistent forward pressure from the tongue over time often results in noticeable changes to dental structure. A prominent sign is an anterior open bite, where the upper and lower front teeth do not meet when the jaw is closed. This persistent force can also cause the upper front teeth to flare outward, creating a gap between them. The improper positioning may contribute to a constantly open mouth posture or visible protrusion of the tongue between the teeth even when the mouth is at rest.
Speech patterns are frequently affected, with the most common symptom being a frontal lisp, particularly when producing /s/ and /z/ sounds. The tongue pushes against or between the teeth during articulation of certain sounds, leading to distorted speech. Individuals may also exhibit difficulty biting or chewing certain foods, as the front teeth cannot meet to cut through items like lettuce or tough meats. Abnormal muscle use can also lead to secondary symptoms such as tension headaches or discomfort in the temporomandibular joint (TMJ).
Common Roots and Contributing Factors
Tongue thrust often originates when an individual does not transition properly from an infantile swallowing pattern to a mature one. The infantile reflex, where the tongue pushes forward to assist with feeding, is normal in newborns but typically disappears around six months of age. When this pattern persists, it can become a habit that requires intervention.
Prolonged non-nutritive sucking habits, such as extended thumb sucking, finger sucking, or pacifier use, are a major contributing factor, forcing the tongue into a low, forward position. Airway obstruction is another frequent cause, often resulting from chronic allergies, enlarged tonsils, or enlarged adenoids. When nasal breathing is difficult, the mouth opens and the jaw lowers, shifting the tongue into an unnatural forward and downward position to facilitate air intake. Anatomical variations, such as a short lingual frenulum (tongue-tie), can also restrict the tongue’s movement and prevent it from elevating to the palate.
Professional Treatment Options and Myofunctional Therapy
Correcting a tongue thrust requires retraining the muscles and establishing new neurological patterns, a process achieved primarily through Oromyofunctional Therapy (OMT). OMT is a specialized, exercise-based program designed to correct the muscle function of the tongue, lips, and face. The therapy’s main objective is to establish the correct tongue resting posture, which involves the entire tongue resting high against the palate.
A trained oromyofunctional therapist, often a specialized Speech-Language Pathologist (SLP), guides the patient through exercises that strengthen the oral muscles and improve coordination. The process focuses on neuromuscular re-education, helping the patient become consciously aware of the faulty muscle behavior and learn the physiological movements required for a mature swallow. This retraining is designed to make the correct resting and swallowing patterns automatic over time.
OMT is frequently integrated with care from other healthcare professionals for a comprehensive approach.
Collaborative Treatment Roles
An orthodontist may be involved to correct dental misalignment caused by the tongue thrust, such as an open bite or flared teeth. Orthodontists may use supportive appliances, such as a habit appliance or tongue crib, to physically block the tongue from protruding and encourage upward movement. An ear, nose, and throat physician may assess the patient for underlying airway issues, such as enlarged tonsils or chronic nasal congestion, that must be resolved for successful therapy.
The therapy typically progresses through stages, beginning with establishing proper oral rest posture and moving toward integrating the correct tongue position into swallowing and speech. This multidisciplinary approach addresses both the cause and the symptoms, which is important for preventing the relapse of orthodontic treatment once braces are removed. Successful intervention requires a commitment to the exercise regimen to replace the long-standing, ingrained muscle habits.
Daily Practice: Simple Exercises for Correction
Daily exercises are crucial for reinforcing the new muscle memory established during OMT sessions. The first step in correction is identifying the proper resting place for the tongue, often referred to as “The Spot” or the alveolar ridge. This is the small, firm bump directly behind the upper front teeth, and the tongue tip should rest there with the mouth gently closed.
Key Exercises
The “tongue pop” or tongue suction helps build the strength required for the tongue to maintain its high position. The patient places the entire body of the tongue against the palate, creates a vacuum by sucking upward, and then forcefully releases it to make a popping sound. Repeating this action multiple times daily strengthens the necessary muscles and helps the tongue become more comfortable resting in this elevated position.
To practice the correct swallowing motion, a small, sugar-free mint or a drop of water can be placed on the tongue tip at “The Spot.” The goal is to swallow while keeping the tongue tip pressed firmly against the alveolar ridge and the teeth gently together. This drill ensures the posterior part of the tongue elevates to propel the substance backward without the tongue tip moving forward or the lips straining.
The “sticky tongue” or tongue hold involves suctioning the tongue to the roof of the mouth and holding it there for several seconds before releasing it. This isometric exercise improves endurance in the lingual muscles, training the tongue to maintain a high, natural rest position. Consistent, short practice sessions throughout the day are more effective than infrequent, long sessions because they help integrate the correct posture into automatic daily functions.