Stopping a tongue thrust requires retraining the muscles of your tongue and mouth so that swallowing happens with the tongue pressing up against the roof of your mouth, not pushing forward against or between your teeth. This retraining is done through a structured program called orofacial myofunctional therapy, sometimes combined with orthodontic appliances, and it works for both children and adults. The process takes months of consistent daily practice, but the pattern can be permanently changed.
What a Tongue Thrust Actually Is
Every infant swallows by pushing the tongue forward between the gum pads. That’s normal. By age two to four, most children naturally transition to a mature swallow pattern, where the tip of the tongue presses against the ridge of the palate just behind the upper front teeth, and the lips and cheeks stay relaxed. A tongue thrust is simply the persistence of that infant swallow pattern past the point when it should have disappeared.
When you swallow with a tongue thrust, the tip of your tongue pushes forward between or against your front teeth, and your lips and cheeks contract to create the seal needed to complete the swallow. You do this thousands of times a day, often without realizing it. Over time, that repetitive forward pressure can push teeth out of alignment, create an open bite (where the front teeth don’t fully meet), and affect how you pronounce certain sounds.
Why It Happens
Tongue thrust has two broad categories of causes: obstructive and functional. The obstructive causes are anything that blocks your nose and forces you to breathe through your mouth. Enlarged tonsils or adenoids, a deviated septum, nasal polyps, and chronic allergies all qualify. When you breathe through your mouth, your lips stay apart, and your tongue drops to a low, forward position. Without a lip seal, the tongue pushes forward during swallowing to create the closure your lips would normally provide.
Functional causes include prolonged thumb sucking or pacifier use, which train the tongue into a forward posture during early development. Some people have a tongue tie (a short or tight band of tissue under the tongue) that limits upward movement and makes the mature swallow pattern physically difficult. In many cases, the original cause resolved years ago, but the swallowing habit simply never updated itself.
Signs You Have a Tongue Thrust
The most obvious sign is visible: your tongue pokes forward between your teeth when you swallow, and you can often see the tip of your tongue pressing against or past your front teeth. Other signs include:
- Open bite: A gap between your upper and lower front teeth even when your jaw is closed.
- Speech differences: A lisp or difficulty with “s,” “z,” “t,” “d,” “n,” and “l” sounds, all of which require precise tongue placement behind the teeth.
- Mouth breathing at rest: Lips apart, tongue sitting low in the mouth rather than against the palate.
- Orthodontic relapse: Teeth shifting back out of alignment after braces, because the tongue keeps pushing them forward.
Prevalence is surprisingly high. Studies report that 40 to 80 percent of children between ages four and six still show tongue thrust swallowing. By ages 12 to 15, that number drops to 3 to 25 percent, meaning many children self-correct but a significant minority carry the pattern into adolescence and adulthood.
Myofunctional Therapy: The Core Treatment
The primary way to stop a tongue thrust is orofacial myofunctional therapy, a series of exercises that retrain your tongue, lips, and facial muscles to adopt the correct resting posture and swallow pattern. Think of it like physical therapy for your mouth. A trained therapist designs a program around your specific issues, and you practice the exercises daily at home between sessions.
The goal of every exercise is the same: get your tongue consistently resting and functioning in the right spot, which is pressed against the palate just behind the upper front teeth. Therapists often call this position “the spot.” The exercises build strength and muscle memory so that your tongue automatically goes there during swallowing, speaking, and rest.
Common Exercises
While a therapist will customize your program, most plans include variations of these core drills:
- Tongue-to-spot holds: Place the tip of your tongue on the ridge behind your upper front teeth and hold it there for increasing intervals, building endurance in the muscles that keep it elevated.
- Palate clicks: Press the full surface of your tongue flat against the roof of your mouth, then pull it down sharply to make a clicking sound. This strengthens the suction and lift of the tongue against the palate.
- Correct swallow practice: With the tongue pressed to the palate, practice swallowing water without letting the tongue push forward or the cheeks contract. This is the central skill you’re relearning.
- Lip seal exercises: Hold a thin object (like a button on a string or a tongue depressor) between your lips without using your teeth, building the lip strength needed for a proper seal at rest.
- Tongue push-ups: Press the tongue firmly against the palate and hold, resisting downward pressure, to build the strength needed for consistent resting posture.
These exercises sound simple, and individually they are. The challenge is consistency. You’re overriding an automatic pattern that your brain has reinforced thousands of times per day for years. Most programs require daily practice, and the full retraining process typically takes several months of active therapy followed by a maintenance period. Progress tends to follow a pattern: first you learn the correct position consciously, then you maintain it during exercises, then it starts to feel natural at rest, and finally the new swallow pattern becomes automatic.
Orthodontic Appliances
For some people, especially children, a dentist or orthodontist may recommend a physical appliance to help break the habit while the muscles are being retrained. The most common is a tongue crib, a small metal framework attached to the upper molars with bars or spurs that sit behind the front teeth. It works less by physically blocking the tongue and more by repositioning it. Imaging studies show that wearing a tongue crib causes the tongue to rest further back and higher in the mouth, essentially forcing the correct posture.
Tongue cribs are most effective when worn for at least six months. Research shows that patients who wore them for shorter periods had limited results. A modified version that includes a small acrylic roller gives the tongue something to interact with, providing positive reinforcement for the new position rather than just a physical barrier. After the appliance is removed, a six-month follow-up period is standard to watch for relapse.
Appliances alone don’t solve the problem. They’re most effective when paired with myofunctional therapy, because the appliance repositions the tongue while the exercises build the muscle strength and habits needed to maintain that position after it comes out.
Addressing the Underlying Cause
If your tongue thrust is driven by chronic mouth breathing, no amount of exercise will produce lasting results until the airway issue is resolved. Enlarged tonsils or adenoids may need to be evaluated by an ENT specialist. Persistent allergies that keep your nose congested need treatment so you can breathe through your nose consistently. A tongue tie may need to be released by a dentist or oral surgeon before the tongue can physically reach the correct position.
This is why treatment often involves a team. Speech-language pathologists who specialize in myofunctional therapy frequently work alongside dentists, orthodontists, ENT specialists, and sometimes physical therapists who focus on jaw function. The specific team depends on your age and what’s driving the problem. For a child with large adenoids and an open bite, the path looks different than for an adult with a long-standing habit and no structural issues.
Finding the Right Provider
Myofunctional therapy falls within the scope of practice for speech-language pathologists in the United States and Australia, but not all SLPs are trained in it. The ones who treat tongue thrust have typically completed specialized postgraduate training in orofacial myofunctional therapy beyond their standard degree. When looking for a provider, ask specifically about their training and experience with myofunctional therapy and tongue thrust correction. Many dentists and orthodontists can refer you to an SLP they already work with.
Some orofacial myologists who are not SLPs also provide this therapy. They may come from dental hygiene or other health backgrounds with additional myofunctional certification. The key is finding someone with specific training in this area, not just a general speech therapist or dentist working outside their expertise.
What Adults Should Know
Tongue thrust correction is often discussed in the context of children, but adults develop and maintain this pattern too. The same therapy approach applies: myofunctional exercises to retrain the muscles, with orthodontic or dental work to address any structural consequences like misaligned teeth. Adults sometimes face a longer retraining period simply because the habit has been reinforced for more years, but the muscles respond to exercise at any age.
If you’re an adult who had braces as a teenager and watched your teeth gradually shift back, an uncorrected tongue thrust is a common reason. Correcting the thrust before or during a second round of orthodontic treatment is essential to prevent the same relapse. The tongue exerts a small but constant force on the teeth, and over months and years, that force wins.