When the tongue is positioned incorrectly, the constant, gentle pressure it exerts can alter the alignment of the teeth and jaw structure. This common condition, often called a tongue thrust or reverse swallow, involves the tongue pushing forward against the front teeth or sideways against the back teeth during rest or swallowing. Because this pressure occurs hundreds or thousands of times a day, it leads to dental misalignment and spacing issues that may undermine previous orthodontic work. Understanding this habit, its causes, and the steps required for correction is key to achieving a stable oral posture.
Defining Tongue Thrusting and Its Effect on Teeth
Tongue thrusting is classified as an orofacial myofunctional disorder (OMD), a pattern of muscle movement that interferes with normal function. Instead of resting against the roof of the mouth, the tongue pushes forward against the back of the teeth when a person swallows, speaks, or rests. The sustained, incorrect resting position of the tongue is the primary force that causes dental changes.
This continuous forward pressure results in several dental consequences. The most common is an anterior open bite, where the upper and lower front teeth do not meet when the jaw is closed, creating a noticeable gap. Tongue thrusting also contributes to dental spacing, often causing gaps between the upper front teeth. For individuals who have undergone orthodontic treatment, the uncorrected habit can lead to a relapse, where the teeth drift back into misaligned positions.
Identifying the Root Causes of Incorrect Tongue Posture
Incorrect tongue posture is often a compensation for underlying physical or anatomical issues. Prolonged oral habits developed in childhood are frequent contributors, such as extended use of a pacifier, baby bottle, or thumb-sucking past the toddler years. These habits condition the tongue to remain in a low and forward position, disrupting the natural pattern of oral muscle development.
Chronic nasal airway obstruction also plays a substantial role, forcing individuals to breathe through their mouths. Conditions like chronic allergies or enlarged tonsils and adenoids make it difficult to breathe nasally, causing the jaw to drop and the tongue to lie low to open the airway. When the tongue rests low, it fails to provide necessary internal pressure against the palate. This lack of pressure can lead to a narrow upper jaw and a greater likelihood of the tongue pushing forward. Genetic factors influencing oral and facial structures can also predispose an individual to this issue.
Professional Assessment and Treatment Options
Addressing this muscular imbalance requires a coordinated approach involving specific healthcare professionals. A general dentist or an orthodontist is usually the first to diagnose the issue, noticing the characteristic dental misalignment or open bite. They assess the extent of the dental damage and determine if orthodontic correction is necessary to address spacing or bite problems.
The specialized treatment for the habit is primarily managed by an Orofacial Myofunctional Therapist (OMT), who is trained to retrain the muscles of the mouth and face. Myofunctional therapy focuses on neuromuscular re-education, teaching the patient proper resting posture, correct swallowing patterns, and nasal breathing techniques. This therapy is effective because it treats the root cause of the pressure, rather than just the dental symptom.
In some cases, the orthodontist may utilize specialized dental appliances as an aid. Devices such as a fixed palatal crib or a tongue spur are cemented behind the front teeth to physically block the tongue from thrusting forward. These appliances serve as a constant reminder to help break the physical habit. They work in tandem with OMT exercises to ensure a stable, long-term correction. Successful treatment requires the therapist and the dental professional to work together to ensure stable tooth alignment.
Daily Exercises for Correcting Tongue Position
The goal of daily exercises is to reprogram the muscle memory of the tongue to adopt the correct resting spot. This spot, known as the “N” spot or the rugae, is the slight ridge of tissue located on the roof of the mouth just behind the upper front teeth. The correct resting posture involves sealing the entire tongue flat against the palate with the lips closed and the teeth lightly touching.
One foundational exercise is the Tongue Suction Hold, which aims to build muscle strength and endurance. To perform this, the patient places the tip of the tongue on the “N” spot and suctions the entire body of the tongue up to the roof of the mouth, creating a slight vacuum seal. The tongue should be held in this position for several seconds, or until the hold breaks, and repeated multiple times throughout the day.
Another common technique is the Suction Swallowing Exercise, which retrains the muscles to swallow correctly. A small sip of water is held in the mouth, and the patient focuses on swallowing by pressing the tongue up against the palate, rather than pushing forward against the teeth. Consistency is required to establish this new muscle memory and replace the old, ingrained habit. These routines are most effective when they are part of a structured program guided by a myofunctional therapist to ensure proper technique.