What is a Tongue thrust?
Tongue thrusting is the habit of placing the tongue in the wrong position during swallowing, either too far forward or to the sides. In this way during swallowing the tongue either pushes against the lower teeth, or protrudes between the teeth when swallowing.
This constant pressure of the incorrect tongue posture will force the teeth and arches out of alignment. If this pattern continues beyond infancy, effects may be observed in facial growth and appearance, health and communication (speech).
Tongue thrust is not simply a childhood issue. Many adults also present with a forward tongue resting posture or swallowing pattern that is not ideal, without even realising. Some common signs of these issues in adults include headaches, snoring, sleep apnoea, clicky jaws (TMJ disorder), tooth and gum disease and relapse of orthodontic treatment.
How does a tongue thrusting habit development?
A tongue thrust swallowing pattern which is also termed infantile swallowing pattern is observed in infants who are breast or bottle fed.
When a infant gets their baby molars and transition to solid foods they begin to adopt the habit of placing the tongue tip against the roof the mouth behind the top front teeth when swallowing. Food is then propelled backwards with a wave-like movement of the tongue, rather than forwards (which is the result when a tongue thrust swallow is present).
What causes the continuation of a tongue thrust swallow?
- Thumb or finger sucking
- Sucking clothing or hair
- Mouth breathing, which can cause the tongue’s posture to be very low in the mouth
- Mouthing objects (for adults this may be chewing pens)
- Nail biting or chewing lips and cheeks
- Large tonsils or adenoids
- Allergies and nasal congestion which can cause mouth breathing
- Tongue tie
- Early loss of teeth
- Sensory processing difficulties
- An exceptionally large tongue
- Some artificial nipples used for feeding infants
What are the consequences of a tongue thrust?
It is estimated that in 24 hours, you swallow a total of 1,2000 to 2,000 times with about four pounds of pressure per swallow.
With the correct swallowing pattern the tongue pushes against the roof the mouth. This stimulates the growth and expansion of the bone in the roof of the mouth. The bone cells in those sutures are different to those in other parts of our body. They do not grow in accordance with a genetically predetermined outcome. They only grow when stimulated. The tongue thrust is acceptable until the age of 4 but if it continues by age 6 the sutures of the hard palate (roof of the mouth) have knitted together and will often lead to a narrow and highly vaulted palate.
When the palate does not expand, there may be a structural barrier to the accurate production of speech sounds. Given that the roof of the mouth is also the base of the nasal cavity, the airway may also be affect. Any barrier to comfortable nose breathing will perpetuate the habit of mouth breathing.
Mouth breathing in children have many health complications associated with it. The turbinates in our nasal cavity act as air filters. When we inhale air through the mouth it enters the lungs cold and unfiltered. This leads to more frequent upper respiratory illnesses. Over time, this may lead to sensitive teeth, swollen gums and an increased likelihood of tooth decay and infections.
Mouth breathing also means that carbon dioxide and oxygen levels in the lungs are not balanced (as when hyperventilating). This impacts the parasympathetic nervous system and the release of diuretic hormones. Children who mouth-breathe are prone to bed-wetting.
How is a tongue thrusting habit treated?
A team approach is used to treat the habit after looking at possible causes to the problem. A referral to an ear nose and throat surgeon, myofunctional therapist, dentist and orthodontist can help to retrain and break the habit. A sincere commitment and cooperation of the child and parent will correct the problem in most cases.
For more information and to arrange a consultation with Dr Linda call (02) 9418 2502 or book online