Tongue thrust is a term used for a retained infantile swallowing pattern. Simply defined, it is the habit of thrusting the tongue forward against or between the teeth while swallowing. According to Dr. T.M. Graber, we swallow a 1,200 to 2,000 times per day. This constant pressure of the tongue can force the teeth out of alignment. The orthodontist applies approximately 1.7 grams of pressure on front teeth to move them, the tongue can put up to 500 grams of pressure during the incorrect swallow!
Many factors may play a role in retaining the tongue thrust swallow. Any of the following may play a role:
Certain artificial nipples used in bottle feeding
Thumb sucking
Allergies, nasal congestion or obstructions contributing to mouth breathing
Large tonsils, adenoids, or many sore throats which cause difficulty in swallowing
An abnormally large tongue
Hereditary factors within the family
Neurological, muscular, or other physiological abnormalities
Short lingual frenum (tongue tied)
Tongues thrust has many variations with different resultant orthodontic problems.
Anterior open bite--the most common and typical type. The front lips do not close -the child often has his mouth open with the tongue protruding beyond the lips.
Anterior thrust--upper front teeth are extremely protruded and the lowers are pulled in by the lower lip. This type is generally accompanied by a strong mentalis (chin muscle)
Unilateral thrust--the bite is characteristically open on either side
Bilateral thrust--the anterior bite is closed , but the back teeth may be open on both sides. It is the most difficult to correct.
The force of the tongue against the teeth is often a causative or at least contributing factor in malocclusion or "bad bites." Many orthodontist have had the discouraging experience of completing dental treatment with what appeared to be good results, only to discover that the case had relapsed because the patient had a tongue thrust swallowing pattern. If the tongue is allowed to continue to push against the teeth, the pressure can contribute to bone loss and possibly exacerbate TMJ problems.
Speech is not frequently affected by the tongue thrust swallowing pattern. The "s" sound (lisping is the one most affected. The lateral lisp (air forced on the side of the tongue rather than forward) is also sometimes present in tongue thrust. However, one problem is not always associated with the other.
Sometimes, correcting the dental structure and widening the roof of the mouth will result in the tongue thrust resolving on its own. Orofacial Myology has not always been offered in many areas, so many times dental professionals are unaware there is a therapy for remediation of the tongue thrust.
With sincere commitment and cooperation of the child and parent, an open airway, and no neuromuscular involvement, correction is possible in most cases. At the present time, successful correction appears to be:
70% of treated cases successful
25% unsuccessful due to poor compliance and lack of commitment of the parent, patient or both
5% unsuccessful due to factors that make correction impossible
We are currently creating content for this section.Pictures to be added.In order to keep up with our high standard of service, we need a little more time. Please check back again soon. Thank you for your interest!
