Sometimes, people can’t help but get in their own way when trying to reach a goal, and getting straight teeth is no different. Orthodontists have to balance providing orthodontic treatment with braces or Invisalign with people’s habits that can get in the way of making progress. One habit many people don’t realize they have is called tongue thrusting, which can get in the way of the teeth straightening process.

What Is Tongue Thrust?

Essentially, a tongue thrust is a bad form of swallowing people do without realizing it. Normally, people should swallow with their tongues firmly planted up against the palate. When someone has a tongue thrusting habit, they have learned to swallow the wrong way. Normally, kids start out with a bit of a tongue thrust but develop into the proper form of swallowing around age six or seven.

Tongue thrusting generally comes in two forms. One type involves pushing the tongue in between the front teeth while swallowing, which is called a reverse swallow. Another form is mouth breathing, which is the practice of leaving the mouth open during breathing. When swallowing, a mouth breather will typically spread the tongue between the upper and lower teeth instead of tipping the tongue upward toward the palate.

Signs of a Tongue Thrust

In younger patients, tongue thrusts can occur due to the type of pacifier or bottle nipples used, or in tandem with a prevalent thumb-sucking habit. A tongue thrust can also occur as a result of nasal or breathing allergies.

Tongue thrusts are typically diagnosed in younger patients by their pediatrician or a speech pathologist and may be referred to an orthodontist. The issue can often be diagnosed just by observing a child’s speaking and swallowing patterns. Another symptom that is easy to observe in both children and adults is open-mouth breathing or an open-mouth posture that creates an unfavorable profile.

Baby Tongue Thrust

As babies are breast or bottle-fed, tongue thrust is very normal. However, as children start to grow and develop, their tongue thrusting habit should naturally fall away. If not, that’s when intervention is necessary. There are several factors in developing a tongue thrust into childhood. 

One of these factors includes long-term sucking habits that impede the tongue’s movement such as thumb sucking, pacifier use, or tongue sucking. Children that have chronically swollen tonsils or adenoids as a result of allergies or frequent illness are also at risk of developing a tongue thrust. Children who experience tongue-tie—where the band of tissue beneath the tongue is tight or short—also can develop tongue thrust. 

In children, tongue thrust has a number of telltale signs that can be easy to observe. This includes when the tongue is visible between the teeth or when the tip of the tongue sticks out between the teeth leading to the inability to close lips completely. Children who are abnormally slow, fast, or messy eaters could also be suffering from the displacement of the tongue. A speech impediment such as a lisp is also a common sign.

Treating a tongue thrust in children early on is recommended to avoid later orthodontic issues later in life. 

Why Is Tongue Thrust a Concern?

In kids, tongue thrusting is often a major factor in facial development. Reverse swallowing results in malocclusions where the front teeth are misaligned, often protruding forward with the direction of the tongue thrust. People with this habit also often develop TMD or jaw pain and can end up with misshapen jaws and spatial problems with their teeth. Due to the tongue resting away from the palate most of the time, the upper jaw develops into a sharper V-shape, resulting in crowding and a long, narrow face.

Early intervention can help fix these issues and make future orthodontic treatment with braces and Invisalign easier, but tongue thrusting will remain a concern during the treatment process if it is not addressed.

Tongue Thrust Therapy

Depending on the severity of the habit, tongue thrusts can be corrected with an appliance such as a tongue crib, orthodontic treatment, or orofacial myology—a kind of physical therapy for the mouth, face, and jaw. Often, treatment plans to correct a tongue thrust may involve a combination of these treatments. Although treatments are pretty similar for both adults and children, the usage of tongue cribs is mostly reserved for younger children.

Tongue thrust therapy helps to correct the placement of the lips, jaw, and tongue while also addressing swallowing habits. It’s been shown that any form of corrective orthodontic treatment without ongoing orofacial myology can lead to a relapse of the bad habit. 

Tongue Thrust Appliances

 A tongue thrust appliance fits behind the teeth against the roof of the mouth and blocks the tongue from thrusting forward against or between the teeth. There are two types of appliances, removable and fixed, which the orthodontist may direct a patient to wear between several months to a year, typically at night.

 A removable tongue thrust appliance is similar to a retainer that a patient can wear over their teeth. It can be worn for a certain length of time each day and removed to eat and brush teeth. A removable appliance is best if the habit is not too severe and for a patient who will wear it as instructed. 

A fixed tongue thrust appliance is attached via metal bands that fit around the back molars. The appliance remains in the mouth at all times until it is removed by a dentist or orthodontist. A fixed appliance is better for severe tongue thrusting habits because it provides a constant reminder and barrier for the tongue. This appliance is typically given to younger tongue thrusters or those who may not otherwise be able to put in a removable appliance.  An example of this type of appliance is a tongue crib, a metal bracket behind the front teeth that keeps the tongue from coming forward.

How Tongue Thrust Affects Your Braces or Invisalign

Not only can this habit increase your need for braces or Invisalign, it can also slow down the progress of your orthodontic treatment. In the same way pressure from your braces or aligners moves your teeth, the pressure from your tongue can move your teeth in the wrong direction. Because of this, tongue thrusting can effectively work against the force of the braces or aligners, slowing down the correction process. It can also lead to the teeth shifting back to their original positions after treatment is over.

Your orthodontist will be able to work with you or your child to decide which treatment approach is best. Tongue thrusting can occur in patterns that are particular to the individual patient so it’s important to have a professional guide you through specialized treatment.

Learn more about orthodontic treatment and find the best options for you by scheduling your free consultation at Milnor Orthodontics today!