Many orthodontic conditions can be caused by something called tongue thrusting. This problem is far more common than you would imagine since all babies are born pushing their tongue forward when they swallow. As a child grows, they need to learn the correct position for their tongue. If they learn too late, it impacts a child in many more ways than orthodontic development.
So, what exactly is it and why does it have such an impact on the way the mouth forms? Perhaps more importantly, how can you identify and change tongue thrusting before it becomes a problem?
What is tongue thrusting and how can you know if a child is doing it?
Quite simply, tongue thrusting is when the tongue is in the wrong position while at rest, while swallowing, or during speech, causing it to push against the teeth. Normally your tongue rests against the roof of your mouth, with the tip sitting just behind the front teeth. When swallowing, your tongue should be in a similar position, and simply exert more pressure against the roof of your mouth.
The most common tongue thrusting position is when the tongue pushes too far forward, either pressing against the back of the upper teeth or even sticking out a bit between the upper and lower teeth.
Signs of tongue thrusting past an appropriate age may include:
An open bite
A tongue that sticks out between the teeth when resting, swallowing, or speaking
Mouth breathing when the child does not have allergies or congestion
A speech impediment caused by the tongue pushing against or protruding between the front teeth while saying the sounds: d, l, n, s, sh, t, or z. A lisp on the s and z sounds is common.
Why is it a problem?
When the tongue pushes against teeth while resting, swallowing, or speaking it is putting pressure on them all the time. Since braces move teeth into proper alignment by using a small amount of consistent pressure against the teeth, it makes sense that this consistent pressure from the tongue can create problems with the way the mouth forms.
Orthodontic treatment moves the teeth and jaws into proper alignment, but an untreated tongue thrust can reverse successful orthodontic work. Tongue thrusting also causes many other problems, including:
Open bite between the top and bottom teeth
Prevent teeth from erupting
Crowded or crooked teeth
Lisp and other speech problems
Difficulty biting into foods, chewing and swallowing
Elongated facial shape
All infants start out tongue thrusting. When babies first begin eating baby food, their tongue pushes most of the food out of their mouth because of tongue thrusting. As they grow, the resting and swallowing tongue position is supposed to mature into a healthy position sometime before age 6.
There are many factors that may prevent this. Genetics, an enlarged tongue, a tongue-tie, certain types of bottle nipples, prolonged use of a bottle or pacifier, prolonged thumb or finger sucking, or allergies that cause chronically swollen tonsils or adenoids may all contribute to tongue thrusting.
When to seek treatment
If your child has an open bite, or you think that they have a tongue thrusting problem, you can schedule a consultation with us. We will evaluate your child to determine if tongue thrusting is the primary problem. In some instances, there can be another problem causing the tongue thrusting. In that case, the underlying problem would also need to be treated.
Depending on your child’s age, the severity of the symptoms and effects on their developing mouth, we may choose to wait and see if they begin to grow out of it. We may also recommend exercises that you can use at home or appliances to correct the tongue-thrusting habit. Treatment for underlying problems or other orthodontic issues may also be necessary.
If we are not seeing much progress with the exercises and/or appliances, we will refer you to a myofunctional therapist who has very specific training to help retrain muscles. If needed, we will create the right team for your child with an orthodontist, pediatric dentist, and myofunctional therapist to make sure they can function and develop properly.
Things you can try at home
You can begin teaching your child the proper way to hold their tongue while resting, swallowing or speaking. If a tongue-thrusting habit is the primary problem, you may be able to correct it with some consistent practice. If you catch it early while their mouth is still developing, it will be easier to correct and some of the damage may reverse itself.
You can also make practicing with young children into a fun game. Since tongue thrusting is an unconscious habit, regular practice is necessary to retrain the tongue and mouth. Practicing multiple times a day will help your child make the change quickly and having fun with it will help the whole process go much smoother.
1. Making the “L,” “D,” or “T” sounds are excellent practice. Since the lips are already slightly parted to make these sounds, it is easier to show your child where their tongue should go. The “L” sound is easy to hold for a while.
Start by making the sound with your child looking at your mouth.
Open your lips and teeth a bit wider while keeping your tongue in the proper position and making the sound.
Have them try it and explain where they need to adjust. For example, explain that just the tip of their tongue should touch the top of their mouth, and it should not be touching teeth.
You can make a game of it by making the correct sound together, taking turns, or seeing who can make the “L” sound longest.
2. Let your child pick a song and replace the words with singing the “lah” or “dah” sound. Focus on the correct tongue placement for the first few sounds, then let them have fun with it.
3. Once they can make the “L” sound with the correct tongue position, it will be a simple step to begin practicing swallowing with their tongue held in the correct position.
You can turn this into a game by sipping a few drops of water.
Hold the drops in your tongue with your lips open.
See if you can swallow without any water dripping out of your mouth.
Once your child masters that, see if they can do the exercise without any water falling off their tongue into the rest of their mouth.
Uncorrected tongue thrusting can have a major impact on the development of a child’s mouth but is it a problem that can definitely be corrected. If this sounds like something that may be impacting your child, please don’t hesitate to ask us about it. We are here to help you and your child address any underlying conditions and change this habit before it has a lasting impact.
Call us at (480) 759-1119
At Jungle Roots Children’s Dentistry & Orthodontics, we strive to provide the highest comprehensive pediatric and orthodontic dental care in a unique, fun-filled environment staffed by a team of caring, energetic professionals. We believe the establishment of a “dental home” at an early age is the key to a lifetime of positive visits to the dentist. Ahwatukee, Phoenix
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