A Tongue Thrust occurs when the tongue is seen pushing either forwards or sideways against the teeth, or pushing between the front or side (back) teeth while at rest or during swallow.
The tongue is the most powerful muscle in the body, and its outward pushing force can exert a lot of pressure against the teeth and move them out of alignment. This can cause the teeth to become crooked or mal-aligned resulting in a "bad-bite" or malocclusion.
There are many types of tongue thrust, all of which result in bite problems:
The most common types are listed below:
Anterior Tongue Thrust:
This is a very common type of tongue thrust. The tongue pushes forward between, and sometimes beyond the front teeth. The mouth is generally open, the person finds it difficult to seal the lips, and very often they become habitual mouth breathers due to the low posture of the tongue.
Unilateral Tongue Thrust:
The tongue tends to thrust out on one side only ("Uni"), thus preventing the teeth from meeting or occluding correctly on that side.
Bi-lateral Tongue Thrust:
The tongue thrusts out on both sides (Bi) and the posterior teeth are open as far back as the molars. The anterior bite is closed.
What Causes A Tongue Thrust?
We don't really know! We are all born with an "infantile swallow", where the tongue thrusts forward during normal breast-feeding. However as food is introduced into the diet, the "infantile swallow" should develop into an "adult swallow" by about the age of 2 years. This means that during every swallow, the tongue should collect saliva, liquid or solid in a "cup shape", lift itself to the roof of the mouth bearing its collected goods, form an appropriate saliva, liquid, or food seal, and then, in a backward muscular wave motion, the tongue should push the goods back towards the throat.
Possible reasons for incorrect tongue function are:
- Thumb, digit and tongue sucking
- Tongue tie
- Abnormally large tongue
- Poor lip seal due to mouth breathing
- Allergies and nasal congestion, and or Nasal obstruction such as enlarged Adenoids, or polyps
- Enlarged Tonsils, and frequent throat infections which cause aberrant swallowing
- Neurological, Physiological, and Muscular Disorders
- Genetic factors
What Problems Will A Tongue Thrust Create?
We generally use our tongue to speak, and to swallow food. While at rest, the tongue should occupy the roof of the mouth at all times. If the tongue is not working efficiently many problems can present including:
- Speech Problems, such as a lisp
- The teeth become Crooked, Crowded or will not meet correctly
- The teeth cannot bite or chew properly
- Orthodontic treatment can be slowed down
- Orthodontic treatment can relapse
- Temporomandibular Joint problems
- Periodontal problems and chronically dry lips, due to mouth-breathing habit
- Bad table manners
Treatment for Tongue Thrust
- This involves training the patient to alter their swallowing pattern.
- It is a specialised remedial program designed to modify and correct the Tongue Thrust through a series of specific exercises.
- Myofunctional training appliances (similar to a mouthguard) are very useful in Re-training the tongue. They are worn throught the night and for at least 1 hour during the day