Tongue thrust is an orofacial myofunctional disorder (OMD) that causes the tongue to rest in an imperfect position while sleeping, swallowing or speaking. Throughout infancy, babies naturally push their tongues forward when they're fed, but this type of tongue movement should disappear as your child grows.
Once your child is older, any exaggerated forward motion of his or her tongue may indicate a need for tongue thrust treatment.
What Causes Tongue Thrust?
The International Association of Orofacial Myology (IAOM) cites a number of factors that can cause a child's tongue to thrust forward. Oral habits like thumb-sucking, nail-biting and teeth-grinding can play a role, as can a developmental abnormality or constricted airway due to allergies or enlarged tonsils. Heredity may predispose a child to these risk factors, too, especially when determining the size and shape of the jaw, arrangement and number of teeth and the strength of the lip, tongue and facial muscles, according to the American Speech Language Hearing Association. In addition, Cincinnati Children's Hospital suggests prolonged pacifier or bottle use can also affect a child's tongue behavior.
Why Treat Tongue Thrust?
The tongue is one of the strongest and most flexible muscles in the body, responsible for your child's ability to speak, swallow and eat. When not positioned properly, however, the force it exerts can interfere with facial development, skeletal growth and tooth alignment. Children with a tongue thrust habit often have an anterior-open bite – wherein the front teeth don't come together – and an elongated face due to their jaw drooping as they come to breathe only through their mouth. This habit often results in a need for orthodontia (a very common investment), but tongue thrust can slow down this treatment or move the teeth out of position once the braces are removed.
Because some children demonstrate speech problems down the line, it's not unusual for them to feel self-conscious. Looking, speaking and eating differently than other children their age is tough to understand, so it's up to you to help them weather these challenges.
What Do I Do?
Children usually transition from tongue thrusting to normal swallows by age 7 or 8, according to RDH Magazine's Connie Sidder, RDH, who recommends early intervention to reduce the amount of orthodontic treatment needed and ensure its long-term success.
Still, the American Academy of Pediatric Dentistry (AAPD) says treating a tongue thrust should ultimately serve to remedy the child's incorrect swallowing pattern. This is done through orofacial myofunctional therapy, which involves exercises aimed at retraining the muscles used when swallowing. Keep in mind myofunctional therapy should be done by a certified orofacial mycologist who has received special training in this area. Correcting the tongue placement through myofunctional therapy can be started as early as age 4, and is 80 to 90 percent effective, according to IAOM.
Orthodontic-style appliances are frequently used to help a child break the habit of tongue thrusting. But according to the AAPD, appliances should only be used when the child wants to kick the habit. For some kids, these appliances are uncomfortable and are only a temporary fix.
Oral Hygiene Despite a Tongue Thrust
Children with tongue-thrusting habits may be more susceptible to tooth decay because their oral cavities become very dry from breathing mainly through their mouth. Without the cleansing effect of saliva, decay-causing bacteria readily accumulate on the teeth. And if your child is wearing a habit-breaking appliance, brushing and flossing thoroughly can be challenging.
For this reason, encourage your child to brush twice a day with anticavity fluoride toothpaste like Colgate TotalSF Clean Mint. To help with flossing, ask your dentist or dental hygienist about flossing techniques and similar aids that can make the job easier when the tongue gets in the way. Above all, schedule regular dental visits so your dentist can check your child's teeth for cavities while monitoring the progress of any tongue thrusting treatment you may already be facilitating.
Tongue thrust can be a true hardship in the way of your child's facial and oral development, but when it affects his or her speech, general health or self-esteem, it's time to get involved. If you notice any unusual positioning in your child's tongue – during swallowing or rest – tongue thrust treatment may be one of the best long-term investments you can make.