WHAT IS TONGUE THRUST?
Tongue thrust, simply defined, is the process of thrusting the tongue forward and/or sideways against the teeth or in between the teeth while swallowing. The number of swallows during the day may not be important for it is believed that the resting posture of the tongue plays much more of a role in dental damage than the swallow itself. The constant pressure of the tongue at rest against or between the teeth, along with the hammering of the tongue during swallowing, can force the teeth out of alignment. Thus, a malocclusion (bad bite) is created.
WHAT CAUSES TONGUE THRUST?
No specific cause has actually been determined for the tongue thrust/ posture problem. Bottle feeding was believed to be the source of the problem. However, recent studies have proven that there is little correlation between bottle and tongue thrusting. Many authorities now believe that upper respiratory disorders, or any obstruction to the airway, may be related to the tongue thrust pattern. Possible causes are:
- Allergies, nasal congestion, nasal obstructions or enlarged adenoids which may contribute to mouth breathing
- Large tonsils or frequent throat infections which cause abnormal >swallowing and tongue /lip posturing
- Abnormally large tongue
- Short lingual frenum
- Thumb sucking or tongue sucking
- Steep mandibular plane (angle of The lower jaw)
- Neurological, muscular, or other physiological abnormalities
- Hereditary factors and growth pattern of the face
HOW IS SPEECH AFFECTED BY TONGUE THRUST?
Articulation of certain sounds may be affected by the low forward postural position of the tongue. The "s/z" sounds are most commonly effected, however not the only sounds effected. The “sh”, “ch”, “r” are a few of the other sounds that may be effected. A percentage of individuals with a tongue thrust may demonstrate a frontal lisp or a lateral lisp (air forced sideways rather than forward through the teeth). Generally, when there is a strong tongue thrust in addition to a speech problem, it is difficult to correct the speech unless the tongue thrust is also corrected.
WHAT ARE THE CONSEQUENCES OF A TONGUE THRUST?
- Slowing and possible relapse of orthodontic treatment
- Periodontal problem
- Difficulty in wearing dentures and dental appliances
- Temporal mandibular joint problems
- Unpleasant chewing and eating appearance
- Soreness of the tongue and teeth
- Speech problems
WHO DIAGNOSES TONGUE THRUST?
As a rule, orthodontists, general dentists, pedodontists, pediatricians, and speech therapists detect the problem.
ARE THERE CASES THAT CANNOT BE CORRECTED?
Tongue thrust is an area that needs more investigation and research. Presently known deterrents to correction are:
- Neuromuscular involvement
- Airway difficulties
- Short lingual frenum
- Large tongue
- Steep jaw angle
- Lack of interest
- Too many activities
- Poor growth patterns
WHAT CAN PARENTS DO TO HELP A CHILD OVERCOME TONGUE THRUST?
Cooperation, understanding, and patience on the part of the parents are essential in the correction of a tongue thrust. The role of the parents is to spend a certain amount time assisting thus helping the child to become more aware or the purpose of the exercise and treatment. Parents must also realize that well established muscle pattens are very difficult to change and that it takes time to make a good correction. Above all, it is important that parents use a positive approach when assisting their child overcoming a thrusting habit.
Some of these definitions were adopted from William E. and Julie Zickefoose