Tongue thrust appears when the tongue presses forward too far in the mouth, resulting in an abnormal orthodontic condition called an “open bite.”
The condition is most common in children. It has a myriad of causes, including poor swallowing habits, allergies, and tongue-tie.
In babies who are breastfed or bottle-fed, tongue thrust is normal. As the child gets older, their swallowing and speaking pattern should evolve.
However, some types of bottle nipples — and prolonged use of a bottle — can lead to an abnormal tongue thrust that lasts past the infant stage and into early childhood.
There are several other potential causes for tongue thrust that begin in infancy. Some of these include:
- long-term sucking habits that influence the tongue’s movement, like sucking of the thumb, fingers, or tongue
- allergies accompanied by chronically swollen tonsils or adenoids
- tongue-tie, where the band of tissue beneath the tongue is tight or short
- a swallowing pattern known as reverse swallow
In children, a tongue thrust is apparent when there’s too much forward movement of the tongue during swallowing and speaking. Most often, the tongue tends to push forward in the mouth. Sometimes the tongue presses into the back of the teeth.
Tongue thrust has a number of telltale signs that manifest in children who have developed the pattern. These can include:
- Tongue is visible between the teeth. The tip of the tongue sticks out between the teeth, whether the child is resting, swallowing, or speaking.
- Mouth breathing.
- Inability to close the lips completely. This could be due to a structural abnormality or habit.
- Open bite. This occurs when the front teeth don’t meet when the teeth are closed.
- Slow, fast, or messy eating.
- Speech impediment. Lisping of s and z sounds is common.
You can carry tongue thrust forward into adulthood from untreated childhood habits or issues.
If you’re an adult with a tongue-thrusting issue, it could’ve developed because of chronic allergies or swelling of the adenoids and tonsils. Stress may also be the cause.
There are reports of tongue thrust developing later in life, but it’s not common.
The symptoms of tongue thrust in adults are similar to those in children. Some symptoms, like messy eating, aren’t likely to be as apparent.
You may thrust your tongue in your sleep. In addition to the symptoms listed above, an adult with tongue thrust might’ve developed an elongated facial structure or appearance because of the inability to close their mouths and swallow normally. They might also have a larger tongue than many adults.
Additionally, an open bite caused by tongue thrust can create trouble when eating. If the front teeth don’t meet properly, biting into certain foods can be uncomfortable. A person may also be unable to bite through some foods, like lettuce or lunch meat, with their front teeth. Instead, the food might slip through the gap in their teeth.
A number of different professionals can diagnose tongue thrust, including:
- general practitioners
- speech language pathologists
Your or your child’s doctor may observe the way you speak and swallow. Some practitioners may evaluate swallowing patterns by holding down the bottom lip to watch how you or your child swallows. Specifically, your doctor will want to see where the tongue is placed when swallowing.
It’s possible that other related medical professionals become involved in the full diagnosis of tongue thrust.
For example, your child’s pediatrician might make the initial diagnosis. But then, your child may need to be evaluated by a speech language pathologist, an orthodontist, an ear-nose-throat specialist, or a gastroenterologist. Any professionals who can lend their expertise to the cause or symptoms of your child’s tongue thrust will become part of their treatment team.
Left untreated, tongue thrust can cause malformed teeth. When the tongue pushes against the back of the teeth, the pressure can make your front teeth move outward. This creates a gap, or open bite, between your middle top and bottom teeth.
Untreated tongue thrust can lead to long-term damage to speech, like a lisp over certain sounds. It can also cause your facial shape to elongate and your tongue to protrude from between your teeth.
Treatment for tongue thrust tends to be similar between children and adults.
One exception is the placement of an orthodontic device known as a “tongue crib” in the roof of a child’s mouth. This corrects an open bite. In some cases, adults receive orthodontic treatment as well, but it’s not widely used.
Generally, orthodontic devices can offer a fairly quick fix, but it’s temporary. Instead, the recommended treatment is orofacial myology. This is an ongoing therapy that corrects the placement of the lips, jaw, and tongue. It addresses swallowing habits, too. Corrections made to open bites without ongoing therapy have been observed to reverse themselves over time.
Your doctor may recommend addressing any nasal, allergy, or breathing issues that may be involved in your or your child’s tongue thrusting. Breathing issues must be resolved for swallowing therapy to succeed.
In addition to swallowing therapy, you or your child might require speech therapy to correct any impediments that may have developed as a result of tongue thrusting. With dedication to weekly therapy recommendations, tongue thrust may be corrected over time.
If you or your child has an underlying condition that’s related to or has caused tongue thrust, you’ll also receive treatment for that specific condition.
Tongue thrust is a highly treatable condition. A full recovery can be made if you commit to attending the appropriate therapy sessions your doctor recommends.
You may also need to address other underlying health conditions that contribute to your tongue thrusting. Once those conditions are treated and you stick to your treatment plan, tongue thrusting should resolve over time.