Tongue thrust
Encyclopedia
Tongue thrust is the common name of orofacial muscular imbalance, a human behavioral pattern in which the tongue
protrudes through the anterior incisors during swallowing
, speech
, and while the tongue is at rest. Nearly all young children exhibit a swallowing pattern involving tongue protrusion, but by the age of six most have switched to a normal swallowing pattern. People who tongue thrust do it naturally and are usually unaware of the behavior.
Since 1958, the term "tongue thrust" has been described and discussed in speech and dental publications by many writers. Many school-age children have tongue thrust. For example, according to recent literature, as many as 67–95 percent of children 5–8 years old exhibit tongue thrust, which may be associated with or contributing to an orthodontic
or speech problem. Up to the age of four, there is a possibility that the child will outgrow tongue thrust. However, if the tongue thrust swallowing pattern is retained beyond that age, it may be strengthened.
(enlarged tongue), thumb sucking
, large tonsils, hereditary factors, ankyloglossia
(tongue tie), and certain types of artificial nipples used in feeding infants. In addition, allergies or nasal congestion
can cause the tongue to lie low in the mouth because of breathing obstruction, contributing to tongue thrusting.
). Many orthodontists have completed dental treatment with what appeared to be good results, only to discover that the case relapsed because of the patient's tongue thrust. If the tongue is allowed to continue its pushing action against the teeth, it will continue to push the teeth forward and reverse the orthodontic work.
Speech is not frequently affected by the tongue thrust swallowing pattern. The "S" sound (lisp
ing) is the one most affected. The lateral lisp (air forced on the side of the tongue rather than forward) shows dramatic improvement when the tongue thrust is corrected. However, lisping and tongue thrust are not always associated.
Tongue
The tongue is a muscular hydrostat on the floors of the mouths of most vertebrates which manipulates food for mastication. It is the primary organ of taste , as much of the upper surface of the tongue is covered in papillae and taste buds. It is sensitive and kept moist by saliva, and is richly...
protrudes through the anterior incisors during swallowing
Swallowing
Swallowing, known scientifically as deglutition, is the process in the human or animal body that makes something pass from the mouth, to the pharynx, and into the esophagus, while shutting the epiglottis. If this fails and the object goes through the trachea, then choking or pulmonary aspiration...
, speech
Manner of articulation
In linguistics, manner of articulation describes how the tongue, lips, jaw, and other speech organs are involved in making a sound. Often the concept is only used for the production of consonants, even though the movement of the articulars will also greatly alter the resonant properties of the...
, and while the tongue is at rest. Nearly all young children exhibit a swallowing pattern involving tongue protrusion, but by the age of six most have switched to a normal swallowing pattern. People who tongue thrust do it naturally and are usually unaware of the behavior.
Since 1958, the term "tongue thrust" has been described and discussed in speech and dental publications by many writers. Many school-age children have tongue thrust. For example, according to recent literature, as many as 67–95 percent of children 5–8 years old exhibit tongue thrust, which may be associated with or contributing to an orthodontic
Orthodontics
Orthodontics, orthodontia, or orthodonture is the first specialty of dentistry that is concerned with the study and treatment of malocclusions , which may be a result of tooth irregularity, disproportionate jaw relationships, or both...
or speech problem. Up to the age of four, there is a possibility that the child will outgrow tongue thrust. However, if the tongue thrust swallowing pattern is retained beyond that age, it may be strengthened.
| Name | Definition |
|---|---|
| Anterior open bite | The most common type of tongue thrust. In this case, the front lips do not close and the child often has his mouth open with the tongue protruding beyond the lips. |
| Anterior thrust | Upper incisors are extremely protruded and the lower incisors are pulled in by the lower lip. This type of thrust is most generally accompanied by a strong mentalis Mentalis The Mentalis is a paired central muscle of the lower lip, situated at the tip of the chin. It raises and pushes up the lower lip, causing wrinkling of the chin, as in doubt or displeasure... . |
| Unilateral thrust | The bite is characteristically open on either side. |
| Bilateral thrust | The anterior bite is closed, but the posterior teeth from the first bicuspid to the back molars may be open on both sides. This is the most difficult thrust to correct. |
| Bilateral anterior open bite | The only teeth that touch are the molars, with the bite completely open on both sides including the anterior teeth. A large tongue is also noted. |
| Closed bite thrust | Typically shows a double protrusion meaning that both the upper and lower teeth are flared out and spread apart. |
Causes
Factors that can contribute to tongue thrusting include macroglossiaMacroglossia
Macroglossia is the medical term for unusual enlargement of the tongue. Severe enlargement of the tongue can cause cosmetic and functional difficulties including in speaking, eating, swallowing and sleeping.- Amyloid Disorders :...
(enlarged tongue), thumb sucking
Thumb sucking
Thumb sucking is a behavior found in humans, chimpanzees, captive Ring-tailed Lemurs, and other primates. It usually involves placing the thumb into the mouth and rhythmically repeating sucking contact for a prolonged duration...
, large tonsils, hereditary factors, ankyloglossia
Ankyloglossia
Ankyloglossia, commonly known as tongue tied, is a congenital oral anomaly which may decrease mobility of the tongue tip and is caused by an unusually short, thick lingual frenulum, a membrane connecting the underside of the tongue to the floor of the mouth...
(tongue tie), and certain types of artificial nipples used in feeding infants. In addition, allergies or nasal congestion
Nasal congestion
Nasal congestion is the blockage of the nasal passages usually due to membranes lining the nose becoming swollen from inflamed blood vessels. It is also known as nasal blockage, nasal obstruction, blocked nose, stuffy nose, or stuffed up nose.Nasal congestion has many causes and can range from a...
can cause the tongue to lie low in the mouth because of breathing obstruction, contributing to tongue thrusting.
Effects
Tongue thrusting can adversely affect the teeth and mouth. A person swallows from 1,200 to 2,000 times every 24 hours with about four pounds (1.8 kg) of pressure each time. If a person suffers from tongue thrusting, this continuous pressure tends to force the teeth out of alignment. Many people who tongue thrust have open bites; the force of the tongue against the teeth is an important factor in contributing to "bad bite" (malocclusionMalocclusion
A malocclusion is a misalignment of teeth or incorrect relation between the teeth of the two dental arches. The term was coined by Edward Angle, the "father of modern orthodontics", as a derivative of occlusion, which refers to the manner in which opposing teeth meet.-Presentation:Most people have...
). Many orthodontists have completed dental treatment with what appeared to be good results, only to discover that the case relapsed because of the patient's tongue thrust. If the tongue is allowed to continue its pushing action against the teeth, it will continue to push the teeth forward and reverse the orthodontic work.
Speech is not frequently affected by the tongue thrust swallowing pattern. The "S" sound (lisp
Lisp
A lisp is a speech impediment, historically also known as sigmatism. Stereotypically, people with a lisp are unable to pronounce sibilants , and replace them with interdentals , though there are actually several kinds of lisp...
ing) is the one most affected. The lateral lisp (air forced on the side of the tongue rather than forward) shows dramatic improvement when the tongue thrust is corrected. However, lisping and tongue thrust are not always associated.