Introduction to Tongue Thrust
- Tongue thrusting is described as a pathological event by dental and speech pathologist professionals.
- It is believed to cause anterior open bite, incompetent lip seal, and speech and swallowing issues.
- Interventional therapy can help resolve these effects.
- Most school-age children exhibit tongue thrusting.
- Tongue thrusting can be seen as abnormal if it persists beyond infancy.

Types and Causes of Tongue Thrust
- Anterior thrust: most common type, associated with low, forward tongue rest posture, protrusion of tongue beyond lips, and anterior open bite.
- Unilateral thrust: tongue pushes unilaterally to the side between back teeth, causing characteristic open bite on that side.
- Bilateral thrust: tongue pushes between back teeth on both sides, with partially open jaw and sometimes only molars touching.
- Large tongue can also be noted in bilateral thrust.
- Bilateral thrust is the most difficult to correct.
- Factors include macroglossia (enlarged tongue), thumb sucking, large tonsils, hereditary factors, ankyloglossia (tongue tie), and certain types of artificial nipples.
- Allergies or nasal congestion can also contribute to tongue thrusting by obstructing breathing.

Effects of Tongue Thrust
- Tongue thrusting can affect teeth alignment and contribute to malocclusion and open bites.
- Continuous pressure from tongue thrusting can force teeth out of alignment and reverse orthodontic work.
- Tongue thrusting can distort certain speech sounds produced by placing the tongue on the upper alveolar ridge.
- Chewing and swallowing with tongue thrusting is less effective than normal motion.
- Speech and orthodontic treatment may relapse if tongue thrusting is not addressed.

Treatment Options for Tongue Thrust
- Orthodontic spikes, prongs, or other tongue reminders can redirect tongue rest posture and swallow.
- Orofacial myofunctional therapists teach oral rest posture and proper chewing/swallowing mechanics without appliances.

Related Topics and References
- Orofacial myological disorders
- Developmental Surveillance and Screening: Algorithm for identifying infants and young children with developmental disorders.
- Treatment of Tongue Thrust Disorder: Speech therapy and orthodontia as treatment options.
- Appliance Use for Oral Habit Patterns: Appliances to correct tongue posture and encourage proper swallowing patterns.
- Tongue Thrust in Speech and Language Pathology: Role of speech and language pathologists in assessing and treating tongue thrust.
- Tongue Disorders and Additional References: Categorization of tongue thrust under tongue disorders and the need for additional references.

Tongue thrust (Wikipedia)

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Tongue thrust (also called reverse swallow or immature swallow) is a pseudo-pathological name of what is either considered a normal adaptive lip seal mechanism, whereby normal nasal breathing or normal swallowing can occur, or seen as an oral myofunctional disorder - a tongue muscle pattern that is perceived as clinically abnormal and in which the tongue protrudes anteriorly to seal otherwise incompetent lips.

Tongue thrusting is only seen during speech, swallowing or eating, and in order to close otherwise incompetent lips on background of an almost ubiquitous small lower jaw and anterior open bite. The behaviour is apparent only during a normal awake state, and whilst the tongue (and rest of the body) is in normal resting tone. By descriptive inference, tongue thrusting is impossible during deep sleep, or non-tone phases; or in particular during non-conscious states.

Nearly all infants exhibit a swallowing pattern involving forward tongue tip push as part of infant suckling behaviour. By six months of age most lose the forward extent of this push once paediatric incisal teeth erupt, and normal lip seal is automatically acquired as solid foods begin.

There are thus two community and clinical professional views of the observation of tongue thrusting behaviour that persists past the neonatal period.

1. Either it is a normal adaptive means of closing an open (or incompetent) lip state, caused by a unique combination of anatomical reasons, or

2. Tongue thrusting is the cause or potentiator of an open or incompetent lip state, and which resists efforts at behavioural change or clinical attempt at remedy.

In generality, tongue thrusting is poorly understood. In particular it lacks consensus on many points of description, causality, effect or management and between the various clinical groups that each offer different forms of treatments or philosophies of professional interest.