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| From spacing |
Tongue thrust (also called reverse swallow or immature swallow) 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.
No one specific cause has actually been determined for the tongue thrust problem.
Any of the following may cause tongue thrust:
1)Certain types of artificial nipples used in feeding infants
2)Thumbsucking
3)Allergies, nasal congestion or obstructions contributing to mouth breathing causing the posture of the tongue to be very low in the mouth
4)Large tonsils, adenoids, or many sore throats which cause difficulty in swallowing
5)An abnormally large tongue
6)Hereditary factors within the family, such as the angle of the jaw line
7)Neurological, muscular, or other physiological abnormalities
8)Short lingual frenum (tongue tied).
There are several different types of tongue thrust and resultant orthodontic problems:
1)Anterior open bite - the most common and typical 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. In general, it has been noted that a large tongue usually accompanies this type of tongue thrust.
2)Anterior thrust - upper incisors are extremely protruded and the lower incisors are pulled in by the lower lip. This particular type of thrust is most generally accompanied by a strong mentalis (muscle of the chin).
3)Unilateral thrust - the bite is characteristically open on either side.
4)Bilateral thrust - the anterior bite is closed; however 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.
5)Bilateral anterior open bite - the only teeth that touch are the molars with the bite completely open on both sides including the anterior teeth. Once again a large tongue is also noted.
6)Closed bite thrust - typically shows a double protrusion meaning that both the upper and lower teeth are flared out and spread apart.
"Tongue thrust" has been noted that a significant number of school-age children have tongue thrust. For example as many as 67 to 95 percent of the children 5 to 8 years old exhibit tongue thrust which may be associated with or contributing to an orthodontic or speech problem.
What are the consequences?
The force of the tongue against the teeth is an important factor in contributing to malformation ("bad bites"). Many orthodontists have had the discouraging experience of completing dental treatment, with what appeared to be good results, only to discover that the case had relapsed because the patient had a tongue thrust swallowing pattern. 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.
Is speech affected by tongue thrusting?
Speech is not frequently affected by the tongue thrust swallowing pattern. The "S" sound (lisping) 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 also corrected. However, one problem is not always associated with the other.
At what age does a child usually exhibit a tongue thrust swallowing pattern?
A child exhibits a tongue thrust pattern from birth. Up to the age of four, there is a possibility that the child will outgrow the tongue thrust pattern and develop the mature pattern of swallowing. However, statistics have shown that if the tongue thrust swallowing pattern is retained, it may be strengthened beyond the age of four. In all probability, the child will need some type of training program to develop the mature swallowing pattern.
Treatment for the tongue thrust swallowing pattern may be handled in two ways:
1)An appliance that is placed in the mouth by the dentist (mechanical method).
2)Correction by oral habit training - an exercise technique that re-educates the muscles associated with swallowing by changing the swallowing pattern. This method must be taught by a trained therapist. Therapy has proven to give the highest percentage of favorable results, however the appliance is still used and is successful in some cases