What Is a Tongue Thrust Habit?

When we are born, we all swallow with an in and out movement of the tongue.  As we grow, most of us transition to a swallowing pattern where the tongue presses against the roof of the mouth.  Some people don’t make the change and their tongue continues to push forward against or between the teeth when swallowing.  The tongue may also lie between the teeth while it is at rest.

How does a tongue thrust affect your teeth?

It doesn’t take a lot of force to move the teeth.  If there is constant pressure from the tongue pushing against your teeth it will cause your teeth to move and become crooked or spaced.  An open bite may also develop which means the teeth will not overlap normally. 

Open bite due to tongue thrust habit

-This can make chewing and swallowing more difficult

-It may be hard to chew with your lips closed

-It may cause an open-lip resting posture where it is hard for you to keep your lips closed even at rest

-An open-lip resting posture may cause gum disease

-An open-lip resting posture may also cause narrowing of the roof of your mouth and affect growth and dental development

-If you wear braces, it will take longer to straighten your teeth

-If you wore braces and your teeth were straightened, your teeth may not stay straight due to the imbalance of the muscles of the tongue, lips and cheeks.

Does everyone with a tongue thrust swallow the same?

No. Not all tongue thrusts are alike.  There are several types of tongue thrusts. Some push forward against and even sometimes through the teeth. Some push against the side teeth, some push against the top teeth and some push against the bottom teeth.

I don’t have a speech problem. Why has my orthodontist recommended I see a Speech-Language Pathologist?

Like any habit, a tongue thrust swallowing pattern is difficult to change.  A speech-language pathologist who offers myo-functional therapy can help you learn the new patterns of tongue movement you need to keep your tongue in the proper place.  Myo-functional therapy exercises given to you by a speech pathologist will help you make the necessary corrections so that it will become second nature for your tongue to rest in the proper place and for you to swallow correctly day and night.

How difficult and demanding is the therapy?

It is important that you want to make the changes and are mature enough to cooperate and stick with it. Therapy requires regular, short pieces of practice involving moving your tongue in specific ways and making sounds differently.  If you are willing to do this, you can change your patterns. The speech- language pathologist will make sure you understand the exercises and how to do them, tailoring them to suit your particular needs. Your job is to practice.

But doesn't the orthodontist straighten teeth?

Yes, your orthodontist can align your teeth and give you a beautiful smile, but if your tongue patterns in swallowing and speech are still pushing on your teeth, your tongue will push your teeth out of alignment again. This is why your orthodontist will refer you to a speech-language pathologist, so that you will have greater success in re-aligning your teeth and avoiding relapse.

Help With Speech For Orthodontic Patients

For some patients, orthodontic appliances like retainers or lingual (behind the teeth) wires and brackets can cause some changes to their speech.  If this sounds like something you've been experiencing, no worries!  The more you talk, the faster you will adapt to your new appliances and your speech will improve.

With Incognito Braces (hidden braces placed behind the teeth), most patients feel like they are speaking with a lisp or that their voice sounds funny.  For these patients, we often recommend that they read the Rainbow Passage several times a day for the first few weeks with their new appliances.  This passage was developed by speech pathologists and contains many of the sounds and sound combinations found in the the English language. The Rainbow Passage is one of the most common standard reading passages to test an individual's ability to produce connected speech and correct any speech impediments.

If you have a new appliance and have noticed changes to your speech, try practicing the Rainbow Passage.  Remember, the more you talk the quicker you will adjust to your new appliance and your speech will improve - so keep talking!

The Rainbow Passage

When the sunlight strikes raindrops in the air, they act as a prism and form a rainbow. The rainbow is a division of white light into many beautiful colors. These take the shape of a long round arch, with its path high above, and its two ends apparently beyond the horizon.
There is, according to legend, a boiling pot of gold at one end. People look, but no one ever finds it. When a man looks for something beyond his reach, his friends say he is looking for the pot of gold at the end of the rainbow.
Throughout the centuries people have explained the rainbow in various ways. Some have accepted it as a miracle without physical explanation. To the Hebrews it was a token that there would be no more universal floods. The Greeks used to imagine that it was a sign from the gods to foretell war or heavy rain. The Norsemen considered the rainbow as a bridge over which the gods passed from earth to their home in the sky.

Others have tried to explain the phenomenon physically. Aristotle thought that the rainbow was caused by reflection of the sun's rays by the rain. Since then physicists have found that it is not reflection, but refraction by the raindrops which causes the rainbows.
Many complicated ideas about the rainbow have been formed. The difference in the rainbow depends considerably upon the size of the drops; the width of the colored band increases as the size of the drops increases. The actual primary rainbow observed is said to be the effect of a super-imposition of a number of bows. If the red of the second bow falls upon the green of the first, the result is to give a bow with an abnormally wide yellow band, since red and green light when mixed form yellow. This is a very common type of bow, one showing mainly red and yellow, with little or no green or blue.

(The Rainbow Passage is a public domain text.)

When is the Best Time to Start Orthodontic Treatment?

At Surrideo Orthodontics, we take a conservative approach to the timing of orthodontic treatment. While the American and Canadian Associations of Orthodontists recommend that the initial evaluation by an orthodontist should occur around the age of 7, we are often happy to see children for their first visit at about 8-9 years of age. 

Evaluation at this early age allows us to examine front-to-back and side to side relationships.  For example, the presence of erupting incisors can indicate possible overbite, open bite, crowding or gummy smiles.  Timely screening can determine if an early start to treatment is necessary, or allow us to set up an appropriate recall schedule to monitor growth and development.  

Drs. Cohen and Yue spend a great deal of time discussing timing of orthodontic referrals with their general and pediatric dental colleagues.  This dialogue allows your child's dentist to know which issues require early intervention, and which ones can wait until your child is a little bit older.  However, if your dentist is unsure, they will likely send you early so as not to miss an important opportunity.

Early evaluation provides both timely detection of problems and greater opportunity for more effective treatment. Prudent intervention when required guides growth and development, preventing serious problems later. When orthodontic intervention is not necessary, the doctors can carefully monitor growth and development with recall appointments. Recall appointments help us to choose the most advantageous time to begin treatment and ensure the greatest results. 

Should you have any concerns or if you are unsure when to bring your child in for an orthodontic evaluation, we would be happy to schedule an initial consultation to give you a better idea of timing and ease your concerns!