WHAT IS A TONGUE THRUST?
The tongue is a powerful group of muscles that coordinate a variety fine motor movements including: speaking (articulation), chewing (mastication), and swallowing (deglutition). The tongue is formed in utero as early as 4 weeks gestation and is established around 12 weeks gestation. Full-term infants are programmed innately to suckle/suck at the breast using “tongue thrust” to express milk from the mother. Tongue thrusting can be considered a part of typical development until about the age of 4 years of age.
A tongue thrust is when the tongue protrudes beyond the anterior incisors (front teeth) during swallowing (deglutition), speech (articulation), and/or at oral rest. There are varying degrees of tongue thrusting and various disorders where tongue thrusting can be more prevalent.
How do I know if I, or my child, has a tongue thrust?
The easiest way to determine if a tongue thrust is present is be evaluated by a speech-language pathologist, dentist, and/or orthodontist.
Other “red flags” to indicate that a tongue thrust might be present include:
- Open mouth rest posture (typical oral rest posture the lips are closed, all facial and other muscles are relaxed, molars are slightly apart or lightly* touching, tongue is up behind upper teeth)
- *clenching and grinding can also be indicative of various orofacial myofunctional disorders as well
- Premature spillage (loss of food and/or drink) beyond the front teeth (anterior incisors) and/or lips during chewing (mastication)
- One of the most notable observations is pursing of the lips and/or cheeks during a swallow
- The increased tension is the way the oral mechanism attempts to compensate for the tongue thrust and helps keep food/drink inside of the oral cavity
When is speech therapy recommended for a tongue thrust?
A tongue thrust is considered typical until about age 4 years of age. If a tongue thrust persists beyond 4 years of age speech therapy is recommended to remediate the swallow. Without remediation the tongue muscles are powerful enough to cause a variety of dental/orthodontic issues including (but not limited to): an open bite, over bite and/or temporomandibular joint disorders (TMJ Disorders). Without speech therapy, dental/orthodontic interventions often see relapse as the habitual causational behavior has not be remediated.
What to expect for tongue thrust therapy?
Each therapy plan is individually based depending on the presentation of the orofacial myofunctional disorders. In general, tongue thrust therapy alone (without the presentation of other concominent factors) is concluded on average in about 12 sessions. After the conclusion of direct intervention, a follow-up program is recommended for a minimum of 6 months (on average every 3-4 weeks) to ensure the newly established behaviors are habituated.
Behaviors that have been known to encourage tongue thrusting behaviors in children:
- Thumb and finger sucking
- Pacifier use
- Bottle and sippy cup use