Tongue thrust
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Tongue thrust (also called "reverse" or "immature" swallow) is the common name given to 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 6 most have automatically switched to a normal swallowing pattern. 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 continual pressure tends to force the teeth out of alignment.
Since 1958, the term "tongue thrust" has been described and discussed in speech and dental publications by many writers[citation needed]. A significant number of school-age children have tongue thrust. For example, according to recent literature, as many as 67–95 percent of the children 5–8 years old exhibit tongue thrust, which may be associated with or contributing to an orthodontic or speech problem. 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, if the tongue thrust swallowing pattern is retained, it may be strengthened beyond the age of four.[citation needed] In all probability, the child will need some type of training program to develop the mature swallowing pattern. Throughout the country, 20–80 percent of orthodontic patients have some form of tongue thrust.
Tongue thrusting can have extreme negative effects on the teeth and mouth. Many people who tongue thrust have open bites. People who tongue thrust do it naturally and are usually unaware of the behavior. Therefore, people who tongue thrust should seek treatment to break their habit immediately before more damage to the mouth is done.[citation needed] The force of the tongue against the teeth is an important factor in contributing to "bad bite" (technically known as "malocclusion"). 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.[citation needed] 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 (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.
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[edit] Causes
Although no one factor is to blame, several possible factors (some developmental) can contribute to tongue thrusting. Certain types of artificial nipples used in feeding infants, thumb sucking, allergies or nasal congestion causing the tongue to lie low in the mouth due to breathing obstruction, large tonsils, hereditary factors or ankyloglossia (tongue tie) can lead to tongue thrusting.
[edit] Treatment
Generally, there are two methods of treatment for tongue thrusting. An appliance may be fashioned (similar to a nightguard) which is placed in the mouth by the patient at night (and sometimes a more permanent device may be placed which can be removed and adjusted by a dentist). The other method requires oral habit training by the patient, 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.[citation needed]
