Everything You Need to Know About Tongue Thrusting

by | Nov 16, 2023 | General Orthodontics, Oral Health, Orthodontic Treatments | 0 comments

10 min reading time

While “tongue thrusting” evokes images of an action-packed martial art technique, it refers to an unconscious habit many of our patients exhibit.

It occurs when the tongue presses too firmly against the teeth during activities like swallowing, speaking, or even when the mouth rests.

Such constant pressure causes a gradual realignment of your teeth, leading to a less-than-perfect smile.

The silver lining?

Orthodontic treatment will remedy the situation!

Let’s explore the subject of tongue thrusting and discover how braces, along with other orthodontic devices, effectively address this oral hiccup!

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What is Tongue Thrusting?

Tongue thrusting defines the pressure the tongue applies against your front teeth during activities such as swallowing or speaking.

Though it may seem harmless, you should not underestimate the strength of the tongue muscles. Persistent pressure against the teeth may prompt them to shift out of place or become misaligned.

Dental professionals often observe this tendency in children. While many outgrow it, some persist in tongue thrusting, incurring complications that require orthodontic intervention later on. The habit may even persist into adulthood for others! 

Recognizing and addressing this involuntary habit early on is crucial—it can be the key to avoiding extensive dental issues in the years to come.

Tongue Thrusting in Infants

Tongue thrusting is a natural occurrence during the early stages of life. 

It acts as a biological safeguard, preventing infants from choking while feeding. Whether they are nursing or bottle-feeding, this reflex is what allows them to move milk toward the back of their mouths to swallow safely— Nature’s clever trick!

This reflex typically diminishes as toddlers transition to solid foods. If it continues beyond this stage, it may be time to seek professional care.

The prevalence of a child’s tongue thrust decreases from 55% to 35% between the ages of 3 and 5.

Tongue Thrusting in Adults

In adults, the repeated motion of the tongue pressing against the front teeth can become an ingrained behavior. Left unmonitored, this persistent nudging by the tongue will disrupt the alignment of your teeth, as if they are being nudged forward incrementally with each swallow. 

Beyond dental concerns, tongue thrusting may also interfere with clear speech, potentially hindering communication.

Between 5% and 15% of older children and adults require tongue thrust therapy.

4 Types of Tongue Thrust

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  • Anterior Thrust: This is the tongue thrust you’ll encounter most frequently. It happens when the tongue presses firmly against the teeth at the front during swallowing.
  • Lateral Thrust: The tongue isn’t content with pressing forward; it also exerts outward pressure, nudging against either the teeth on the sides or the inner cheeks. It may happen on one side (unilateral) or both (bilateral).
  • Posterior Thrust: Rather than pushing straight ahead, the tongue opts for an upward jab against the palate, just behind the front teeth. It’s as if the tongue attempts an upward bump to the roof of the mouth.
  • Multiple Thrust: Think of this as the combo pack of tongue thrusts. In this scenario, the tongue is a renegade, pushing against the front teeth, outward to the sides, and upward—all at once.

What Causes Tongue Thrust?

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  • Natural Childhood Development: Every infant begins life with a tongue thrust reflex—crucial for successful feeding, whether from the breast or bottle. As children mature, this reflex diminishes, although it persists in some.
  • Thumb Sucking and Pacifier Use: Children who frequently suck their thumbs or use a pacifier encourage the continuation of this forward tongue motion.
  • Improper Swallowing: In some instances, children don’t adopt the typical swallowing technique, where the tongue presses against the roof of the mouth. Instead, they push their tongue forward.
  • Enlarged Tonsils or Adenoids: Enlarged tonsils or adenoids may obstruct nasal breathing, leading to more mouth breathing. This creates a pathway for the tongue to move forward more often.
  • Allergies and Nasal Congestion: When allergies/a stuffed nose force mouth breathing, they pave the way for the tongue to shift into a forward-thrusting position.
  • Neurological or Developmental Issues: In rarer cases, specific neurological (such as cerebral palsy, Down syndrome, or Autism spectrum disorders) or developmental issues contribute to persistent tongue thrusting behaviors.

Can Anxiety Cause Tongue Thrusting?

Stress subtly shapes our behaviors, leading to the formation of unintended routines. Think of everyday nervous actions like chewing on fingernails, incessant foot tapping, or twirling strands of hair when under pressure. 

In a similar vein, the tongue presses against the teeth or jut out reflexively in response to stress-induced discomfort.

While stress itself isn’t a direct precursor to tongue thrusting, it can certainly set the stage for such a pattern to emerge.

Specifically, you may be more prone to developing a tongue thrust habit if you find yourself frequently engaging in stress-related activities such as:

8 Signs of Tongue Thrust

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  • Tongue Protrusion: A primary indicator of the tongue thrust reflex is the tongue consistently protruding through the front teeth during speech or swallowing.
  • Speech Issues: When the tongue makes unexpected appearances, it can distort certain sounds. The letters “S,” “Z,” “Sh,” and “J” are the common culprits.
  • Mouth Breathing: Patients with persistent tongue thrust may default to mouth breathing, bypassing nasal respiration.
  • Orthodontic Issues: The relentless thrust of the tongue against the dentition will eventually force teeth out of alignment, opening gaps and causing the anterior teeth to protrude.
  • Difficulty Swallowing: Swallowing may appear as an overemphasized push of the tongue rather than a seamless motion.
  • Chewing With Your Mouth Open: The forward pressure of the tongue can make it more comfortable for some to chew with an open mouth.
  • Drooling: An improperly positioned tongue can lead to inadvertent drooling, often noted during sleep.
  • Frequent Biting of the Tongue or Cheeks: An irregular tongue position increases the risk of unintentionally biting the tongue or inner cheeks.

Tongue Thrust Diagnosis

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Diagnosing tongue thrust involves a series of procedures:

  • Observation: Professionals such as speech pathologists or orthodontic specialists will observe your speech and swallowing techniques closely. They’re looking for any instances of tongue protrusion during specific phonetic sounds or swallowing. They may even request you consume food or liquid to watch this dynamic in real time.
  • Medical History: Experts will inquire about your past concerning speech or swallowing difficulties, dental irregularities, or other pertinent issues.
  • Speech Testing: Specialists will have you articulate particular phrases and phonemes to detect any articulatory impairments associated with tongue thrusting. They’re assessing for any distortions in sound that could be attributed to the tongue’s movement.
  • Physical Examination: Experts will meticulously examine the resting position of your tongue, as well as the condition of your teeth and the roof of your mouth.
  • Questions: Specialists will delve into any early childhood behaviors such as sucking on a thumb or extended use of a bottle.

How Do Experts Treat Tongue Thrust?

Seeing a Speech Language Pathologist

Your speech therapist will guide you through a series of exercises designed to retrain your tongue’s resting position and movement. Consider it a workout regimen tailored for your tongue’s strength and agility!

Myofunctional Therapy

Myofunctional therapy consists of targeted exercises that work the muscles of the tongue and face. This regimen enhances the tongue’s strength and mobility. Through consistent repetition, the tongue gradually adopts a typical pattern of movement.

Orthodontic Treatment

Your orthodontist is a key player in your treatment journey.

Should tongue thrust have altered your dental alignment, orthodontic strategies such as braces or other corrective devices can realign your teeth.

Alternatively, your orthodontist may recommend a specialized tool known as a tongue crib to aid in proper tongue placement, particularly during swallowing.

This device, constructed from metallic wires, is situated behind the upper front teeth. It creates a physical boundary that deters the tongue from pressing forward against both the teeth and the palate. The crib design encourages the tongue to settle at the floor of the mouth—its natural resting place.

You might wonder, “Does a tongue crib cause discomfort?” or “Will it feel painful?” As with any novel oral appliance, a tongue crib may initially seem foreign and uncomfortable. However, with time, it will become a natural part of your mouth’s landscape.

Can Orthodontic Treatment Address Tongue Thrusting?

Although braces and clear aligners will contribute to your treatment, they aren’t a standalone fix for tongue thrusting.

Consider them as one instrument within a toolkit. They play a role in the broader strategy, particularly for aligning teeth.

Yet, for most patients experiencing tongue thrust, the primary relief often comes through avenues like speech or myofunctional therapy.

The Dangers of Untreated Tongue Thrust

Tongue thrusting might appear as just an odd or inconsequential habit, but over time, it will have undesirable effects.

Consider our mouths a finely tuned ecosystem where everything from teeth to jaws is precisely aligned.

A tongue perpetually pressing against the teeth acts like a powerful bulldozer, forcing teeth from their designated spots. While uneven teeth are perfectly fine, for those pursuing a perfectly aligned smile, tongue thrusting could be a hindrance.

Moreover, this habit may throw off your jaw alignment, resulting in an overbite or underbite. These misalignments cause jaw discomfort and headaches and could even interfere with speech.

The tongue is crucial in speech, aiding in the enunciation of words and sounds.

If it’s regularly protruding, it may alter speech patterns, causing some sounds or words to be mispronounced or muffled. This is particularly challenging for children, who may face ridicule or become self-aware.

Then, there’s the act of swallowing.

Swallowing involves a complex muscle choreography that can be disrupted by tongue thrusting. While this may seem trivial, it can cause complications with eating and potentially with digestion as time goes on.

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Address Your Problematic Tongue Thrust With Dr. Lee’s Help!

Contact Loudoun Orthodontics if orthodontic care is the solution to your dental woes. Whether you want to learn more about the benefits of orthodontic care or have questions about the process, use our live chat or call (703) 858-0303 or send us a message through our Contact Us page to connect with our friendly staff today and book a complimentary orthodontic consultation! 

Our office—located at 19465 Deerfield Ave. Suite 304 Lansdowne, VA 20176—proudly serves the Lansdowne, VA area. So, if you’re residing in Ashburn, Sterling, or Leesburg and are looking for one of the best orthodontists in Virginia, don’t hesitate to visit our office! 

We also invite you to keep up with our blog to get answers to many of the frequently asked questions about maintaining your perfect smile, and follow us on Facebook and Instagram to become a part of our smiling community!


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  6. “What Is Tongue Thrust and Why Is It a Concern?” Kids Mile High, 20 Sept. 2023, www.kidsmilehigh.com/what-is-tongue-thrust-and-why-is-it-a-concern/. Accessed 22 Sept. 2023.
  7. “What Is Tongue Thrust in Adults: Signs, Affect on Face & Teeth, How to Stop?” What Is Tongue Thrust in Adults: Signs, Affect on Face & Teeth, How to Stop?, www.mewing.app/blog/what-is-tongue-thrust-how-to-stop-tongue-thrusting. Accessed 22 Sept. 2023.