During swallowing Tongue thrusting is the habit of placing the tongue in the wrong position, either to the sides or too far forward. The tongue either pushes against the lower teeth or protrudes between the teeth, in this way during swallowing. Out of alignment, the constant pressure of the incorrect tongue posture will force the teeth and arches. Effects may be observed in facial growth and appearance, health, and communication if this pattern continues beyond infancy. Tongue thrusting is not a simple childhood issue. Without even realizing it, many adults also present with a forward tongue resting posture or swallowing pattern that is not ideal. Headaches, sleep apnoea, clicky jaws, snoring, tooth and gum disease, and relapse of orthodontic treatment, are some common signs of these issues in adults.

Characteristics of Tongue Thrusting

A tongue-thrusting habit development swallowing pattern which is also termed infantile swallowing pattern is observed in infants who are breast or bottle-fed. When swallowing an infant gets their baby molars and transition to solid foods, they begin to adopt the habit of placing the tongue tip against the roof of the mouth behind the top front teeth. Rather than forwards food is then propelled backward with a wave-like movement of the tongue.

Causes of Tongue Thrusting

The main causes of the continuation of the swallowing tongue thrust are sucking clothing of hair, thumb or finger sucking, mouth breathing which can cause the tongue’s posture to be very low in the mouth. An exceptionally large tongue, early loss of tongue, nail-biting or chewing lips and cheeks, mouthing objects, large tonsils or adenoids, sensory processing difficulties, allergies, and nasal congestion which can cause mouthing breathing, some artificial nipples are used for feeding infants.

Consequences associated with Tongue Thrusting

The symptoms associated with a tongue thrust are estimated to appear within 24 hours. You swallow a total of 12000 to 20000 times with about four pounds of pressure per swallow. The tongue pushes against the roof of the mouth with the correct swallowing pattern and force. The expansion of the bone in the roof of the mouth stimulates growth. The bone cells in those sutures are different to those in other parts of our body. They only grow when stimulated and do not in accordance with a genetically predetermined outcome. Until the age of 4, the tongue thrust is acceptable but if it is continued by age 6, the sutures of the hard palate can knit together and will often lead to a narrow and highly vaulted palate.

There may be a structural barrier to the accurate production of speech sounds when the palate does not expand. The airway may also be affected, along with the roof of the mouth and the base of the nasal cavity. The habit of mouth breathing can act as a barrier to comfortable nose breathing and it can perpetuate to the habit of mouth breathing. The children have many health complications associated with mouth breathing. Like air filters, the turbinates in our nasal cavity act. It can affect the lungs when we inhale cold and unfiltered air through our mouth. This leads to more frequent upper respiratory illnesses. This may lead to sensitive teeth, swollen gums, and an increased likelihood of tooth decay and infections. When carbon dioxide and oxygen levels in the lungs are not balanced, it also means mouth breathing as when hyperventilating. This impacts the parasympathetic nervous system and the release of diuretic hormones.

Treatment for Tongue Thrusting

A tongue-thrusting habit is treated after looking at the possible causes of the problem. A referral to an ear, nose and throat surgeon, myofunctional therapist, dentist, and orthodontist can help to retrain and break the habit. In most cases, a sincere commitment and cooperation of the child and parent will correct the problem in most cases. Three major problems are usually associated with abnormal forward tongue positioning- protrusion of the incisors, anterior open bite, and lisping. Two major reasons for a relatively high prevalence of anterior tongue positioning in children are related to physiology and to anatomy. During swallowing to help establish an airway for respiration, infants normally position the tongue forward and down in the mouth at rest. By strong lip activity, an infant’s swallow is characterized, by the placement of the tongue tip against the lower lip and relaxation of the elevator muscles of the mandible. Physiologic transition in swallowing patterns begins during the first year of life as teeth erupt and continue over the next several years as oral function matures. An abnormal swallowing pattern prolonged into the mixed and permanent dentitions is characterized by protrusion of the tongue between the anterior dentition, lack of molar contact, and excessive circumoral muscle activity. Studies have shown the prevalence of tongue thrust to be much greater than the prevalence of anterior open bite.