speech therapy exercises for tongue thrust

Addressing Tongue Thrust: Effective Exercises Explained

• August 22, 2023

Mastering tongue thrust exercises can seem like a daunting task.

The truth is, when it’s time to address orofacial dysfunction and improve oral health, their biggest challenge is…

Tongue thrust exercises.

Many people are clueless about how to do them correctly. This hurdle separates those who continue struggling with sleep issues, speech impediments and dental problems from those who take control of their oral health. But if you’re unsure about performing these exercises effectively, you’ll never experience the full benefits they offer.

Folks, getting tongue thrust under control isn’t easy.

Table of Contents:

Speech impediments linked to tongue thrust issues, the connection between tongue thrusting and sleep issues, a look into the role of experienced myofunctional therapists, beyond improving swallow dysfunction, treatment duration & expectations with omt, the journey from diagnosis to treatment plan, spearheading myofunctional therapy exercises, cultivating improved oral habits, detailed instructions for performing tongue thrust exercises, maintaining motivation throughout therapy sessions, transformative journeys: success stories in tongue thrust therapy, identifying the need for combined therapies, what exercises fix tongue thrust, how do you train yourself to stop tongue thrusting, can a tongue thrust be corrected, how can adults stop tongue thrusting, unraveling the concept of tongue thrusting.

Tongue thrusting, also known as orofacial muscular imbalance, is a habitual pattern where the tongue protrudes between or pushes against teeth during swallowing and speaking. This habit often begins in childhood due to prolonged thumb sucking, allergies causing nasal obstruction forcing mouth breathing, certain artificial feeding methods during infancy, and structural abnormalities.

The implications on oral health are significant. It can lead to dental malocclusion – misalignment between upper and lower teeth when biting down. The constant pressure from the tongue forces teeth outwards, creating gaps (open bite) or an overbite where upper front teeth overlap extensively with lower ones.

A consequence not commonly considered is bruxism, more familiarly referred to as teeth grinding . When your tongue constantly exerts force against your dentition, it may stimulate jaw muscles leading to involuntary clenching and grinding, especially while sleeping. Not only does this wear down tooth enamel, but it also leads to experiencing jaw pain too.

Beyond these physical manifestations, there’s another important aspect that needs addressing: speech impediment issues linked directly back to persistent infantile swallow patterns such as lisping difficulty articulating sounds clearly because their tongues do not maintain proper position for correct speech production. Studies show that early intervention prevents future orthodontic treatment needs related specifically to open bites caused by ongoing incorrect swallowing habits prevalent amongst school-aged children who continue practicing them into adolescence and adulthood stages without receiving necessary corrective measures taken timely enough to prevent further complications arising later in life. This makes it even more difficult to treat effectively, efficiently, and successfully in overall general terms, conditions, circumstances, situations, scenarios, contexts, etc.

The Impact of Orofacial Dysfunction on Daily Life

Orofacial dysfunction is a complex issue that often goes unnoticed, yet it significantly impacts everyday life. It’s crucial to understand its implications and how tongue thrusting contributes to this condition.

Imagine enduring constant jaw pain because your orofacial muscles are working overtime due to improper swallowing habits. Persistent discomfort in the jaw region can result from more serious conditions, like TMJ (temporomandibular joint) disorders, which is caused by incorrect swallowing practices that make the orofacial muscles overwork.

Sleep issues might not be the first thing you associate with tongue thrusting, but there’s a significant connection between them. When your tongue doesn’t rest in the correct position during sleep, airways can become obstructed leading to snoring or even sleep apnea – a severe disorder characterized by interrupted breathing patterns throughout the night. This study from NCBI provides further insights into these connections.

If left untreated over time, such disruptions may result in chronic fatigue and poor concentration levels among other complications which impact daily functionality substantially. MyoHab offers specialized treatment plans for managing these symptoms effectively.

Beyond impacting quality of sleep through physical symptoms such as jaw pain, digestive problems also emerge as potential consequences. The incorrect swallow pattern characteristic of tongue-thrust behavior could hinder proper digestion starting right from inadequate chewing function up till esophageal stages. According to this PubMed article .

Demystifying Orofacial Myofunctional Therapy

Orofacial Myofunctional Therapy (OMT) may sound complex, but its essence is straightforward. It’s a specialized treatment that concentrates on building up and re-instructing the muscles of your face and oral cavity.

The end goal? To address conditions like tongue thrusting, which can lead to dental malocclusion, teeth grinding, and speech impediment issues, among others. Here’s an insightful blog post for a more in-depth understanding of OMT.

An experienced myofunctional therapist plays a crucial role in diagnosing oropharyngeal disorders such as tongue thrusting. They assess each patient’s unique needs before prescribing suitable exercises aimed at improving their condition over time.

Your therapist will guide you through these exercises step by step, ensuring they are performed correctly while continuously monitoring progress to ensure optimal results are achieved over time.

The benefits derived from undergoing OMT extend beyond just improving swallow dysfunction. By focusing on correcting oral posture and breathing patterns, patients often report improved sleep quality due to reduced instances of snoring caused by obstructed airways, according to this research study .

In addition, correct positioning of the tongue during rest periods promotes facial symmetry, thus reducing the chances associated with developing Temporomandibular Joint Disorder (TMJD).

Different factors determine how long it takes for noticeable changes after starting treatment, including age and severity, among other things. However, most people start noticing improvements within 6 months if consistent practice is maintained throughout this period

The Role of Speech Therapists in Tongue Thrust Management

In addressing tongue thrust issues, speech therapists play a crucial role. They have expertise in understanding orofacial structures and their functions, which is key to diagnosing and managing conditions like tongue thrust.

Tongue thrust often manifests as difficulties with articulation, affecting certain sounds during speech. This is where the role of a speech therapist becomes invaluable.

A comprehensive evaluation serves as the first step in effectively addressing tongue thrust problems. During this process, an experienced myofunctional therapist observes how individuals swallow and speak.

If signs of improper swallowing patterns or inappropriate forward pushing against teeth while speaking are detected (indicative of a potential upward push issue), they proceed to develop tailored treatment plans for each individual case.

An integral part of any effective treatment plan involves exercises aimed at re-educating the muscles involved in proper swallowing patterns, collectively known as myofunctional therapy exercises . Our project, MyoHab , offers more insights into fostering good oral habits through these therapeutic practices under the expert supervision of certified professionals like speech pathologists. These specially trained experts guide patients through prescribed exercise regimes, ensuring that the targeted muscle groups responsible for correct swallow function are properly exercised over time.

In addition to prescribing corrective exercises, experienced speech therapists also provide education on better oral habits that support the long-term functioning of orofacial muscles. This could include guidance on optimal chewing techniques, advice on adopting beneficial postures while eating or sleeping, and other critical factors that contribute to reducing instances of inappropriate tongue movements commonly seen with dental malocclusion caused by persistent tongue thrusting behavior.

Speech therapists are vital in managing tongue thrust issues, thanks to their understanding of orofacial structures. They diagnose and create tailored treatment plans which include myofunctional therapy exercises under expert supervision. Additionally, they educate on improved oral habits for long-term muscle function.

Effective Exercises for Tongue Thrust Correction

Tongue thrust exercises , a fundamental aspect of orofacial myofunctional therapy, aim to rectify improper tongue positioning that may lead to complications such as dental malocclusion and speech impediments.

A seasoned myofunctional therapist typically prescribes these exercises tailored according to the specific needs of each individual. Some common examples include “push upwards,” “push tongue left,” and “spoon-push” against the hard palate.

The push upwards exercise involves placing your tongue flat on the roof of your mouth while exerting gentle pressure upward. This position should be maintained for approximately five seconds before relaxing.

In contrast, the push tongue left exercise requires pushing your tongue against one side of your teeth while resisting with cheek muscles simultaneously. Such an action helps strengthen both lingual (tongue) and buccinator (cheek) muscles effectively. This video tutorial demonstrates how these therapeutic techniques can be performed correctly at home under professional supervision from an experienced myofunctional therapist.

It is important to stay motivated during your therapy sessions to ensure the effectiveness of tongue thrust exercises. Here are some tips to help you stay motivated:

• Set realistic goals: Break down your therapy goals into smaller, achievable milestones. Celebrate each milestone to stay motivated.
• Track your progress: Keep a record of your exercises and track your progress over time. Seeing improvements can boost your motivation.
• Find a support system: Enlist the aid of your nearest and dearest, or join a support group to receive encouragement during therapy.
• Reward yourself: Treat yourself to small rewards after completing your therapy sessions or reaching significant milestones. This can help keep you motivated and make the process more enjoyable.
• Stay positive: Focus on the positive changes you are experiencing and remind yourself of the benefits of correcting tongue thrust. Positive thinking

Tongue thrust exercises, part of orofacial myofunctional therapy, correct improper tongue positioning to prevent dental and speech issues. Techniques like “push upwards” and “push tongue left” are tailored by therapists for individual needs. Maintaining motivation through goal-setting, progress tracking, support systems, rewards and positivity is key to successful treatment.

The transformative power of myofunctional therapy exercises is best illustrated through the success stories of those who have experienced it. Additional exercises and patient testimonials shed light on this life-changing journey.

Orthodontic Treatment and Myofunctional Therapy: A Complementary Approach

The integration of orthodontic treatment with myofunctional therapy offers a comprehensive solution to oral health issues such as dental malocclusion, often caused by tongue thrusting. While each approach has its unique benefits, their combination can lead to more effective results. MyoFunctional Therapy LA , for instance, provides specialized services that combine both therapies.

Determining when it’s necessary to integrate orthodontics with myofunctional therapy depends on several factors. The severity of dental misalignment due to prolonged tongue thrust is one primary indicator where an experienced therapist from MyoHab , alongside a certified American Association of Orthodontists member, would be beneficial.

• Persistent discomfort despite extensive prescribed exercises under supervision might also necessitate combining these treatments.
• If speech impediments continue even after consistent practice with speech-related exercises, additional intervention via orthodontistry may prove advantageous.

FAQs in Relation to Tongue Thrust Exercises

Tongue push-ups, spoon-push against the hard palate, and lateral tongue strengthening are effective exercises to correct tongue thrust. These should be done under professional guidance.

Orofacial myofunctional therapy can help retrain your muscles for proper swallowing. Regular practice of prescribed exercises is key in overcoming this habit.

Absolutely. With consistent orofacial myofunctional therapy and possibly orthodontic treatment, it’s possible to correct a tongue thrust over time.

Besides regular therapeutic exercises, adults may also benefit from speech therapy and orthodontic treatments as part of a comprehensive approach towards correcting their tonguing habits.

Understanding tongue thrusting is the first step to correcting it. It’s more than just a habit; it impacts your oral health and sleep quality.

Orofacial dysfunction can lead to several daily life issues like jaw pain, snoring, and digestive problems. But there’s hope in addressing these early on.

Enter orofacial myofunctional therapy – an effective approach to re-educate those muscles for improved function. A certified therapist guides you through this journey.

Tongue thrust exercises play a crucial role here. Tailored according to individual needs, they help correct the habits that led us down this path in the first place.

The road towards improvement isn’t always easy, but success stories from others who’ve been there remind us of its worthiness.

Orthodontic treatment often complements myofunctional therapy, providing comprehensive solutions for dental malocclusion caused by tongue thrusting.

If you’re ready to embark on this journey towards better oral health and improved sleep quality with our unique combination of therapies, including tongue thrust exercises, consider reaching out today at Myohab . We are committed to helping you achieve optimal health outcomes while enhancing your smile

Related Posts

Sleep Apnea Machine Guide: Breathe Better, Sleep Well

Discover how a sleep apnea machine can transform your nights, ensuring peaceful sleep and better health. Explore types, benefits, and maintenance tips.

Breathe Easy: Winning Over Inspire Sleep Apnea Treatment

Discover how inspire sleep apnea therapy is revolutionizing treatment for obstructive sleep apnea, offering hope and better rest to sufferers.

Speech Therapy for Tongue Thrust

What is tongue thrust.

Tongue Thrust refers to the habit of thrusting or pushing the tongue towards the front of the mouth, between the lower and upper teeth when swallowing, speaking, and when the tongue is at rest. Correct positioning of the tongue during these involves the tip of the tongue pushing or pressing against the gums directly above the back of the front upper teeth. Tongue thrust can also be referred to as orofacial muscular imbalance. While it is relatively common for children to display a pattern of swallowing that involves the protrusion of the tongue between the front teeth, most children by the age of 6 have transitioned naturally to a more normal tongue placement and swallowing pattern. If you or a loved one is affected by tongue thrust, get help today by scheduling your free introductory call !

How Does Tongue Thrust Affect Speech?

The most common effect of tongue thrust, if left untreated, is misaligned or malformed teeth. When the tongue is constantly putting pressure on the back of the upper front teeth, these teeth can move forward. This can result in what is referred to as an ‘open bite’ or a significant gap between the front upper and lower teeth. Tongue thrust that isn’t treated can result in long-term damage to speech and language development. Articulation disorders are among the most commonly seen speech disorders in children with tongue thrusts. Tongue thrust can also result in a change to the shape of the face, making it appear elongated, and the tongue may appear to protrude from between the front teeth.  

What Causes Tongue Thrust?

It is not always clear what causes tongue thrust, and in many cases, tongue thrust can be the result of a variety of factors. Speech challenges related to tongue thrusts can be serious, and if an effective speech therapy program is not followed, they can become worse over time. Most experts agree that tongue thrusting is the result of one or a combination of several factors. The most common of these factors are: 

Upper Airway Constriction – In many cases, the absence or inability to breathe through the nose is the result of frequent or unresolved infections in the upper respiratory system or other constrictions or obstructions such as chronic nasal congestion or a deviated septum.

Improper Habits – Prolonged use of items such as pacifiers, bottles, and sippy cups can contribute to the development of tongue thrust. Other habits such as thumb or finger sucking, biting or chewing nails and/or cuticles, sucking on the tongue, lips, or cheeks, or teeth clenching/grinding can be significant factors as well.

Physical or Structural Abnormalities – In some cases, tongue thrust is the result of a physiological difference such as a lip/tongue tie or a low lying, forward position of the tongue.

Genetic Predisposition – For some people affected by tongue thrust, genetics are a contributing factor. The shape and structure of the cranial bones, jaw, and teeth as well as inherited health issues such as seasonal allergies can certainly contribute to the development or progression of tongue thrusting and other orofacial myofunctional disorders .

Developmental Delay – Sometimes tongue thrusting is related to a developmental difference as a result of such disorders like cerebral palsy, autism, and epilepsy.

Learn more about tongue thrusting and how speech therapy can help by scheduling your free introductory call today! 

How Do I Stop My Child From Tongue Thrusting?

One of the best resources for fixing tongue thrust in a child or adult is time with a registered speech and language pathologist. Even if the tongue thrust hasn’t affected speech abilities, speech therapists are experts in teaching the correct placement of the tongue when speaking, swallowing, and at rest. Training the tongue to find the correct position each time can reduce or eliminate the effect on the teeth, prevent misalignment of the teeth and correct or prevent the development of an articulation disorder. 

When Should You Start Tongue Thrust Therapy?

While it is relatively normal for children under the age of six to exhibit tongue thrust when speaking, swallowing, or at rest if the tongue thrust persists beyond that age, it is best to seek support. After the age of six, baby teeth begin to be replaced by adult teeth, and tongue thrust can affect the establishment of the adult teeth and proper alignment. 

Do Speech Therapists Treat Tongue Thrust?

Speech therapists are highly trained and experienced in helping someone remediate their tongue thrust habit. While each case is different, speech and language pathologists possess a wealth of strategies, exercises, and tips to help someone strongly establish proper tongue placement and swallowing patterns. 

What Exercises Fix Tongue Thrust? How Can Speech Therapy Help with Tongue Thrust?

To correct tongue thrusting and improper swallowing patterns, speech pathologists employ the use of various exercises that are designed to promote a normal swallowing pattern, tongue placement, and proper speech production. During the initial evaluation session, the speech therapist may administer swallowing and articulation tests to see where the challenges lie. In some cases where only “pure” tongue thrust is indicated without any articulation problems, then three to five sessions may be enough.

The speech and language pathologist will then assign a core set of exercises and drills that will work against tongue thrusts and can be done on a daily basis for at least two months. The speech therapist will work closely with the patient to establish realistic goals, and support and encourage them as they work to remediate the tongue-thrusting habit.

In the case of articulation problems such as misarticulated consonants (most commonly: /s/ , /z/ , /sh/ , /ch/ , /ts/) – then the speech therapist will work on correcting each sound while simultaneously doing the same oral physiotherapy. The good news is that with dedication and commitment, tongue thrust (and any accompanying articulation challenges) can be corrected with the guidance and support of a qualified and experienced speech and language pathologist. Help is nearby – don’t delay. Get started by scheduling your free introductory call today! 

Copyright © 2024 SpeechPathology.com - All Rights Reserved

• Remediating Tongue Thrust

Michelle Harmon, Ph.D,CCC-SLP

April 5, 2004.

• Ask the Experts
• Articulation, Phonology, and Speech Sound Disorders

Tongue thrust, otherwise known as an infantile or reverse swallow pattern, refers to a swallowing movement where the tongue moves forward to approximate the lower lip. It also refers to labial and lingual resting postures. The resting tongue posture is characterized by a forward carriage of the tongue with the tongue tip pressed against, or carried between, the anterior teeth. The lips maintain an open resting posture, or an open mouth posture, which facilitates the forward tongue carriage. Often other myofunctional variables are associated with the tongue thrust, all of which may lead to dentofacial developmental differences that could have negative dental, speech, and psychosocial consequences. Management of the tongue thrust, therefore, requires a team approach and may include a dentist, orthodontist, physician, and a speech pathologist. Variables that must be addressed by the team sometimes include: (a) anatomical differences (high narrow palatal vaults, malocclusions, restricted frenulums, and lip incompetencies), (b) oral behaviors (thumb/finger/pacifier sucking, licking the lips, teeth grinding, and mouth breathing), (c) medical conditions (obstructions to the airway, and upper respiratory complications), and (d) associated speech problems (lalling and lisping behaviors). With the understanding that a tongue thrust may be accompanied by many complicating factors that need to be addressed by a team, some specific behavioral activities designed to remediate the above defined tongue thrust often addressed by the speech language pathologist, may include the following: (a) education regarding the importance of proper tongue and lip postures when at rest and when swallowing, (b) awareness training to establish appropriate resting postures for the lips and tongue, and (c) exercises to develop an appropriate swallow movement. A few of my favorite procedures are explained below.

• Education: Tell the student and the parent that proper tongue placement and lip closure at rest is very important for proper dental-facial growth and development. Our tongue is a very strong muscle, and if carried against or between the teeth, it can easily alter our dentition over time. Our lips are also muscles that help hold the teeth in their proper position and must remain closed when at rest in order to do their job effectively. Correcting the constant resting posture of the tongue between or against the teeth is probably the most important objective of tongue thrust therapy.
• Awareness training: The student must become aware of proper placement of the tongue tip when a rest and when initiating the swallow pattern. The following exercises may be helpful in achieving this objective: a.) The clinician touches the anterior portion of the alveolar ridge (right behind the upper central incisors) using a cotton swab or a tongue depressor. The student is asked to locate and hold the tongue depressor or cotton swab on the "spot" 5-10 times for several seconds at a time. Another similar activity involves the student holding a tiny dental rubber band between his/her tongue tip and alveolar "spot" for several minutes, rest, and then repeat the holding procedure several times in order to insure awareness for the tongue tip's correct resting position. b.) Homework: The student is encouraged to continue heightening his/her awareness of proper tongue placement using the dental rubber-band exercise periodically during the day. c.) The student must become aware of proper lip closure when at rest. Remind the student to keep his/her lips closed (within their structural limitations) when at rest. Catch the student "being good". A good reinforcement schedule is identifying 5 good behaviors to every 1 correction. Use age appropriate cues to help remind the student to keep his/her lips closed when at rest. d.) Homework: Carry reminders, chart closed-lip behaviors.
• Establishing a swallow pattern: My favorite procedure, perhaps a little messy but very effective, is "trapping the tiny sip" exercise. a.) Educate the student by explaining the correct swallow pattern. Explain that the food or water to be swallowed should be tightly trapped between the tongue and the roof of the mouth. The tongue tip is placed on the "spot" with the sides of the tongue lifted to approximate the roof of the mouth. When we swallow, the tongue slightly moves back pushing the food posteriorly into the esophagus. The lips should remain closed and relaxed during the swallow. b.) Demonstrate what happens with an incorrect swallow. Have paper towels ready and a small basin to catch water spillage. Tell the student that you are going to show them what happens when the tongue moves forward instead of back as it should during the swallow. Take a very tiny (and I mean tiny) sip of water, trap the water between your tongue and alveolar ridge, then pull you lower lip down with your gloved index finger so the student can view the swallow behavior. Swallow letting your tongue come forward such that the trap is slightly released. Water should drip out the corners of your mouth (remember you have your lips apart so they can see the swallow). The student will quickly see that the forward movement of the tongue pushes the tongue and water forward rather than back. c.) Demonstrate the correct swallow, holding the lower lip down but keep the lips relaxed. Show that no water spills from the corner of the mouth. In addition, alert the student to the fact that the lips are relaxed with little or no movement (no lip pursing) during the swallowing behavior. Tell the student that performing this exercise helps them to establish the correct tongue placement for the swallow movement. d.) Homework: Since this exercise may be embarrassing to practice in front of the clinician the first time due to water spillage, especially for the older student, you might ask them to try it in the privacy of their home, in front of their bathroom mirror following the initial demonstration. Most students learn to trap the water correctly very quickly in order to prevent the spillage. Let them show you their success the next time you see them. Sometimes younger students are very willing to make their first attempt in your presence. If they are, find the success in their attempt. Tell them you are sure they will be able to accomplish the task very quickly. e.) Continued practice: Once the student can demonstrate "trapping the tiny sip", there is no longer any need to pull the lip down during the swallow to see proper tongue placement. Instead, they now need practice keeping the lips closed and relaxed during the swallow. Once sufficient success is achieved, ask the student to perform the swallow movement with other foods beginning with soft foods like pudding, and then on to more solid foods that require chewing. f.) Homework: Chart meals. Ask the student to begin to identify which meals they intend to make conscious attempts at using the correct swallow pattern. Request reports of his/her success. g.) Alternative procedure: Practice the following sequence. Trap the liquid or food as instructed above, bite down on the back of the teeth, smile, and push the substance back to complete the swallow. Request feedback from the student. Make a list of the sequence above. Chart or check-off the sequence of steps as they are completed correctly with each swallow.

Related Courses

Treatment approach considerations for school-aged children with speech sound disorders, course: #9472 level: intermediate 1 hour, back to basics: down syndrome, course: #8975 level: introductory 1 hour, 20q: dynamics of school-based speech and language therapy variables, course: #10002 level: advanced 1 hour, sleuthing for /s/ and /r/: facilitating strategies for residual sound errors, course: #9237 level: introductory 2 hours, 20q: a continuum approach for sorting out processing disorders, course: #10008 level: intermediate 1 hour.

Our site uses cookies to improve your experience. By using our site, you agree to our Privacy Policy .

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• Int J Clin Pediatr Dent
• v.14(2); Mar-Apr 2021

Orofacial Myofunctional Therapy in Tongue Thrust Habit: A Narrative Review

Sejal s shah.

1,2,4 Department of Pediatric and Preventive Dentistry, Dr DY Patil Dental College and Hospital, Pune, Maharashtra, India

Meenakshi Y Nankar

Vikas d bendgude.

3 Department of Pedodontics and Preventive Dentistry, Dr DY Patil Dental College and Hospital, Pune, Maharashtra, India

Bhagyashree R Shetty

Aim and objective.

The respective review article is to provide an overview of the various exercises in orofacial myofunctional therapy (OMT) as a treatment modality for tongue thrust habit. Tongue thrust is the persistence of an infantile swallow pattern during late childhood. This leads to breathing and speech difficulties, open bite, and protruded teeth. During formative years, most children successfully transition from an infantile to a mature swallowing pattern. However, a few develop a retained infantile swallow and tongue thrust habit which could be due to abnormal habit like thumb sucking or an underlying cause like enlarged adenoids. Adverse effects of these habits can be avoided by early detection and intervention in a growing child. Tongue thrust can be treated in different ways with early diagnosis, removal of underlying causes, correcting tongue posture, and breaking of habit with the use of orthodontic appliances. This review article is focused on the various OMT techniques employed for the correction of tongue thrust. There are several exercises in OMT which can help a child with tongue thrust. These can be performed at home under the supervision of the child's parents. Orofacial myofunctional therapy has provided a dramatic and positive influence on patients treated for tongue thrust. The joy of eating, speaking, and correct breathing can be regained along with confidence, self-esteem, and improved quality of life. Clinically, OMT plays a positive role by not only improving swallow but also the posture of tongue, improper muscle function, and reduces relapse of previous orthodontic treatments.

How to cite this article

Shah SS, Nankar MY, Bendgude VD, et al. Orofacial Myofunctional Therapy in Tongue Thrust Habit: A Narrative Review. Int J Clin Pediatr Dent 2021;14(2):298–303.

B ackground

What is tongue thrust.

Tongue thrust is a term that describes a swallowing pattern in which an individual pushes the tongue against or between the teeth. This habit has also been called deviate swallow, deviant deglutition, reversed swallow, perverted swallow, oral myofunctional disorder, visceral swallow, infantile swallowing pattern, and abnormal swallow. Tulley defines it as 1969—the forward movement of the tongue tip between the teeth to meet the lower lip during deglutition and in sounds of speech so that the tongue becomes interdental. 1

When to Correct Tongue Thrust?

Tongue thrusting is normal in the neonate in which the tongue lies between the gum pads and the mandible is stabilized by facial muscles during a swallow. This gradually disappears with an eruption of primary dentition. Normal mature swallow shows the positioning of the tongue high on the palate behind the maxillary incisors and no lip and cheek activity during swallowing. A transitional swallowing pattern is seen in mixed dentition, when some primary teeth are lost and permanent are yet to erupt or are erupting. This type of swallow is self-correcting. In cases of open bite mostly created by habits like thumb sucking, the tongue gets thrusted ahead to achieve a lip seal. This type of tongue thrust is called a “Simple Tongue Thrust”. “Complex tongue thrust” is seen in individuals with a diffuse open bite, seen most commonly in mouth breathers and in a child with a history of chronic nasorespiratory disease/allergies. “Retained Infantile Swallow” is when the infantile swallowing reflex perseveres after the eruption of permanent teeth. Intervention by a pediatric dentist is only required in cases of simple and complex tongue thrust as well as in “Retained Infantile Swallow”.

This review aims to act as a reference guide for clinicians enlisting the various myofunctional training methods for tongue-thrusting habit. It also describes the patient selection for orofacial myofunctional therapy (OMT) and cautions against the limitations of the same.

R eview R esults

Treating tongue thrust.

Management of tongue thrust includes: 2

• Habit-breaking appliances like tongue cribs act as reminders and restrict the forward movement of the tongue.
• Correction of malocclusion.
• Myofunctional therapy to correct the position of the tongue at rest and during swallow.

All these management strategies go hand in hand. A habit-breaking appliance only attempts to block the heavy force of swallowing, which, even when added up, only amounts to about 20 minutes a day. 3 The light, constant pressure of the tongue and lips have much more influence on oral equilibrium than tongue thrust ever will. Only treating the intermittent heavy force created by tongue thrusting is not treating the source of the problem and hence after removal of the habit correction appliance and the reason of the tongue thrust is not attended to, the forward tongue position and functions can return leading to relapse.

Myofunctional Therapy

Orofacial myofunctional therapy includes exercises of the cervical and facial muscles for the improvement of proprioception, tone, and mobility. 4

Orofacial myofunctional therapy is neuromuscular re-education of the muscle function to improve the functions of swallow, tongue, oral breathing, and rest posture of lips, tongue, and cheeks. 5

Orofacial myofunctional therapy acts as an adjunct to orthodontic treatment and helps in harmonizing the orofacial function. 6

It includes exercises that help with toning and resistance training of the oral musculature. 7

Orofacial myofunctional therapy in tongue thrust habit acts as an adjunct to speech therapy and orthodontic correction of malocclusion. 8 It also helped stabilize the treated malocclusion 9 and improve the child's oral awareness. 10

Orofacial myofunctional exercises for tongue thrust:

Tightly closing the lips together. The child holds a piece of cardboard/ice cream stick between the upper and lower lip for 5 seconds and repeated 5–10 times. This will improve lip competency.

The child is asked to force air in-between the lips and teeth and puffing out the lips as much as possible ( Fig. 1 ).

Lip puffing exercise

The child is asked to spread the lips and purse them as in an exaggerated “oo-ee”.

Ballooning exercise

The child is asked to blow into a balloon till its full capacity, followed by letting the air release and then repeating again ( Fig. 2 ).

A child blows bubbles from a toy with help of lips.

• Button-pull exercise

A thread/string is passed through a big button of about 2–3 cm. The patient is asked to keep the button between lips and teeth. The thread is pulled outside at the same time the button is being held tightly in place by the lips. This improves the strength of the lips.

Two buttons can be used. One of the buttons is placed between the lips of the patient, while the other is held by the patient outside.

The child can use a whistle as a prop or purse the lips together for whistling. Whistling activates the perioral and cheek muscles. 11

• Lip-stretching exercise

The patient stretches the upper lip in a down and out motion till its maximum capacity. This is repeated 10 times. Variation of the same exercise is to hold the stretched upper lip down by pressing the lower lip against it for 30 seconds and repeated 15–20 times a day. This exercise improves the tone of the upper lip. 12

• Gum drop exercise

“Gum drop exercise” in which a large size gum drop is taken, approx. 1 ounce. An 18–20 inch string, depending on the height of the patient is taken. One end of the string is attached to the gum drop, and the other end is behind the teeth and held with the lips. The patient is asked to place his/her hands behind the back and to bend forward till the face is parallel with the floor and the string is stretched. Then, the patient is asked to open his lips and stretch them as far down as possible, and the same procedure is followed 5–10 times a day.

• Card-pull exercise

In “card pull exercise” a piece of paper or cardboard is held tightly between the upper and lower lip. The child tries to pull the cardboard in an outward motion, the lips try to resist the same. It is similar to “tug of war” and “button pull exercise”. 12

• Drinking out of a straw

Drinking from a straw is an exercise that shows high compliance with children which aids in oral posture correction exercising lip, cheek, and tongue muscles. However, only a small segment of the straw should be allowed inside the mouth. A “Lip Blok” aids this activity where it acts as a stopper.

The impact of these exercises can be increased by using twisted straws and thick liquids like milkshakes that demand more effort to suck.

• Spoon-holding exercise with lip

The child is asked to hold the handle of a spoon between the lips, just like in a lemon-spoon race, only this time the spoon is not held by teeth but only with the help of lips. The spoon should be parallel to the floor. As the strength of the lips improves, the weight on the spoon can be increased. Repeat 10 times.

• Exercise by wind instruments

The use of wind instruments like trumpet strengthens the lip muscles and assists in confining the action of the tongue within a definite area. The supply of blood to that part of the lips coming in contact with the mouthpiece improves due to a stimulating effect. Regular and monitored usage of this instrument will result in improved tonicity of the hypotoned tissue and lengthening of short flabby lips. The position of the tongue during the usage of the wind instrument is high in the palate which is desirable, as it stimulates tissues of the lower lip while reducing tension in the upper lip. When a child plays other wind instruments like the flute, the upper, and lower lips are engaged, thereby improving the strength and tone. 13

• Suck in the cheeks and lips to make the lips look fish face. Hold this position for 5 seconds.
• Hold the lips into an “O” shape.
• Open the mouth wide to open out the lips wide apart.
• Lip KISSES.
• Make child line up stuffed animals and kiss them all goodnight.
• Tongue spot

The child is asked to locate the spot behind the upper incisors on the palate. Hold the tongue at the spot for 10 seconds and repeat 10 times.

• Tongue click

Placing the tongue against the roof of the mouth (at the spot) snap it down, to make a clicking or popping noise.

• Swallowing thin liquid

The child is asked to take some water in the mouth, at the same time holding the tongue at the spot, not allowing the liquid to fall out of the mouth. Hold for 5 seconds and swallow. The same can be repeated by closing the teeth together followed by swallowing. In this, the tongue surface touches the roof of the mouth. 14

• Swallowing thick liquid

Ask the child to take a sip of a thick liquid like a milkshake and hold the tongue at the spot, not allowing the liquid to fall out of the mouth. Hold for 5 seconds and swallow.

• 4S exercise

4S stands for spot, salivate, squeeze, and swallow. The tongue is taken to the “Spot”, behind the maxillary incisors, patient is asked to hold the tongue there as he salivates, followed by squeezing the spot and then swallowing with the teeth brought together while maintaining the tongue at the position. It is advisable to follow this swallowing exercise at least 40 times a day to imbibe this new swallowing pattern. 15

• Touch-nose exercise

Touch nose exercise involves protruding out the tongue and trying to touch the tip of the nose. This has to be held in this position for 10 seconds and repeated 10 times.

• Touch chin exercise

In this exercise, the child is required to protrude out the tongue to try to lick the bottom of the chin. The position should be held for 10 seconds and should be repeated 10 times.

• Tongue-sideways movement exercise

This exercise involves protruding the tongue out and moving it in extreme right and left directions. The tongue is to be held in each direction for 10 seconds. This exercise is to be repeated 10 times on each side.

• Tongue-rolling exercise

In this exercise, the child is required to roll the tongue by folding its edges toward the midline such that it resembles a taco shell. In this rolled position the child has to protrude the tongue out to the maximum extent possible while holding it for 10 seconds. This exercise has to be repeated 10 times.

• Orthodontic elastics and swallow

This exercise is done with either no. 5 or 6 elastics. The child is required to place the elastics at the tip of the tongue followed by raising the tongue to touch the spot on the palate. This exercise is to be repeated several times. While continuing to hold the elastic at the spot, the child should salivate, followed by swallowing.

• Hold and pull exercise

The hold and pull exercise is aimed at stretching the lingual frenum. 16 In this exercise, the child is asked to slowly open his mouth while holding the tip of the tongue constant against the hard palate at the crest.

• Tongue-exercise using food reinforcers

Any sticky food item can be placed either on the palate, in the vestibule, corners of the mouth, or on the lips and the child licks it off with the tongue, thereby increasing the tongue strength. For these exercises, peanut butter or yogurt acts as a good reinforcer.

• K sound and swallow

This exercise involves pronunciation of the sound “Kh”. When the child says “Kh” in an explosive way, the posterior part of the tongue touches the soft palate and the tip of the tongue remains low. This creates awareness of the posterior tongue action in the child. K sound and swallow exercise involves first saying the “Kh” sound, followed by salivating, and then swallowing. This refines the normal way of swallowing for the child.

• Hold of tongue blades and push the tongue

This exercise strengthens the muscles of the tongue and the throat. In this exercise, the child is expected to keep two tongue blades/ice cream sticks on the incisal edge of lower anterior teeth with 2–3 cm of the blade extending inside the mouth. Then, the child is required to try and lift the tongue blades against the resistance of the firmly held blades ( Figs 3 and ​ and4 4 ).

Hold of tongue blades

Tongue push exercise

• Tongue exercise using a spoon

A spoon or any hard object is to be held in front of the lips while the tongue pushes against it. This has to be done for 10 seconds with the tongue steady, straight, and not allowing it to point downward. Complete 10 repetitions of this exercise.

• Tongue retraction

In this exercise, the patient is required to touch the back of his tongue against the palate while holding it in this position for a minimum of 3 seconds. This activity is to be repeated 5 times at any given instant.

• Tongue-extension exercise

In this exercise, the patient is required to protrude his/her tongue in-between the lips to a maximum extent as possible, holding it constant in this position for 3–5 seconds. This activity is to be repeated 5 times at any given instant. 15

• Tongue-pull exercise

Gently pull tongue outside and hold it with help of hands by applying light pressure. Variations: pull your tongue left, right, up, or down.

• Tongue around the world

The child is asked to move his/her tongue around the teeth in small circles (4–5 rounds) building up 15 in each direction 3 times a day to strengthen tongue muscles.

• Tongue push-ups

The child pushes his/her tongue up against a spoon/popsicle stick 10 times. He/she can try to make the tongue move straight up. While doing this exercise ask kids to look into a mirror to see whether they are doing it right or not.

Monkey face exercise

Ask kids to put their tip of tongue over front teeth under upper lips. In the case of a full monkey face, more than a tip of the tongue covers front teeth below the upper lip. hold it for 10 seconds. This is a fun exercise and strengthens muscles ( Fig. 5 ).

• Orthodontic rubber band exercise

First place an orthodontic rubber band on the tip of the tongue. Place the tip of the tongue against the roof right behind the upper front teeth. Occlude your teeth in a regular bite. Do not bite forward Keep the lips apart and swallow while keeping your lips apart and teeth closed Two sets of 30 swallow practices are recommended every day. 17

• Lingual immaturity exercises

In this exercise, the patient has to protrude out the tongue and move it in different directions and speed. First, the patient learns to move the tongue in various directions and practices holding it steady. The next level is to move it in circular motions clockwise and anticlockwise, 10 times each. While performing circular motions the tongue tip should sweep the vermillion border of the lips. The child can perform this exercise with the help of a mirror. The difficulty of this exercise can be increased by turning the lips outward/toward the buccal surface and performing circular motions with the tongue. 18

• Vibrating toothbrush

A vibrating toothbrush can be used for brushing teeth. The vibration stimulates tongue movement and acts as a strong sensory input.

• Teeth counting exercise

Ask children to count teeth with the use of the tongue. This helps by movements of the tongue in all the directions and challenging yet funny exercise for children ( Fig. 6 ).

Teeth-counting exercise

• Self-realization and swallow lessons

The child needs to ensure that the muscles used for facial expression are not engaged during swallowing for all the myofunctional training exercises listed here. The child should be made aware of the perioral, mentalis, and facial muscle contractions. 11

• Air-sucking exercise

In cases of children with open bite malocclusion, either partial, complete or thrusting of the tongue sideways, “open-lip, tongue-back, air sucking exercise” is beneficial. In this exercise, the child has to close his back teeth tightly together, open his lips wide and suck in air vigorously. At the same time, the tongue is to be drawn back such that the tip of the tongue touches the back of the palate ridges, followed by swallowing. A mirror should be used to ensure that the tongue is pulled back and stays in the same position without touching the teeth at any point of time or place. 19

• Bite and swallow procedure

The child is asked to bite on a pliable rubber/chewie/soft tube and then by making a click sound patient is asked to bite and swallow. This activity is for improving masseter and temporalis muscle contraction.

• Cheek exercises

These exercises use a combination of water, tongue movements, and puffing to strengthen the cheek muscles.

• While holding water in the mouth the child is required to shift the water sideways.
• Alternatively, the patient can puff his/her cheeks with air. The child shifts the air from one cheek to the other while ensuring that no air escapes from the mouth or the nose. This is to be repeated a minimum of 5–10 times and should be performed 5 times a day.
• Fish face exercise: Puffing the cheeks with air, the child should blow a fish face repeating the activity 10 times at any given instant.
• Yawning exercise

Yawning strengthens the throat muscles as it pulls the tongue backward, upward, and also toward the back of the throat.

• Mirror exercise for the soft palate

Exercising the uvula while looking into the mirror is an effective way to improve the strength and tonicity of muscles in the soft palate and the pharynx.

• Handheld massagers held to the jaw for a few seconds at a time are known to stimulate the muscles of mastication. Vibration is very stimulating in short bursts and helps in relaxing the taut muscles.
• Open the jaw wide and say aaahhh!! And hold for 3–6 seconds.
• Massage the jaw gently toward and away from the lips.
• Breathing exercises

Breathing exercises include a combination of pranayam, balloon blowing, and water holding in the mouth, all while performing breathing through the nasal cavity. For pranayam, the air is inhaled and exhaled rapidly through the nose keeping the mouth shut, but relaxed. Balloon blowing exercise has a high degree of compliance from child patients. A deep breath is taken through the nose and this air is exhaled into a balloon. The balloon is expanded to its maximum capacity by exhaling more breaths into it. This can be repeated 3 times a day. 15

• Subconscious therapy:

After multiple exercise sessions, reminder signs or boards can act as cues for the child to ingrain the correct swallowing pattern in the subconscious.

D iscussion

Patient selection for orofacial myofunctional therapy in tongue thrust.

Orofacial myofunctional therapy is not indicated in tongue thrusters in absence of speech/dental problems according to the authors Proffit and Mason. 8 There is no common agreement in the published literature regarding the right age for starting OMT in tongue thrust. 20 Some pediatric dentists have successfully used myotherapy in children <10 years of age. 21 Whereas some prefer waiting till 10 years of age or more, as there could be spontaneous closure of the anterior open bite. 8 Before starting OMT for tongue thrust patients, it is important to make sure that any anatomical variation like tongue-tie is corrected. The need for surgical reduction of excessive lymphoid tissue should also be evaluated before initiating myotherapy. 22

Number, Duration, and Frequency of Sessions

A treatment program planned for any child should have a minimum of 20 sessions. The first 10 sessions are dedicated to learning the tongue posture. The next sessions help with monitoring the taught exercises. The myotherapy sessions should continue till the exercises are ingrained in the child's subconscious. The duration of each session should last 30 minutes. The frequency of visits can be weekly at first followed by every 15 days and later every month. 18

Limitations of Orofacial Myofunctional Therapy

It is important to understand that OMT cannot replace orthodontic correction nor does it bring about changes in the morphology. It is a concept of active exercise the success of which depends critically on the motivation levels and compliance of children and their parents, equally. 10

Future Scope of Orofacial Myofunctional Therapy

Successful management of tongue thrust including OMTs requires a team approach. The team includes general dentists, orthodontists, pediatric dentists, speech pathologists, and pediatricians as well. It will be crucial to bringing the attention of the clinicians to the oral musculature and its functions, which will hold the key for successful treatment of oral functions.

C onclusion

Orofacial myofunctional therapy definitely has a role in the management of tongue thrust and should be included as a part of the comprehensive treatment plan for the patient. It makes the patient aware of the faulty rest position and dynamic positions of the tongue and helps to learn the physiological myofunctional behavior. 10

C linical S ignificance

Orofacial myofunctional therapy in tongue thrust helps to:

• Improve tongue elevation strength.
• Correct tongue resting posture.
• Correct tongue placement while swallowing.
• Improve tongue motility. 10
• Improve maxillary constriction. 23
• Prevent relapse of corrected malocclusion.
• Improve sleep-disordered breathing. 9

Source of support: Nil

Conflict of interest: None

R eferences

IJustWantTo Correct My Tongue Thrust

Online Tongue Thrust Therapy

Tongue thrust is the forward position of the tongue against the teeth while swallowing, speaking, or at rest.  this can push the teeth out of alignment and may cause:,  tongue thrust  stop snoring  mouth breathing  lisp  morning headaches  big/fat tongue,  chapped lips  tooth grinding  dry mouth  daytime sleepiness  waking with sore throat.

Purchase & Start Now

How Long Does It Take To Correct a Tongue Thrust?

This  is a step-by-step program that leads you through tongue exercises explained in written words and videos to  correct your tongue thrust in only SEVEN WEEKS.

The author, Janet Bennett, M.Ed., CCC-SLP, has a Master’s degree in Speech Pathology and has been a licensed Speech Pathologist for over 40 years. She has treated Tongue Thrust exclusively since 1994.

In the online videos, you will see her treating someone for all seven lessons. Your tongue will get stronger and feel more comfortable in your mouth, and if you snore, it should gradually get quieter and quieter. As your tongue muscles get stronger due to you doing the exercises, more changes should occur.

The tongue exercises vary weekly but take 15-20 minutes twice daily. Most of them can be performed while driving to work, reading, watching TV, or vacuuming.

There is an option to meet with the speech pathologist, Janet, over Zoom video for a consultation before starting.

It is recommended for ages 8 and over. A younger child may be able to perform the exercises, depending on their maturity.

Tongue Thrust Speech Therapy

Convenient & Effective Speech Therapy

TONGUE THRUST SPEECH THERAPY

What is tongue thrust speech therapy?

Tongue thrust, also known as orofacial myofunctional disorder, is a condition in which the tongue pushes forward against the teeth or between them during speech, swallowing, or at rest. This improper tongue posture can lead to various speech, dental, and swallowing issues.

Tongue thrust speech therapy, also called orofacial myofunctional therapy , is a specialized approach that aims to correct tongue positioning and associated difficulties. Here's an overview of tongue thrust speech therapy:

Assessment: A speech-language pathologist or a trained orofacial myofunctional therapist assesses the individual's tongue posture, swallowing patterns, and speech.

Individualized Treatment: Tongue thrust therapy is tailored to the individual's needs. The therapist designs a personalized treatment plan that addresses the improper tongue posture during rest, swallowing, and speech.

Tongue Rest Posture: This therapy focuses on teaching proper tongue rest posture, where the tongue rests on the roof of the mouth behind the upper front teeth.

Swallowing Technique: This therapy aims to retrain the swallowing pattern. Individuals with tongue thrust often use a forward or incorrect swallowing motion.

Tongue Exercises: Therapists guide individuals through specific tongue exercises to strengthen and coordinate the tongue muscles. These exercises help establish correct tongue movements during speech, swallowing, and rest.

ROLES IN TONGUE THRUST THERAPY

What are the roles of the speech therapist in tongue thrust therapy?

Speech therapists play crucial roles in providing effective tongue thrust therapy. Their expertise and guidance are essential for helping individuals correct improper tongue posture and associated speech, swallowing, and dental issues. Here are the key roles of speech therapists in tongue thrust therapy:

Assessment and Diagnosis: Speech therapists begin by assessing the individual's tongue posture, swallowing patterns, speech, and any related issues. They diagnose the specific nature and severity of the tongue thrust and its impact on speech and oral function.

Individualized Treatment Planning: Based on the assessment, speech therapists design individualized treatment plans tailored to the individual's needs.

Education and Awareness: Therapists educate individuals and their families about tongue thrust, its causes, consequences, and the importance of proper tongue posture for speech, swallowing, and dental health.

Tongue Rest Posture Instruction: Speech therapists teach individuals the correct tongue rest posture, where the tongue rests against the roof of the mouth behind the upper front teeth.

Swallowing Technique Training: Therapists retrain individuals in proper swallowing techniques, ensuring that the tongue moves correctly against the roof of the mouth during swallowing. They provide exercises and strategies to reinforce the desired swallowing pattern.

FORMS OF TONGUE THRUST THERAPY

What are the forms of tongue thrust therapy?

Tongue thrust speech therapy employs various techniques and approaches to address improper tongue posture and its related issues. These forms of therapy are tailored to the individual's needs and can include:

Tongue Posture Training: Therapists work with individuals to establish proper tongue rest posture. They teach the correct position where the tongue rests against the roof of the mouth, rather than pushing forward against the teeth.

Swallowing Pattern Correction: Therapists guide individuals in retraining their swallowing patterns. The goal is to ensure that the tongue moves correctly against the roof of the mouth during swallowing, rather than pushing forward.

Tongue Muscle Exercises: Therapists provide exercises that target the muscles of the tongue. These exercises help strengthen and coordinate tongue movements, contributing to improved speech and swallowing.

Breath Control Techniques: Therapists teach individuals proper breathing techniques to encourage nasal breathing and discourage mouth breathing, which can contribute to tongue thrust.

Articulation Exercises: Tongue thrust can impact speech sound production. Therapists work on articulation exercises to help individuals produce speech sounds correctly, addressing sound errors caused by improper tongue posture.

TONGUE THRUST THERAPY TECHNIQUES

What are some common tongue thrust therapy techniques?

Tongue thrust speech therapy employs various techniques to address improper tongue posture and its related speech, swallowing, and dental issues. These techniques are designed to retrain the tongue's movements and encourage correct oral posture. Here are some common tongue thrust speech therapy techniques:

Tongue Rest Posture Practice: Therapists teach individuals how to position their tongue correctly at rest, with the tongue resting against the roof of the mouth behind the upper front teeth. Regular practice helps establish this proper resting position.

Swallowing Pattern Correction: Therapists guide individuals in retraining their swallowing patterns. The focus is on ensuring that the tongue moves upward and backward against the roof of the mouth during swallowing, rather than pushing forward.

Tongue Muscle Exercises: These exercises help strengthen and coordinate the tongue's movements for improved speech, swallowing, and oral posture.

Lip and Cheek Exercises: Exercises targeting the muscles of the lips and cheeks help individuals achieve proper lip and cheek posture, contributing to improved oral muscle function.

Tongue Mobility Exercises: Therapists guide individuals through exercises that involve moving the tongue in various directions and patterns. These exercises help improve tongue flexibility and control.

BENEFITS OF TONGUE THRUST THERAPY

What are the benefits of tongue thrust therapy?

Tongue thrust speech therapy offers a range of benefits for individuals who are dealing with improper tongue posture and its related issues. Here are some key advantages of undergoing tongue thrust speech therapy:

Corrected Tongue Posture: The primary goal of tongue thrust therapy is to establish proper tongue rest posture. This correct posture contributes to improved oral health, better speech articulation, and enhanced swallowing patterns.

Improved Speech Clarity: Tongue thrust can lead to speech sound errors. Therapy techniques address these errors, resulting in clearer speech and improved communication skills.

Enhanced Swallowing Patterns: Individuals learn to retrain their swallowing patterns, ensuring that the tongue moves upward and backward during swallowing. This contributes to more efficient and appropriate swallowing.

Dental Health Improvement: Proper tongue posture and swallowing patterns can positively impact dental alignment, reducing the risk of orthodontic issues and promoting overall oral health.

Reduction of Oral Habits: Therapy helps individuals eliminate harmful oral habits such as thumb sucking or pacifier use, which can contribute to tongue thrust and dental problems.

How to Improve Your Speech?

Join Better Speech

We'll Match You With  the Ideal Therapist

 No Waitlists - Start This Week

Improve Speech

Live Weekly Zoom Sessions 

150+ Licensed and Experienced Therapists

Our  speech therapists  are all licensed and certified, with ~10 years of experience. We cover every state in the USA. We offer speech therapy services for children   and   adults.

WHY PEOPLE LOVE US

Our Shining Testimonials

It's really convenient, easy and affordable. My son speech really got better.

We have seen our son just explode in terms of speech, language and confidence.  It gets our highest recommendation! 

I love the flexibility of the online schedule. Also with insurance, it was a fraction of the cost of a clinic, I wish I have tried Better Speech sooner. 

Get Free Guide to Improve Speech

Improve your communication skills

Improve your child’s speech

Understanding Tongue Thrust: Causes, Symptoms, and Treatment Options

by Rian | Apr 6, 2024 | Tongue Thrust

Tongue thrust is a common yet often overlooked condition that can have a significant impact on a child’s oral and dental development. At the Center for Orofacial Myology, we are dedicated to helping parents and patients understand and effectively manage this orofacial myofunctional disorder (OMD). In this comprehensive guide, we’ll delve into the intricacies of tongue thrust, its causes, symptoms, and the various treatment options available.

What is Tongue Thrust? Tongue thrust, also known as an orofacial myofunctional disorder (OMD), is a condition characterized by the abnormal forward positioning of the tongue during rest, swallowing, and speech. Instead of resting in its proper position behind the upper front teeth, the tongue protrudes forward or thrusts against or between the teeth, creating undue pressure and interfering with proper oral function.

Causes of Tongue Thrust There are several potential causes of tongue thrust, each contributing to the development of this condition:

• Prolonged Thumb or Finger Sucking, or Extended Pacifier Use: These habits can cause the tongue to adopt an abnormal forward position during rest and swallowing, as the presence of an object in the mouth forces the tongue downward and forward.
• Upper Airway Obstruction: Conditions such as enlarged tonsils, adenoids, allergies, or nasal obstructions can make nasal breathing difficult, forcing the jaw and tongue to move forward to open the airway and facilitate breathing through the mouth.
• Missing Teeth or Open Bite: When the upper and lower teeth do not meet properly due to missing teeth or an open bite, it can contribute to or result from a tongue thrust, as the tongue seeks to fill the gap.
• Poor Oral Muscle Strength or Tone: Low muscle strength or tone in the oral cavity can cause the jaw to drop, mouth to open, and tongue to move forward, perpetuating the tongue thrust habit.
• Genetics: Some individuals may have a genetic predisposition or family history of oral and facial structures that promote a forward tongue position, increasing their likelihood of developing tongue thrust.

Symptoms of Tongue Thrust While tongue thrust may initially seem innocuous, it can lead to a range of oral and dental issues if left untreated. Some common signs and symptoms include:

• Abnormal Swallowing and Biting: During swallowing, the tongue moves forward abnormally, causing difficulty in biting and chewing food properly. An open bite, where the upper and lower teeth do not meet, can further exacerbate this issue.
• Dental Issues: The persistent pressure of the tongue against the front teeth can cause them to flare out or create an open bite, where the upper and lower teeth do not meet properly when the jaws are closed. This misalignment can lead to various dental problems and aesthetic concerns.
• Speech Difficulties: Individuals with tongue thrust often exhibit a “frontal lisp” during speech, where the tongue is positioned against or between the teeth when producing sounds like /s/, /z/, /sh/, /ch/, and /j/, resulting in distorted speech patterns.
• Jaw Pain and Headaches: The abnormal positioning of the tongue and jaw muscles can contribute to jaw discomfort, tension headaches, and other related issues.

Treatment Options for Tongue Thrust At the Center for Orofacial Myology, we offer a comprehensive range of treatment options to address tongue thrust effectively:

• Myofunctional Therapy: This specialized therapy aims to develop a normal oral resting position where the lips and teeth are closed, and the tongue rests against the ridge behind the upper front teeth. Through targeted exercises, patients learn to achieve proper tongue movement during swallowing, speech, and rest, correcting the tongue thrust habit.
• Speech Therapy: In many cases, speech therapy is necessary to address the abnormal tongue position and correct the frontal production of specific speech sounds resulting from tongue thrust.
• Parent and Patient Involvement: Successful treatment of tongue thrust relies heavily on active participation from both the patient and their parents. Our team will provide guidance and resources to help reinforce the exercises and techniques learned during therapy sessions through consistent practice at home.
• Multidisciplinary Approach: In some cases, a collaborative effort involving speech-language pathologists, myofunctional therapists, orthodontists, and other healthcare professionals may be necessary to address underlying issues contributing to tongue thrust, such as airway obstructions or muscle tone imbalances.

At the Center for Orofacial Myology, our team of experienced professionals is dedicated to providing personalized treatment plans tailored to each patient’s unique needs. We understand the potential impact tongue thrust can have on a child’s oral and overall development, and we are committed to helping families overcome this condition through comprehensive and effective treatment strategies.

If you suspect your child or yourself may be experiencing tongue thrust, we encourage you to schedule an evaluation with our team. Early intervention is key to preventing further complications and ensuring optimal oral function and development. Don’t hesitate to contact us today at (208) 793-7006 to learn more about our services and take the first step toward conquering tongue thrust.

Speech Therapy Treatments For Tongue Thrust

Table of Contents

Tongue thrust is preventable condition that often develops during infancy or childhood.

If left untreated, it will persist into adulthood and can cause complications that affect your speech.

A team of healthcare professionals is usually required to address the condition once diagnosed.

Speech therapists are an integral part of this team because they can address multiple aspects of the condition.

If your child is diagnosed with tongue thrust, it’s important to make sure that speech therapy treatments for children become a core focus of your treatment plan.

Now, let’s dive in.

What Is Tongue Thrust?

Tongue thrust is a condition that occurs when your tongue presses too far forward in your mouth.

This results in an abnormal orthodontic condition called an ‘open bite’.

There are wildly varying statistics on how common tongue thrust is, with one study claiming 2.7% of children have it, and another claiming 74% of children are tongue thrusters.

Symptoms Of Tongue Thrust

There are different symptoms of tongue thrust that present depending on your age.

Let’s find out more, starting with symptoms of tongue thrust in babies.

In babies, the main symptom of tongue thrust is visible when there’s too much forward movement of their tongue.

You’ll see this while your baby is swallowing or attempting to babble.

Their tongue will push forward into their mouth.

If they’re at the age where they have some teeth, their tongue will press into the back of their teeth noticeably.

Some other signs that your baby is developing tongue thrust include:

• Their tongue tip protrudes between their teeth during resting, swallowing, and speaking
• They noticeably breathe through their mouth
• They are unable to close their lips completely
• As they age, they have developed an open bite, which is when their front teeth don’t meet when their mouth is closed
• They might also need speech therapy for speech sound disorders as they age to correct a lisp

If you notice your child has tongue thrust, it’s a good idea to seek early intervention speech therapy , since it has been shown to improve results.

In adults, the symptoms of tongue thrust around the mouth are similar to those in children.

But, you might also have developed some other signs that point to the condition.

These include:

• Thrusting your tongue while you sleep
• An elongated facial structure because you can’t close your mouth or swallow normally
• A larger than average tongue
• Difficulty biting foods

While tongue thrust is similar with adults and children, speech therapy for adults with tongue thrust is significantly different.

What Causes Tongue Thrust?

There are many possible causes of tongue thrust that can occur during your childhood.

Some of the common causes include:

• Poor swallowing habits

You can also develop tongue thrust during your infancy.

Some causes of tongue thrust during infancy include:

• Long term reliance on sucking on objects or fingers
• Allergies and chronically swollen tonsils
• A specific swallowing pattern called reverse swallow

It is very rare to develop tongue thrust as an adult, but not impossible.

Complications From Tongue Thrust

Remember, if you don’t treat tongue thrust, it will carry forward into adulthood.

It can also cause malformed teeth because of the constant pressure of your tongue against your teeth.

This creates an open bite, which is when a gap opens up between your middle top and bottom teeth.

In addition, growing with an open bite can cause your facial shape to elongate over time and your tongue will eventually stick out between your teeth.

It can also cause long-term damage to your speaking ability, and create a lisp over certain sounds.

Diagnosing Tongue Thrust

There are many different healthcare professionals who can diagnose tongue thrust.

This list usually includes general practitioners, pediatricians, dentists, orthodontists, and of course, speech pathologists .

In order to diagnose tongue thrust, your evaluator will pay attention to how you swallow, and where your tongue is placed when swallowing.

After being diagnosed with tongue thrust, you’ll most likely work with a team of interdisciplinary healthcare professionals to reduce the impact of the condition.

This is to ensure the best possibility for success.

Speech therapy treatments for tongue thrust can be very effective, both for your speaking abilities and your swallowing abilities.

The treatment plan is similar regardless whether it is for a child or an adult.

Your speech therapist will create a plan after evaluating your needs and help you to correct any impediments that resulted from your tongue thrust condition.

It’s especially important that you maintain your treatment plan, because without ongoing therapy your resolved tongue thrust can reverse itself over time.

Let’s find out more about some strategies to reduce tongue thrust.

1. Stopping Non Nutritive Sucking

One key strategy to reduce and prevent tongue thrust is to break any sucking habits your child may have.

Your goal should be to stop this habit by age three.

Your speech therapist can give you strategies to help with this that are all based on positive reinforcement.

You’ll want to encourage and praise appropriate mouth behavior to help your child break their habit.

On the chance it persists, the hard stop is by the time your child’s adult teeth begin to show.

If they are still sucking by this age, their risk factor for developing tongue thrust will increase quite a bit.

2. Developing A Healthy Oral Resting Posture

Before doing any dental work, your speech therapist will work with your child to create or recreate a healthy resting relationship between your child’s tongue, lips, teeth, and jaw.

This includes working with your child to reduce their mouth breathing, which can negatively impact their resting posture.

This is important, since with just dental work, they will eventually revert back.

3. Stabilizing Their Nasal Breathing

It’s important to have any structural or physiological challenges to nasal breathing ruled out.

Your speech therapist can only teach your child to breathe through their nose if they are physically able to breathe through their nose.

This includes investigating the potential for allergies if that is causing them any problems.

Your goal is for your child to have a closed mouth resting position, breathing easily through their nose.

4. Addressing Their Articulation Issues

Finally, your speech therapist will work to correct their speaking and articulation challenges once their breathing and oral resting posture have been achieved.

It has to happen in this order to improve their chances for success.

Any speaking challenges can be worked out with therapy once the underlying systems that support speech are addressed.

This includes any lisps or other articulation challenges.

Book An Appointment With Sol Speech And Language Therapy

You can see that there are a lot of treatment options available to you if you think you or your child might have tongue thrust.

Your best bet is to work with a team of healthcare professionals that will address different aspects of the condition based on their expertise.

Our licensed speech pathologists can play an integral part of your healthcare team.

Book your appointment with Sol Speech And Language Therapy today to schedule an evaluation at one of our Texas clinics .

Sol Speech & Language Therapy offers personalized skilled intervention to those struggling with their speech and language skills. Services offered include screening, consultation, and comprehensive evaluation. We also provide one-on-one and/or group therapy for speech sound disorders, receptive/expressive language delay/disorder, stuttering/cluttering, accent reduction, and much more.

Masks Strongly Recommended but Not Required in Maryland, Starting Immediately

Due to the downward trend in respiratory viruses in Maryland, masking is no longer required but remains strongly recommended in Johns Hopkins Medicine clinical locations in Maryland. Read more .

• Vaccines  
• Masking Guidelines
• Visitor Guidelines  

Rehabilitation Services

Tongue thrust.

An orofacial myofunctional disorder (OMD) is an abnormal lip, jaw or tongue position during rest, swallowing or speech. This can include:

Dental abnormalities

Open-mouth resting posture

Tongue thrust

Children with OMDs may have issues with eating, drinking or speech. You may also see these disorders when your child has prolonged oral habits like thumb or finger sucking, or prolonged mouth breathing.

Our certified speech-language pathologists at Johns Hopkins All Children’s are specially trained in the evaluation and treatment of OMDs. We work with you and your child’s dentist and orthodontist to provide a comprehensive treatment plan that addresses your child’s unique needs.

Evaluation and treatment

The speech-language pathologist will gather information on your child’s feeding history, oral habits and dental or orthodontic history. We will then examine your child’s oral structures, observe your child while eating and drinking, and assess his or her articulation (speech sound production). Evaluation appointments last about one hour.

We will develop an individualized treatment plan for your child, focusing on tongue and facial resting postures, swallowing patterns, and speech sound production with appropriate tongue placement. The treatment plan will include a daily home exercise program.

When to begin treatment

The best age to being treatment is 8 years old. Most patients are 8-12 years old. Treatment may be recommended for younger children, ages 4-7, depending on the child’s condition.

Children ages 4-7 typically receive treatment if their dentist or orthodontist notes a developing malocclusion, such as an overbite, overjet, or open bite; the child demonstrates an open-mouth resting position; and none of the following factors are present:

• Thumb or finger sucking habit
• Enlarged tonsils/adenoids
• Allergies or other sinus issues
• Planned rapid palatal expansion
• Restricted lingual frenulum (tongue-tie)

Parents must be able to complete the daily home exercise program while their child is receiving treatment.

To schedule an evaluation or for more information, call us at  727-767-4141 .

You can also request an appointment online using our online form.

Medical records may be faxed to 727-767-6743.

• What Happens During an Evaluation
• Teletherapy
• Pediatric Speech Therapy
• Occupational Therapy
• Feeding/Swallowing Therapy
• Comprehensive Speech and Language Evaluation
• Speech and Language Therapy
• Classes and Groups Sessions
• Patient Portal
• Our Philosophy
• The Leaf Newsletter
• Parents Guide to Teletherapy

480-787-5387 📞

Speech Therapy

Tongue Thrust 101: A Plain English Guide for Parents

  january 10, 2020.

Have you recently heard the term “tongue thrust” from your child’s pediatrician or perhaps a friend, but don’t know what it truly means?

With this disorder accounting for nearly half of all orthodontic patients, it is unfortunate that many parents never get the chance to learn more about it.

That’s what we hope to change with today’s post. We’ll start with the fundamental question of what this condition is and then unravel all the intricate details in simple terms.

What Is a Tongue Thrust?

Tongue thrust is the common name for a disorder involving dysfunctional muscle patterns in the mouth.

Patients with this disorder tend to have a behavioral problem where they push their tongue forward against the front teeth in certain situations. Usually, this pattern is triggered when the patient is swallowing, speaking, or just resting their tongue.

Generally speaking, this thrusting pattern is nothing out of the ordinary in young children. In fact, most children display signs of tongue thrusting when swallowing. That’s because they tend to use their tongue to latch on and squeeze the milk out rather than sucking it, regardless of whether they are breastfed or bottle-fed.

However, as kids grow up, most of them tend to overcome this habit and learn to follow a normal swallowing pattern. Unfortunately, while most kids do break this pattern with time many don’t.

If such problems persist beyond the age of 6, it’s usually a strong indicator of a disorder and tongue thrusting is the most common culprit.

Before we move on, please know that you may also hear this disorder called by other names like reverse or immature swallow.

Why Is It a Problem?

Even though it may not seem like a big cause for concern, tongue thrusting can cause significant problems. Let us elaborate. 

Did you know that the average child swallows up to 2,000 times a day?

Did you also know that the average swallow exerts a pressure of about four pounds (1.8 kg)?

With those facts in mind, it shouldn’t come as a surprise that the pressure applied on the front teeth can significantly alter the alignment of the teeth.

For an illustrative comparison, braces offer a great example as they apply continuous pressure throughout the day to slowly move and reshape teeth. The same thing happens when the tongue applies a pressure of 4 pounds at each of the 2,000 times a child swallows in a single day.

Apart from the misaligned positioning of the teeth, tongue thrusts may also result in speech problems. This usually includes difficulty making some sounds correctly or speaking with a lisp.

Lastly, some kids with this condition struggle to swallow their food correctly. For instance, they may take large bites, swallow without chewing properly and have an all-around messy eating habit.

To sum it up, not only does tongue thrusting present practical challenges in a child’s daily life, but it can also lower their self-esteem with the changes in appearance that follow.

What Are the Consequences of Not Treating a Tongue Thrust?

If left untreated, tongue thrusting can result in complications such as:

• Malformed Teeth: The constant pressure on teeth presents numerous dental repercussions. For example, it can push the front teeth forward and create a gap between the middle top and bottom teeth. This condition is known as an open bite.
• Incorrect Speech: The incorrect production of certain speech sounds will most likely persist and may be accompanied by a permanent lisp. 
• Orofacial Changes: Some kids also experience a dramatic shift in face shape, usually resulting in an elongated facial structure. A more common complication involves the tongue bulging out from between the teeth.

Considering all the long-term consequences outlined above, we highly recommend consulting a professional and starting treatment as soon as possible.

As with many conditions, early intervention is key to successful treatment.

What Causes Tongue Thrusting?

While there is no conclusive cause for tongue thrusting, the following is a list of possible causes:

• An exceptionally large tongue
• Bad oral habits like thumb sucking
• Allergies along with swollen tonsils
• Neurological or developmental difficulties
• Breastfeeding or bottle-feeding beyond the age of 18 months
• A disorder called tongue-tie that limits the motion of the tongue
• Family members diagnosed with the same condition

How to Identify a Tongue Thrust?

Following are some of the most common symptoms for this disorder: 

• Breathing through the mouth, especially in the absence of allergies or nasal congestion
• Inability to fully close the lips due to either an irregular structure or habit
• Having a gap between the top and bottom front teeth (an open bite)
• Producing certain sounds incorrectly, usually with a lisp
• Tongue protruding between the front teeth. This is the biggest telltale sign of tongue thrust.

While that list of symptoms is a great start, you should always consult a professional for proper diagnosis as it is quite complex. Apart from that, you should also consider the age of your child. Kids under the age of 4 tend to have a naturally flawed swallow pattern that goes away on its own.

How Do Tongue Thrusts Impact Orthodontia?

The long-term success of any orthodontic treatment relies significantly on curing tongue thrusts first.

While the orthodontist may be able to fix the specific problems initially, such efforts are futile without a proper plan to get rid of or at least minimize the thrusting habit. That’s because any corrections will deteriorate over time, as the tongue pressure that required them in the first place is still there. Hence why relapse is almost guaranteed among patients who don’t get treated for tongue thrusts.

To put another way, getting rid of tongue thrusting allows for orthodontic treatments like braces to fix the teeth sooner and then keep them perfectly aligned thereafter.

What an SLP Can Do to Help Correct a Tongue Thrust?

A speech-language pathologist (SLP) can help treat tongue thrust using speech therapy methods that are noninvasive yet highly effective.

The treatment usually involves a customized plan of exercises designed to encourage a normal tongue resting position and swallowing pattern. If there are any articulation errors, the treatment plan is adjusted to account for them as well. Apart from that, a speech pathologist also helps identify and break any negative oral habits such as thumb sucking.

With an effective therapy plan in place, your child will see a significant drop in tongue thrusting within 8-12 weeks. Just remember: therapy sessions will guide and keep your child on the right track, but the major steps in this journey will come from following the exercise plan at home.

If you feel your child would benefit from therapy to help correct a tongue thrust, please feel free to contact us . We are here to help!

You may also like

Hand flapping in toddlers, auditory processing disorder—how pediatric speech therapy can offer a key to unlock this complex issue.

Privacy Policy