Tongue Thrust Disorder by Leela Rao
What is Tongue Thrusting?
“Tongue thrusting,” also known as the immature or reverse swallow, is formally known as Orofacial Myofunctional Disorder (OMD). It is characterized by the inaccurate placement of the tongue in a child older than the age of five during speech or swallowing.
There are various types of bites that are characteristic of tongue thrusters:
Anterior Open Bite: child often has his or her mouth open with the tongue protruding beyond the lips.
Anterior Thrust: child has extremely prominent upper incisors and lower incisors that are pulled in by the lower lip.
Unilateral thrust: child has a bite that is open on both sides
Bilateral thrust: child has a bite that is closed in the front but is open on both sides toward the back.
Bilateral open bite: child has a bite which is completely open except for the molars, which are the only teeth that touch.
Closed bite thrust: child has a bite in which both the upper and lower teeth are spread apart.
In a mature swallow, the tongue is placed on the alveolar ridge (the gums behind the front teeth) and moves food backwards with a rolling motion. In an abnormal swallow indicative of tongue thrusting, however, the sides of the tongue push against the front teeth while the front of the tongue pushes upward. This movement causes the tip of the tongue to thrust forward, propelling the food backward into the throat.
What are some signs of tongue thrusting?
Tongue thrusting is normal in children under the age of six. However, with time this habit should disappear. If your child is over the age of five, odd swallowing habits may be indicative of tongue thrusting.
Additionally, if your child continuously breathes through his or her mouth or places the tongue between their teeth or out of their mouth while at rest, OMD may be present.
What is it caused by?
Oftentimes tongue thrusting is caused by forces that make breathing through the nose difficult, such as the presence of allergies or enlarged tonsils or adenoids. Also, excessive thumb or finger sucking, lip or finger biting, and teeth grinding has also been found to be correlated with tongue thrusting. And, as with most behaviors, family heredity has also been seen as a major factor in the presence of tongue thrusting.
What are the effects of tongue thrusting?
At times, tongue thrusting may result in the incorrect pronunciation of various sounds such as: /s/, /t/, /z/, /d/, /n/, /l/, and /sh/. For example, if your child has an issue with tongue thrusting, he or she may pronounce the word “thumb” as “some” or some other deviant of the word.
Another effect of tongue thrusting may include a frontal lisp caused by an overbite or spaces between the front teeth, both of which are results of constant tongue pressure on the front teeth.
What should you do if you suspect your child has OMD?
If your child is a mouth breather, try to find the cause behind this habit (allergies, enlarged tonsils or adenoids, etc.) and address it first. If your child is under the age of five, give the problem some more time to self-correct.
However, if the tongue thrusting behavior persists and you cannot find a base problem for the mouth breathing, see a certified and licensed Speech Language Pathologist (SLP) and an orthodontist to get the issue properly diagnosed and treated, if present.
Tongue Thrust and Treatment of Subsequent Articulation Disorders