Tongue thrust (also called "reverse" or "immature" swallow) is the common name given to orofacial muscular imbalance, a human behavioral pattern in which the tongue protrudes through the anterior incisors during swallowing, speech and while the tongue is at rest. Nearly all young children exhibit a swallowing pattern involving tongue protrusion, but by the age of 6 most have automatically switched to a normal swallowing pattern. A person swallows a total of 1,200 to 2,000 times every 24 hours with about four pounds of pressure per swallow.
If a person suffers from tongue thrusting, constant pressure of the tongue will force the teeth out of alignment. Statistics have shown that if the tongue thrust swallowing pattern is retained, it may be strengthened beyond the age of four. In all probability, the child will need some type of training program to develop the mature swallowing pattern. Tongue thrusting can have extreme negative effects on your teeth and mouth. Many people who tongue thrust have openbites. People who tongue thrust do it naturally and are usually unaware that they are even doing it. Therefore, people who tongue thrust should seek treatment to break their habit immediately before more damage to the mouth is done. The force of the tongue against the teeth is an important factor in contributing to malformation ("bad bites").
Many orthodontists have had the discouraging experience of completing dental treatment, with what appeared to be good results, only to discover that the case had relapsed because the patient had a tongue thrust swallowing pattern. If the tongue is allowed to continue its pushing action against the teeth, it will continue to push the teeth forward and reverse the orthodontic work. Speech is not frequently affected by the tongue thrust swallowing pattern. The "S" sound (lisping) is the one most affected. The lateral lisp (air forced on the side of the tongue rather than forward) shows dramatic improvement when the tongue thrust is also corrected. However, one problem is not always associated with the other. Although no one factor is to blame, several possible factors (some developmental) can contribute to tongue thrusting. Certain types of artificial nipples used in feeding infants, thumb sucking, allergies or nasal congestion causing the tongue to lie low in the mouth due to breathing obstruction, large tonsils, hereditary factors or ankyloglossia (tongue tie) can lead to tongue thrusting.
Generally, there are two methods of treatment (myofunctional therapy) for tongue thrusting. An appliance may be fashioned by your dentist that prevents the tongue from thrusting forward. This appliance is usually bonded to the teeth, and after retraining the tongue, will be removed within 4-12 months. The other method requires oral habit training by the patient, an exercise technique that re-educates the muscles associated with swallowing by changing the swallowing pattern. This method must be taught by a trained speech therapist.
Infants may use pacifier or thumb or fingers to soothe themselves.Thumb sucking can start as early as 15 weeks of growth in the uterus or within months of being born. Prior to 12 weeks, the fetus has webbed digits. Most thumb-suckers stop gradually by the time they are five years old. Most children stop sucking on thumbs, pacifiers or other objects on their own between two and four years of age. No harm is done to their teeth or jaws until permanent teeth start to erupt. The only time it might cause concern is if it goes on beyond 6 to 8 years of age. At this time, it may affect the shape of the oral cavity or dentition. Praise children for not sucking, instead of scolding them when they do. If a child is sucking their thumb when feeling insecure or needing comfort, focus instead on correcting the cause of the anxiety and provide comfort to your child. If a child is sucking on their thumb because of boredom, try getting a child's attention with a fun activity. Involve older children in the selection of a means to cease thumb sucking.
The pediatric dentist can offer encouragement to a child and explain what could happen to their teeth if they do not stop sucking. Only if these tips are ineffective, remind the child of their habit by bandaging the thumb or putting a sock/glove on the hand at night. Your dentist may wish to place a bonded appliance to the teeth to prevent the child from obtaining suction, and thus make the habit less pleasurable.