Understanding Tongue Thrusts

Understanding Tongue Thrusts

If you’ve seen someone push their tongue forward when swallowing or speaking, you may be observing a tongue thrust. Though it might appear harmless, this habit can impact oral health, speech, and facial development.

What Is a Tongue Thrust?

A tongue thrust, also called a reverse swallow or orofacial muscular imbalance, is when the tongue pushes against or between the front teeth during swallowing, speaking, or at rest. Ideally, the tongue should press against the roof of the mouth, behind the front teeth. Tongue thrusting is normal in infants but should resolve by age four to six. If it continues beyond that, it can become problematic.

What Causes Tongue Thrust?

Common causes include:

• Prolonged thumb sucking or pacifier use
  
  
• Tongue-tie (ankyloglossia), limiting tongue mobility
  
  
• Chronic nasal congestion or allergies, leading to mouth breathing
  
  
• Enlarged tonsils or adenoids
  
  
• Neurological or developmental delays
  
  
• Learned behaviors without a clear cause
  
  

In cases with enlarged tonsils or adenoids, pushing the tongue forward can help open the airway by creating space behind the tongue and soft palate. This compensatory motion may:

• Pull the tongue base away from the back of the throat
  
  
• Temporarily improve airflow during swallowing or rest
  
  

However, this adaptation is not ideal long-term. It often signals airway obstruction and can lead to:

• Malocclusion (misaligned teeth)
  
  
• Poor tongue posture
  
  
• Inefficient swallowing
  
  
• Ongoing airway issues
  
  

Why Is Tongue Thrust a Concern?

If untreated, it can contribute to:

• Misaligned teeth (open bite, overjet)
  
  
• Speech difficulties (especially /s/, /z/, /sh/, /ch/)
  
  
• Swallowing problems
  
  
• Changes in facial growth, like a long face or protruding teeth
  
  

Orthodontic treatment alone may not correct these problems if the tongue thrust pattern remains.

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How Is It Treated?

Treatment depends on the cause and may include:

• Myofunctional therapy to retrain the tongue and facial muscles
  
  
• Speech therapy for articulation concerns
  
  
• Surgery for tongue-tie or enlarged tonsils
  
  

A proper evaluation by a speech-language pathologist or myofunctional therapist is often the first step.

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Final Thoughts

While a tongue thrust may seem minor, it can have lasting effects. The good news is that it's treatable with early detection and the right intervention. If you or your child shows signs, we’re here to help guide you to the right care.