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What is Tongue Thrust: 4 Different Classification Types

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Dr. Andreas

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Written by

Q.F. Nayibe Cubillos Morales

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Medically Reviewed by

Dr. Gustavo Assatourians D.D.S

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In this article, you will learn about tongue thrust or protrusion of the tongue. The tongue is an organ that performs multiple functions during chewing, breathing, swallowing, and speaking. The muscles that compose it are in constant use, which is why, although it is such a small organ compared to others, it is known to be the strongest in the human body.

Swallowing is the act by which food and saliva pass from the mouth to the stomach and is something done between 1,000 and 2,000 times a day. On some occasions, this process does not happen in the normal way when atypical swallowing appears.

 

What is Tongue Thrust?

This is an oral habit, in which the tongue exerts constant pressure on the front teeth when speaking, swallowing food, or passing saliva. It puts pressure on the sides of the mouth, affecting the teeth furthest back.

The thrust of the tongue can be divided into 2 stages:

1. Tongue thrust in babies (up to 6 months of age)

In babies, before the first teeth appear, a normal type of swallowing is observed: babies place their tongues on their gums to swallow, and since there are no teeth, it poses no problem.

2. Tongue thrust in children and adults

Since the first teeth emerge, it is normal that during the swallowing process, the tongue touches the palate and then descends to promote the passage of the food bolus toward the pharynx.

When the child grows up and the habit of tongue protrusion persists, it can cause multiple effects on the normal development of occlusion, speech, and breathing. Tongue thrusting, a habit where the tongue pushes against the front teeth during swallowing, can have a significant impact on dental health. This repetitive pressure on the teeth over time can result in misalignment or crooked teeth.

 

How is the Habit of Pushing the Tongue Classified?

The tongue thrust can be classified into 6 groups and depending upon the habit’s level of severity, it can also cause various dental anomalies:

close-up-picture-of-tongue-thrust

 Type I or non-deforming tongue thrust: The habit does not cause damage or considerable changes in the mouth.

 Type II or anterior deforming tongue thrust: The habit causes anterior open bite, protrusion of the anterior teeth, or crossbite posterior.

 Type III or lateral deforming tongue thrust: The habit causes posterior open bite, posterior crossbite, or a deep overbite.

 Type IV or anterior and lateral deforming tongue thrust: The habit causes anterior and posterior open bite, protrusion of the anterior teeth, and posterior crossbite.

 

What are the Signs of Tongue Thrust?

In addition to dental abnormalities, this habit can cause:

Deep palate

Speech problems: orofacial myofunctional disorders (OMDs)

Problems chewing

Open lips and incorrect position of the tongue when at rest

 

Why does this Habit Occur? What Causes it? 

kid using a pacifier

Tongue thrust can be caused by several factors:

Sucking habits

The finger

The bottle or pacifier after the age of 4 or 5 years

Anatomical conditions in the mouth

Tractioning tongue-tie or ankyloglossia

Large tonsils

Narrow palate

Very large tongue

Environmental factors

Allergies

Congestion and difficulty breathing through the nose

 

What is the Treatment for Tongue Thrust? 

Treatment in both children and adults is very similar. Initially, it will focus on eliminating the cause of the tongue protrusion; after that, the habit will be corrected, and finally, any dental problems that arose from the tongue thrust will be fixed.

kid is practicing speech and breath therapy exercises

Depending upon the severity of the habit, it could require one or more of the following procedures:

1. Interconsultation with several professionals: Dentist (a specialist in orthodontics and/or pediatric dentistry), physician, otolaryngologist, and speech therapist.

2. Speech and breathing therapy

3. Control of basic diseases

4. Orthopedics: Appliances to correct the habits that caused the tongue thrust.

Appliances to eliminate the habit of tongue protrusion.

5. Orthodontics: Addresses the anterior and posterior open bite, crossbite, and deep overbite, as well as the position and inclination of the teeth, while also incorporating early orthodontic treatment.

Treatments for tongue protrusion are highly effective. Their success will depend to a large extent upon the level of commitment of the patient and their parents or guardians.

The ideal process is to detect the tongue thrust habit as soon as possible.

This problem can be diagnosed from a very early age; therefore, it is necessary for parents to get into the habit of taking their children to dental appointments from the moment their first teeth appear in order to detect and treat this and any other problems that may occur.

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References

1. American speech-language-hearing association. Orofacial Myofunctional Disorders. (Consulted December 29, 2022). Available in: https://www.asha.org/public/speech/disorders/orofacial-myofunctional-disorders/

2. Dan Brennan, MD. What is a tongue crib? WebMD. Reviewed: June 14, 2021 (Consulted December 29, 2022). Available in: https://www.webmd.com/children/what-is-a-tongue-crib

3. Gowri sankar, Singaraju & Chetan, kumar. (2009). Tongue Thrust Habit – A Review. Annals and Essences of Dentistry. Available in: https://www.researchgate.net/publication/45643793_Tongue_Thrust_Habit_-_A_Review

4. Tongue Thrust in Children and Adults: What You Should Know. Reviewed: March 24, 2020 (Consulted December 28, 2022). Available in: https://www.healthline.com/health/tongue-thrust

5. Mendes, AE, Nascimento, L., Mansur, LL, Callegaro, D., & Jacob Filho, W. (2015). Tongue forces and handgrip strength in normal individuals: association with swallowing. Clinics (Sao Paulo, Brazil), 70(1), 41–45. Available in: https://doi.org/10.6061/clinics/2015(01)08

6. Shah, SS, Nankar, MY, Bendgude, VD, and Shetty, BR (2021). Orofacial Myofunctional Therapy in Tongue Thrust Habit: A Narrative Review. International journal of clinical pediatric dentistry, 14(2), 298–303. Available in: https://doi.org/10.5005/jp-journals-10005-1926

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