Tongue thrust — also called an orofacial myofunctional disorder (OMD) — is more common than most people realize. It affects both children and adults and can have a significant impact on dental alignment, speech clarity, and facial development.
What Is Tongue Thrust?
Tongue thrust occurs when the tongue pushes forward against or between the front teeth during swallowing, speaking, or at rest. In a normal swallow pattern, the tongue presses upward against the roof of the mouth (the palate). With tongue thrust, the tongue pushes forward instead.
The average person swallows 500–1,000 times per day. If the tongue is pushing against the teeth with each swallow, that creates significant forward pressure — often 1–6 pounds per swallow — which can gradually push teeth out of alignment.
Signs of Tongue Thrust
In Children
- Tongue visibly presses against or between the teeth when swallowing
- Open mouth posture at rest (lips apart, tongue visible)
- An open bite — the front teeth don't meet when the back teeth are together
- Speech sounds affected: commonly /s/, /z/, /t/, /d/, /n/, /l/ (may sound "lisped")
- Messy eating or difficulty with certain food textures
- Mouth breathing
In Adults
- Teeth shifting after orthodontic treatment (relapse)
- Persistent lisp or fronted speech sounds
- TMJ pain or jaw tension
- Open bite or gap between front teeth
- Visible tongue push during swallowing
What Causes Tongue Thrust?
Several factors can contribute to tongue thrust:
- Prolonged bottle feeding or pacifier use — can establish a forward tongue pattern
- Thumb or finger sucking — maintains a forward tongue posture
- Mouth breathing — when the mouth is open, the tongue drops to the floor of the mouth instead of resting on the palate
- Enlarged tonsils or adenoids — can block the airway and promote mouth breathing
- Tongue tie (ankyloglossia) — a restricted lingual frenulum can limit the tongue's ability to reach the palate
- Allergies or chronic nasal congestion — forces mouth breathing, which promotes tongue thrust
The Domino Effect
Tongue thrust rarely exists in isolation. It often occurs alongside other orofacial myofunctional disorders:
Tongue thrust → mouth breathing → low tongue posture → narrow palate → crowded teeth → orthodontic treatment → relapse (if tongue thrust isn't addressed)
This is why treating the tongue thrust itself — not just the dental symptoms — is essential for lasting results.
How Myofunctional Therapy Treats Tongue Thrust
Myofunctional therapy is the gold standard for treating tongue thrust. The therapy program typically addresses:
- Tongue resting posture — training the tongue to rest on the palate with the tip just behind the upper front teeth
- Correct swallowing pattern — retraining the swallow so the tongue pushes up against the palate instead of forward against the teeth
- Lip seal — strengthening the lip muscles to maintain a closed-lip posture at rest
- Nasal breathing — establishing nose breathing as the default
- Habit elimination — addressing any thumb sucking, pacifier use, or other contributing habits
Treatment typically involves:
- Weekly sessions for 6–12 months
- Daily home exercises (10–15 minutes)
- Gradual progression from conscious practice to automatic, habitual patterns
When to Seek Treatment
The ideal time to address tongue thrust depends on the situation:
- Children age 7+ are generally old enough to understand and participate in the exercises
- Before orthodontic treatment — correcting the tongue thrust first creates a better foundation for orthodontic success
- During orthodontic treatment — working in coordination with the orthodontist
- After orthodontic treatment — if teeth are starting to shift back, addressing tongue thrust can help prevent further relapse
- Adults — it's never too late; adults can successfully retrain these patterns
"Many parents come to me after their child's orthodontist has noticed a tongue thrust. The great news is that myofunctional therapy is highly effective at correcting these patterns, and it can make a real difference in orthodontic outcomes." — Laura Friedman, MS, CCC-SLP, QOM
Ready to Take the Next Step?
If you or your child is showing signs of tongue thrust, early treatment can prevent dental and speech complications. Schedule a consultation to learn how myofunctional therapy can help.