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What is Tongue Thrust and Why is it a Concern?

By March 8, 2022December 19th, 2023Kids Dentistry

As most parents know, a child’s early life — from birth to early childhood — is filled with milestones that track their developmental progress. The first time your little one holds up their own head, the first rollover… crawling and walking. And don’t forget the transition to eating solid food. When it comes to that last milestone, our little ones practice how to break down and swallow food safely… and it’s when the tongue thrust reflex comes in handy. 

In babies, tongue thrust is a natural reflex for pushing food away from their throat to avoid choking — like when they’re not ready to swallow because the food’s not chewed up enough, there’s too much of it, or, well, they just don’t like it (we’re talking about your prunes and kale)! Before that, babies also tongue thrust when they’re breastfeeding or bottle feeding: contrary to what many might think, a baby latches on and squeezes milk out with their tongue instead of sucking it. It’s a pretty powerful muscle. In fact it is widely considered the most powerful muscle in the body for its size.

What is Tongue Thrust?

That being said, baby tongue thrust is a normal and much-needed part of a child’s first months. But if tongue thrusting continues on into toddlerhood and early childhood, it takes on a not-so-helpful role and can lead to an orofacial myofunctional disorder (OMD). Something we’ve seen our fair share of at Kids Mile High pediatric dentistry.

What is orofacial myofunctional disorder, you ask? An orofacial myofunctional disorder is an abnormal lip, jaw, or tongue position when you’re at rest, swallowing, or talking. You might also see signs of an OMD when your child has been sucking their thumb, fingers, or pacifier for too long.

So what does tongue thrust look like past the baby stage? Typically, baby tongue thrust fully transitions to normal functioning by age 7 or 8. But if your child continues to push their tongue against or between the front teeth when they speak or swallow, this can become problematic. Crazy fact: constant tongue thrust against the front teeth can amount to up to four pounds of pressure! And if there isn’t enough resistance from the lips, your kiddo’s teeth and jaws can become misaligned. 

What Causes Tongue Thrust?

Tongue thrust that goes on past the baby stage is due to either prolonged baby habits or genetics. Causes for this kind of tongue thrust include: 

Thumb sucking into early childhood – thumb or finger sucking makes the tongue push forward, causing tongue thrust. 

Using certain kinds of pacifiers or bottles –  the shape of some pacifier or bottle nipples can encourage the tongue to push at the teeth. But tongue thrust can also become an issue if your child uses pacifiers, breastfeeds or bottle feeds for too long, no matter which kind or shape.

Bruxism (also called teeth grinding) – Does your child grind their teeth? Teeth grinding is known to happen along with tongue thrust in young children.

Allergies – If your child has allergies, nasal congestion or enlarged tonsils can make it harder for them to breathe. To open the airway and make it easier to mouth-breath, their tongue might lie lower in the mouth instead of resting against their palate.

Macroglossia – This is the fancy word for an enlarged tongue. It’s an inherited condition that typically is part of a genetic condition like diabetes or Downs syndrome.

Ankyloglossia (also known as tongue-tie) – Tongue tie is when the tip of your baby’s tongue is attached to the bottom of their mouth by a thick, short, or tight band of tissue. Tongue tie can affect how a baby feeds, and later how they eat, speak, or swallow. 

Signs of Tongue Thrust

Spotting the signs of tongue thrust in your school-aged child is fairly easy. Here are the most common signs of tongue thrust to watch out for:

  • Breathing through their mouth, even when they’re not experiencing allergies or nasal congestion
  • Inability to fully close their lips when their face is neutral — like when they’re not eating or talking
  • Having a gap between their top and bottom front teeth
  • Pronouncing certain sounds incorrectly, like lisping their “s” or “z” sounds
  • Sticking their tongue out between their teeth when their face is neutral.

We should mention that kids age 4 and under do have a naturally-flawed swallow pattern. So if your child hasn’t started elementary school yet but shows some of the above signs, it’s not 100% sure they have tongue thrust. But if your child is older it’s more likely. Either way, we suggest making an appointment with us at Kids Mile High, even just to build a habit of good oral health. Your Denver-area pediatric dentists can perform a professional examination and diagnosis, then together, we’ll move forward with options for how to fix your child’s tongue thrust if they have it.

Complications of Tongue Thrust

Like we mentioned earlier, tongue thrust can turn into an orofacial myofunctional disorder if not treated. Finger or thumb sucking on only one side of the mouth can lead to a crossbite. Mouth breathing can turn into an elongated face, that, in turn, can cause an overbite or open bite that affects their ability to eat or chew properly. Or if your little one is lisping, it’s common for other types of speech problems to also happen. And let’s not forget your child’s social-emotional life: complications from tongue thrust can lower a child’s self-confidence, cause them a lot of frustration, or affect their social behavior.

How to Fix Tongue Thrust

All that said, the million-dollar question is: how to stop tongue thrusting? Step one: start with a visit to Kids Mile High. As pediatric dentists, Dr. Paddy, Dr. Roger, or Dr. Meredith have the expertise in OMD issues to help your child. We’ll be able to pinpoint the reasons for your child’s tongue thrust, then lay out the options for tongue thrust therapy that will help your child with normal facial and dental development. 

The Myobrace System at Kids Mile High

The most preferred myofunctional therapy to fix tongue thrust is the Myobrace system. Designed for kids 5-15 years old, Myobrace is a series of habit-breaking appliances that stops tongue thrust in young children while also gently and naturally aligning teeth and jaws that have misaligned as a result. And if your child is a mouth breather? Myobrace encourages a more open airway to help your child breathe through their nose. It’s really a win for overall health because breathing easier can improve your little one’s asthma and allergies.

We combine Mybrace with myofunctional exercises called trainer activities — they’re like a workout for your kiddo’s mouth! Together, it’s a powerhouse, and sometimes lessens or even eliminates the need for orthodontic treatment in the future. And unlike traditional ways of teeth straightening, your kiddo’s teeth won’t relapse and migrate back to their original positions after treatment.

Myobrace is also super kid-friendly: treatment only lasts for 1-2 years, and your child has to wear their Myobrace appliance for only 1-2 hours a day and when sleeping. This means your kid might not have to wear this habit-breaking appliance at school or during activities — only at home. A bonus for a child that might feel a little self-conscious about their appliance. Kids take out their Myobrace appliance to brush and floss like normal, and wearing it at night means it’s a great solution for how to control tongue thrust when asleep and help with teeth grinding.

A Tongue Crib: A Habit-breaking Appliance for Thumb Sucking and Tongue Thrust

Sometimes your little one just needs some habit-breaking mechanisms to stop their thumb-sucking, pacifier use, or tongue thrust before it results in serious OMD. If so, some dentists and orthodontists might suggest a tongue crib as a habit-breaking appliance. A tongue crib is a metal device that’s fitted to the top front of your kid’s mouth. It looks like a metal grate that blocks off the front part of the mouth behind the front teeth, making it impossible for your child to achieve suction if they put their fingers or a pacifier in their mouth and try to suck. A tongue crib is also helpful for how to fix tongue thrust because it can encourage the tongue to rest away from the top teeth.

A tongue crib is either fixed or removable. The choice depends on if your child can remember to wear it regularly and not lose it. Tongue crib therapy lasts for a few months up to a year, depending on how long it takes your child to stop their thumb sucking or tongue thrusting habit.

Other Habit-Breaking Appliances

There are also a few other habit-breaking appliances like a tongue crib that help stop tongue thrust or thumbsucking like:

  • a tongue trainer
  • a tongue rake
  • Hawley’s appliance
  • a tongue screen
  • a rolling tongue-sucking appliance

Again, these tools are meant as habit-breaking appliances, not for correcting orofacial myofunctional disorders of the jaw, teeth, face or lips. This would need separate myofunctional therapy like braces or Invisalign®.

Your Myofunctional Therapy Support Team

Many hands make light work. This is especially true for helping your little one with tongue thrust. Your child’s tongue thrust therapy might involve not only us at Kids Mile High, but several professionals, from an orthodontist, your pediatrician, family doctor, an ENT specialist, to a speech therapist. Like if tongue-tie is an issue, your pediatrician can ensure this is corrected with a frenulotomy — a simple surgical procedure that allows the tongue to move more freely. Or if your child has speech issues or swallowing problems because of tongue thrust, a speech therapist can work with your kid to correct these.

Your Kids Mile High Team to the Rescue

We at Kids Mile High want the best for your child’s oral health, just like you do! So if you’re seeing signs of tongue thrust, we want to help! Contact us today to make an appointment at our Englewood, Central Park, or Thornton office. We’re all about making a trip to the dentist fun and relaxed — for the kids and you!

Dr. Paddy

Author Dr. Paddy

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