Tongue Thrust in Children and Adults: Symptoms and Treatment

20 Mar 2024, by

Dr. Lusine Badalian

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Tongue thrust is a condition characterized by the tongue's forward position during swallowing, speaking, or resting, potentially leading to speech difficulties and dental misalignments. This condition can originate from natural infant reflexes but may require intervention if it persists. It affects both children and adults, with varying causes such as prolonged use of pacifiers in babies and structural issues in adults. Effective management involves exercises, professional therapies, and possibly orthodontic appliances, highlighting the importance of early detection for successful treatment.

tongue thrust

What is Tongue Thrust?

Tongue thrust, often referred to in the realm of oral health, is a condition that catches the attention of both parents and adults alike. But what is tongue thrust? Simply put, it's when the tongue presses too far forward in the mouth, notably during swallowing, speaking, or even when at rest. This action can push against or slip between the teeth, disrupting the natural harmony of the mouth's landscape.

Interestingly, the tongue thrust reflex is a natural occurrence in infants. It's a built-in mechanism that aids babies in breastfeeding, acting as a safeguard against choking. During early infancy, this reflex plays a pivotal role in feeding. However, as a child grows, this reflex should diminish, paving the way for mature swallowing patterns to develop.

Causes and Symptoms of Tongue Thrust

In Babies

When observing baby tongue thrust, it's crucial to recognize that it's a normal part of infant development. This reflex is not only natural but necessary for feeding efficiently. Despite its importance in infancy, if the tongue thrust persists beyond the baby stage, it may hint at underlying issues needing attention. According to Healthline, in children, tongue thrust is apparent when there’s too much forward movement of the tongue during swallowing and speaking, indicating it's time to evaluate the situation further. The causes in infants and young children can range widely, including:

  • Extended use of bottles or pacifiers beyond the age of 3 to 4 years, potentially reinforcing the tongue's forward positioning.
  • Allergies that lead to nasal congestion, prompting the child to adopt mouth breathing, inadvertently affecting tongue position.
  • Habits such as prolonged thumb sucking, which may encourage the tongue to maintain its thrusting position.


If you're noticing persistent tongue thrusting in your child, consider using the Child Symptom Checker as a preliminary step to understanding whether these symptoms might need professional attention. Remember, while this tool offers insights, consulting with a healthcare professional is essential for a comprehensive evaluation and guidance.

In Adults

The persistence or development of tongue thrust in adulthood might come as a surprise to many. Signs of tongue thrust in adults can manifest subtly, often overlooked until oral health issues arise. Several factors can contribute to its presence in adults, including:

  • Untreated tongue thrust from childhood, which seamlessly transitions into adult life.
  • Stress and certain habits, like pen chewing or nail-biting, which can encourage the tongue to press forward.
  • Structural issues, such as misalignment of teeth or jaw abnormalities, fostering an environment where tongue thrust finds its place.

 

For adults experiencing or suspecting they have tongue thrust, Symptom Checker for Adults can be a useful starting point to identify potential related symptoms

Impacts of Tongue Thrust

The effects of tongue thrust stretch beyond a mere inconvenience, influencing oral health, speech, and even the structure of the face—known as tongue thrust face. In children, the condition can lead to orthodontic problems like open bites or misaligned teeth, which, if unaddressed, may persist into adulthood. Adults might face challenges such as speech impediments, including lisping, and aesthetic concerns due to the altered facial structure.

The distinction between impacts on children and adults highlights the condition's evolving nature. While interventions in childhood can lead to significant improvements, addressing tongue thrust in adults often requires more comprehensive approaches, underscoring the importance of early detection and treatment.

Diagnosing Tongue Thrust

Identifying tongue thrust involves a keen eye and often the expertise of professionals across various disciplines. In both children and adults, the diagnosis starts with observing the telltale signs—such as difficulty swallowing, speech challenges, and the tongue's position when at rest or during speech. However, the process goes beyond mere observation.

Professionals like pediatricians, dentists, orthodontists, and speech-language pathologists play crucial roles in diagnosing the condition. An interdisciplinary approach ensures a comprehensive evaluation, considering not just the oral aspect but also potential underlying causes like allergies, habits, or structural anomalies. For example, a speech-language pathologist may assess the impact on speech, while an orthodontist examines the alignment of teeth and jaw.

Treating Tongue Thrust

Effective treatment for tongue thrust varies depending on the individual's age, the severity of the condition, and the underlying causes. A tailored approach, often involving a combination of exercises, professional therapies, and sometimes appliances, offers the best chance for improvement. Here's a deeper dive into the treatment options:

Exercises for Tongue Thrust

Tongue thrust exercises aim to reinforce the proper positioning of the tongue and strengthen the muscles involved in swallowing. These exercises are beneficial for both children and adults:

  • Spot Push: Ask the individual to press the tip of their tongue against a specific spot on the palate just behind the upper front teeth. Hold for a few seconds. This exercise helps train the tongue to rest in the correct position.
  • The Glide: Starting with the tongue tip behind the upper front teeth, glide the tongue backwards towards the soft palate and then return to the starting position. This motion helps in strengthening the tongue's control.
  • Balloon Puff: Instruct the person to take a deep breath and puff their cheeks out with air, keeping their lips tightly closed. Then, press the puffed cheeks with fingers while resisting the pressure with the cheek muscles. This exercise can help in strengthening the facial muscles and promoting nasal breathing, which is often a challenge for tongue thrusters.


Consistency is key with these exercises, and they should be performed several times a day for the best results.

Professional Treatments

Professional treatments for tongue thrust may involve one or more of the following, depending on the individual case:

  • Myofunctional Therapy: This therapy focuses on "retraining" the facial muscles and the tongue, encouraging them to function correctly during swallowing and resting. A certified myofunctional therapist uses various techniques and exercises tailored to the individual's needs.
  • Orthodontic Appliances: For children, appliances such as the Tongue Habit Appliance can be beneficial. This device prevents the tongue from pushing against the teeth, helping to break the habit of tongue thrusting. In some cases, orthodontic treatment with braces or Invisalign may be recommended to correct the misalignments caused by tongue thrust. Adults can also benefit from orthodontic treatments if misalignment is a concern.
  • Speech Therapy: If tongue thrust has affected speech, working with a speech therapist can be crucial. They can offer specific exercises and techniques to improve speech clarity and correct lisping associated with tongue thrust.


The treatment process is often gradual, requiring patience and persistence. Engaging in regular follow-ups with healthcare providers ensures the treatment plan remains effective and adjusts as necessary to meet the individual's evolving needs.

It's important for individuals undergoing treatment for tongue thrust, especially parents guiding their children, to remember that progress takes time. Incorporating fun and encouragement into daily exercises can significantly enhance motivation and compliance, leading to better outcomes in managing and correcting tongue thrust.

Tips for Parents

Monitoring and managing baby tongue thrust can seem daunting, but parents play a pivotal role in early identification and intervention. Here are a few tips:

  • Be Observant: Watch for signs of tongue thrust during eating, speaking, and rest. Early detection is key.
  • Encourage Proper Habits: Discourage prolonged use of bottles and pacifiers beyond the recommended age to prevent habitual tongue thrusting.
  • Exercise Together: Engage in tongue thrust exercises with your child, making them a fun and routine part of your day.


If concerns persist, seeking professional advice is crucial. Early intervention by specialists can significantly reduce the impact of tongue thrust on a child's development, paving the way for healthier oral habits and speech patterns.

Summary

  • Tongue thrust is a condition where the tongue presses too far forward in the mouth, affecting swallowing, speech, and dental alignment.
  • It can stem from natural reflexes in infants, but if it persists, it may require attention and treatment.
  • Causes vary by age, with habits such as prolonged pacifier use in babies and structural issues in adults being common contributors.
  • The condition can lead to dental problems, speech impediments, and changes in facial structure if left unaddressed.
  • Treatment options include exercises to strengthen the muscles and promote proper tongue positioning, as well as professional interventions like orthodontic appliances and myofunctional therapy.
  • Early detection and intervention are crucial for effective management and correction of tongue thrust.

Frequently Asked Questions

What Is the Tongue Thrust Reflex?

The tongue thrust reflex is a natural response in babies, designed to aid in breastfeeding and prevent choking. It usually diminishes as the child grows and starts to develop more mature swallowing patterns.

How Does Baby Tongue Thrust Differ from Normal Infant Reflexes?

While baby tongue thrust is a normal reflex that assists in feeding during infancy, it becomes a concern if the habit persists beyond the expected age, potentially leading to speech and dental issues.

What Causes Baby Tongue Thrust to Persist?

Persistent baby tongue thrust can be caused by factors such as extended use of pacifiers or bottles, allergies leading to mouth breathing, or habits like thumb sucking that encourage the forward position of the tongue.

What Are the Signs of Tongue Thrust in Adults?

In adults, signs of tongue thrust may include difficulties in swallowing, lisping or other speech impediments, and dental issues like misaligned teeth or an open bite, indicating that the habit has carried over from childhood or developed due to other factors.

How Can Tongue Thrust Affect Your Face?

Tongue thrust can impact facial structure, often referred to as "tongue thrust face," by influencing jaw development and alignment. Persistent pressure against the teeth from improper tongue positioning can lead to an elongated face, open bite, and other dental or orthodontic issues.

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