Did you know that 20 to 80 percent of orthodontic patients throughout the U.S. present with some form of tongue thrust? Do you know what tongue thrusting is? Babies are born with this natural “extrusion reflex” for survival. When their lips are touched, they extend their tongue expecting the breast or bottle. Within the first few months this reflex begins to fade, but sometimes not. In today’s blog, your Lake Forest Dentist, Dr. Fondriest discusses the issue of tongue thrusting.
When you need specialized dental care in the greater Chicago area, consider Dr. James Fondriest. For years, Dr. Fondriest has served not just the Lake Forest community but patients from across the United States. His experience and skill have led him to become a leader in his field of esthetic restorative dentistry and prosthodontics. Dr. Fondriest commits to continuing training and advancement to offer the best care with the latest techniques and materials. If you’re needing a second opinion on a dental diagnosis, contact our practice at 847.234.0517.
A Rose by Any Other Name
The phrase “tongue thrusting” apparently was coined around 1958, and is also referred to as anterior tongue position, anterior resting tongue position, reverse swallow, infantile swallow, and reverse infantile swallow. Babies are born with it, hence the name infantile swallow, but usually grow out of it by the age of four. An involuntary action that may become stronger and more frequent if it doesn’t fade by age four, the tongue thrusting motion can damage to your teeth and cause a misaligned bite.
The Tongue Thrust: What does it mean?
During the swallowing process the tongue normally remains seated against the roof of your mouth while the muscles in the back of your tongue help push food down your throat. For those with a reverse tongue thrust, the tongue is “thrust” forward when swallowing pressing against the front teeth. The tongue exerts four pounds of pressure against the teeth each time you swallow. Because you swallow 2,000 times a day, this repeated pressure can force teeth out of alignment resulting in “buck teeth,” crooked teeth, or a misaligned bite. Unless a patients tongue thrusting condition is diagnosed and corrected, orthodontic treatment is often unsuccessful. A mature bite is a requirement for orthodontic treatment to remain successful long term.
Types of Tongue Thrusts
There are various types of tongue thrusts including:
- Anterior open bite: An anterior open bite is the most common type of tongue thrust. With an anterior open bite the lips do not close naturally, and the tongue will protrude out from between them. A large tongue is often noticeable in cases such as these.
- Anterior thrust: With an anterior thrust the upper front teeth are extremely protruded while the lower incisors are pulled in by the lower lip. The patient with an anterior thrust more often than not possesses strong chin muscles (mentalis).
- Unilateral thrust: With a unilateral thrust, the patient’s bite is open on either side. An open bite is when the upper and lower teeth protrude outwards and do not touch when the mouth is in a closed position.
- Bilateral thrust: The bilateral thrust is the most difficult to correct. With the bilateral thrust the anterior bite (front teeth) is closed, but the back teeth from the first bicuspid to the back molars are often open on both sides.
- Bilateral anterior open bite: With the bilateral anterior open bite, the only teeth that touch are the molars. The bite is completely open on both sides including the front teeth. A large tongue is often noticeable in such cases.
- Closed bite thrust: A closed bite thrust often includes a double protrusion. In such cases, both the upper and the lower teeth protrude. They flare out and are spaced apart.
Treatment for Tongue Thrusting
Statistics indicate that 67 to 95 percent of school-aged children between 5 and 8 present with some type of tongue thrust. In order to help these children develop a mature swallow, therapeutic intervention is often required. While statistics indicate that 70 percent of treatments are successful, 25 percent fail due to lack of cooperation and/or lack of commitment on the part of the patient, the patient’s parents, or both. It has been found that 5 percent of tongue thrust cases cannot be corrected due to specific insurmountable factors.
One type of therapy includes a simple swallowing exercise to retrain the tongue during the act of swallowing. To perform the activity, patients complete the following set of steps:
- First, patients should put a small orthodontic rubber band on the tip of the tongue.
- While balancing the rubber band, patients then stick the tip of the tongue against gum tissue directly above the back of their front incisors.
- Then, patients should bite down, bringing the top and bottom teeth together as in a regular bite. Biting “forward” should be avoided – this may seem the most natural bite at the beginning of therapy, however.
- While keeping the lips apart and open, patients should then swallow. Care should be taken to avoid letting the lips close or the teeth coming apart from their bite.
Once a tongue thrusting behavior has been treated, patients may require orthodontic treatment such as traditional braces, Invisalign®, or other solutions to improve misaligned teeth or to correct a malocclusion such as an open bite or overbite. In rare cases, oral surgery may be needed to correct extreme malocclusion issues in older children or adults.
About Your Lake Forest Dentist
Aside from providing dependable family, general, and restorative dentistry services to our community, Dr. James Fondriest also holds respected academic appointments at the Pankey Institute in Key Biscayne, FL, and the Spear Institute in Scottsdale, AZ, and he is an adjunct Assistant Professor in the Department of Prosthodontics at the University of Florida Dental School. At Lake Forest Dental Arts, Dr. Fondriest combines his impressive array of experience with modern technology and caring, compassionate, knowledgeable staff, and we proudly serve patients from all surrounding communities. To schedule a consultation, or another appointment, call our office today at (847) 234-0517. You can also email us at [email protected].