Tongue Thrusts and Thumb Sucking

What Is A Tongue Thrust?

A tongue thrust is an abnormal placement of the tongue or a deviant swallowing pattern that causes the tongue to push against or between the teeth. Other facial muscles also function incorrectly during a tongue thrust.

Infants utilize tongue thrust actions for feeding purposes. However, by the time a child reaches the stage of mixed dentition (both permanent and baby teeth), tongue thrust actions should disappear.

What Are the Results of A Tongue Thrust?

Abnormal placement of the tongue or an incorrect swallowing pattern can result in malocclusion of the teeth. Therapy can help to retrain the muscles involved in swallowing and aid in correcting resting posture of the tongue and lips and in creating and maintaining a h ealthy oral environment. Because the orthodontic process can be hindered by the tongue thrust action, we recommend that our patients who need braces seek an evaluation when we feel it is appropriate.

What Can Be Done To Help?

An intense myofunctional therapy program may be recommended to eliminate tongue thrust behaviors, improve tongue and lip resting posture, and alleviate related oral habits (thumb sucking, etc.). A professional who specializes in this area usually carries out the program. In less severe instances these therapy sessions will be held in our office.

Tongue Retraining

Various “reminders” can be used to help re-train the tongue.

1. A “basket” or “crib” can be placed behind the upper front teeth to catch the tongue before it can be placed between the teeth.

2. Little metal spurs can be placed behind the lower front teeth to restrain the tongue before it p asses over the lower front teeth.These types of reminders can be quite irritating for several days after placement. Please be assured that everything will become comfortable within a few days. You may use any form of non-prescription pain reliever that you would normally use during this period.

3. A very simple type of reminder may be used in a retainer type of device. A “bump” or “hole” can be placed in the plastic behind the upper front teeth. This form of reminder is not uncomfortable at all, but may be necessary on a long-term basis.

4. A sugarless lifesaver can be placed on the roof of the mouth behind the upper front teeth. The tip of the tongue is then placed in the “hole” of the lifesaver while swallowing. This can be done at various times throughout the day when speech is not necessary.

Thumb and Finger Sucking

We all know that thumb sucking can cause very serious dental and orthodontic problems. If this habit is stopped at an early age (two to three years), in most cases no long-term ill effects are likely. However, if continued beyond this age, permanent changes will usually occur. If thumb sucking is discontinued, orthodontic treatment alone is almost always successful in a child who is still growing. Even orthodontics, however, cannot overcome the continued effects of this habit.

There are various ways to overcome this problem. We have had a high degree of success in assisting our patients in solving this problem.

Mouth Breathing

(Due to allergies, nasal obstruction, enlarged adenoids, etc.)

We place great emphasis on the airway. The way a child breathes can definitely affect the development of the jaws. Normal breathing occurs with the lips together, inhaling through the nose. Narrow nasal openings are a sign that breathing is occurring mainly through the mouth. Another sign of mouth breathing is red, swollen gums. There are several causes of mouth breathing:

1. Enlarged adenoids

2. Allergies that can cause nasal blockage

3. Under-developed nasal passages

4. Malocclusions (bad bites) that are characterized by the upper teeth and jaws being so far forward that the lips cannot easily close

5. Deviated nasal septum

6. Enlarged nasal turbinates

These conditions cause the lower jaw to grow downward, which then causes an “open bite.” This condition is exhibited when the front teeth do not meet.

How can you tell when there is an airway problem? Below is a list of symptoms and signs.

1. Chronic open mouth position

2. Gummy smile

3. Swollen gums

4. Chronic dark circles under the eyes

5. A crease on the nose (about 1/3 of the way up from the tip)

6. “Pouting” lower lip

7. Short upper lip

8. Narrow “V” shaped upper jaw

9. Upper teeth in “bucked” position

10. Chronic chapped or cracked lips

11. Excessive snoring

Since ninety percent of growth is accomplished by age twelve, it is important to begin treatment very early. Typical treatment in our office includes a combination of expanders and braces.