tonguethrust

Tonguethrust, commonly referred to as tongue thrust or anterior tongue thrust, is a term used in dentistry and speech-language pathology to describe a pattern of tongue placement and swallowing in which the tongue pushes forward against the teeth during swallowing, speech, and at rest. It is considered a functional pattern rather than a disease and can influence dental and facial development if persistent.

Causes and associations include habits and factors such as prolonged pacifier use, finger or thumb sucking, mouth breathing often due to nasal obstruction, or enlarged tonsils or adenoids. In some cases, tongue thrust arises as part of a broader orofacial myofunctional pattern, and it may be associated with airway or development issues. It can occur in children and may persist into adolescence or adulthood if not addressed.

Clinical features commonly observed by clinicians include a forward positioning of the tongue during swallowing, a resting tongue posture that sits between or against the teeth, and dental changes such as spacing (diastemas) or an open bite. Speech problems, such as lisping, can accompany persistent tongue thrust.

Diagnosis is typically made through clinical observation by a dentist or speech-language pathologist, sometimes supplemented by dental imaging or evaluation of the swallowing pattern. An assessment may also consider airway health and orofacial muscle function.

Treatment focuses on retraining tongue posture and swallowing patterns, often through orofacial myofunctional therapy. Orthodontic or dental interventions may be used to correct bite issues, and appliances like tongue cribs can discourage thrusting in some cases. Addressing underlying airway problems and eliminating contributing habits are also important components. Prognosis is generally favorable with therapy, though untreated tongue thrust can contribute to ongoing malocclusion.