What is tongue thrust?

Tongue thrust is the negative oral habit of pushing your tongue forward between the upper and lower teeth when you swallow. The proper positioning for the tongue is for the tip to push against the gum above the back of your upper front teeth.  Tongue thrust is also called “reverse swallow” or “immature swallow” and is one of the most common Orofacial Myofunctional Disorder (OMD).

Tongue Thrust Video

Tongue Thrust Causes

Some of the causes of tongue thrust include:


macroglassia (i.e. enlarged tongue)

thumb sucking

lip biting

nail biting

clenching or grinding

large tonsils

heredity

ankyloglossia (tongue tie)

use of artificial nipples used in feeding infants

allergies or nasal infections

structural issues

Thumb sucking is one of the causes of tongue thrust

Tongue thrust signs and symptoms

Common signs and symptoms of tongue thrust include:

  • The tongue is visible between the teeth or tongue protrusion. The tip of the tongue sticks out between the teeth, whether the child is resting, swallowing, or speaking.
  • Mouth breathing
  • Inability to close the lips completely
  • Open bite (see image below)
  • Slow, fast, or messy eating
  • Speech impediment
  • Teeth are pushed out
An image of a misaligned bite due to tongue thrust

Tongue Thrust Consequences

Untreated tongue thrust may cause all sorts of problems into adulthood if not treated:

  • Adults with tongue thrusts often suffer from dental malformations, such as a misaligned bite.
  • Breathing issues such as sleep apnea commonly become linked to adult cases of untreated tongue thrusts.
  • Speech impediments also are quite common.

When to seek help for tongue thrust?

Tongue thrust is not always visible. If you are able to safely eat a variety of foods, swallow pills, and don’t have any dental problems, then you probably don’t need tongue thrust therapy.

However, if you are seeking orthodontic treatment and your orthodontist discovers a tongue thrust, it is imperative that you receive treatment to prevent orthodontic relapse in the future. Braces are expensive and nobody wants to pay twice when relapse occurs due to a tongue thrust.

Additionally, if you are a messy eater, have difficulty swallowing pills or eating foods with different textures, tongue thrust may be factor.

Tongue thrust diagnosis

A number of different healthcare professionals can diagnose a tongue thrust, including:

  • general practitioners
  • pediatricians
  • speech language pathologists
  • dentists
  • orthodontists


A speech language pathologist especially one trained in myofunctional therapy will evaluate swallowing patterns by holding down the bottom lip to watch how you or your child swallows. Specifically, your therapist will want to see where the tongue is placed when swallowing. The therapist may have you chew and swallow different foods with different textures to get an overall picture of your myofunctional health.

Any professionals who can lend their expertise to the cause or symptoms of your child’s tongue thrust may become part of their treatment team.

Tongue thrust treatment

Myofunctional therapy and possibly speech therapy (if there are speech issues) can be provided for the treatment of tongue thrust. The goal of myofunctional therapy is to develop a normal oral resting position where the lips and teeth are closed, and the tongue tip rests against the ridge behind the upper front teeth. Myofunctional therapy is physical therapy for the muscles of the face and mouth which are painless and entail learning exercises that are relatively simple. Treatment usually consists of a regular program of exercises. Note treatment length may vary based on several factors (e.g. motivation of client, age of individual, severity of issue, etc.).

Other recommendations may be made depending on the outcome of a proper OMD evaluation.

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