ABNORMAL SWALLOW & TONGUE THRUST

Please note: this information is about kids. Not adult abnormal

swallowing habits.
Tongue (abnormal swallow) thrusting is the abnormal habit of placing
the tongue between the teeth before and during the act of swallowing.
During a normal swallow, the mid-tongue should be placed on the
roof of the mouth, not between the teeth. Placing the tongue between
the teeth pushes the teeth apart and out.
Tongue (abnormal swallow) thrust and abnormal facial muscle habits
are all part of a complex myo-functional environment which produce
many of the problems associated with orthodontics and braces.
Unless we successfully treat the myo-functional problems,
orthodontic treatment will be much more likely to fail.
Swallowing occurs 24 hours per day and about 2000 times per day.
During each swallow, the tongue can exert momentary pressures of 1
to 6 pounds on the surrounding structures of the mouth. This
pressure will push the teeth and bone forward or apart. An abnormal
swallow will move teeth into abnormal positions and cause growth
distortions of the face and teeth.
It is natural for infants to swallow with the tongue between the gums,
but a transition should be made about age seven where the tongue is
placed on the roof of the mouth and the teeth are in full contact
during the swallow. If the tongue is placed between the teeth during
the swallow like an infant, the muscles surrounding the teeth and lips
are used to gain suction rather than using the muscles of the throat.
Lip puckering and lip licking prior to a swallow are easy signs to look
for when a child is swallowing with the tongue between the teeth. The
result of the forward tongue position is an open bite where the teeth
do not touch. There is usually a protrusion of the upper front teeth
and constriction of the dental arches.
Lip biting or sucking can be a major factor in moving the front teeth.
The cracked and swollen lower lip is a prime indicator of a lip habit.
The majority of patients we treat for protrusion of the upper teeth
have a forward tongue positioning thrust! There is also a type of
thrust which is to the sides of the mouth (lateral thrust) and is almost
untreatable unless normal arch form is established early in treatment.

If the front teeth are brought back into alignment, but the thrust habit
is not broken, the teeth may be moved back out after treatment. So,
what can be done to stop this habit? Habit correction (myo-functional
therapy) by a speech therapist may be necessary if the exercises
which we recommend during treatment are not followed. Finding a
knowledgeable speech therapist is very difficult. They all know what
it is, but few know how to effectively treat it.
In situations where the habit is severe, a removable appliance may be
used to block the tongue away from the front teeth. Unfortunately,
some thrusters are never corrected due to lack of parental support or
lack of cooperation (or denial) on the part of the patient. In either
case, orthodontic treatment is sure to be negatively effected.
See the page on oral habits of compulsion for additional information
on related habits which adversely effect treatment.
Some of the nicest people we know have abnormal swallows...!

Who me? A thruster? No way! D-E-N-I-A-L....!

If you detect an open bite, where the front teeth don't touch, then the
child should be seen around age seven for a preliminary orthodontic
exam.
During a normal swallow: the tongue is on the roof of the mouth and
behind the front teeth. The front and back teeth touch during the
entire swallow and do not protrude. The tongue is not between the
teeth at any time during the swallow and the lips contact normally.
During an abnormal swallow: the tongue is between the front teeth,
the lower lip is licked prior to the swallow and the lower lip is usually
swollen, red, and cracked due to constant licking. There is pursing of
the lower lip and chin during the swallow. The abnormal swallow
pushes the upper teeth forward and keeps them apart in the front of
the mouth, causing an open bite.

The damage
done by the
tongue to the
skeletal
features and
teeth can be
seen in this xray which
shows the
back teeth in
full contact
while the front
teeth are
completely
wide apart and
forward. This
is an open bite
due to an
abnormal
swallowing
pattern.
Click the x-ray
to enlarge it.
Severe thumb
habit often
lead to an
abnormal
swallowing
pattern. The
distortions
caused by the
thumb or a
finger habit
will severely
distort the
teeth and bone
positions.
In the lower
photo, you can
see the
distortion
caused by the
thumb position
shown above.
This patient
has just had

the braces
placed to
move the teeth
back into
position
during a Phase
One treatment.

An abnormal swallowing pattern is associated with:

a retruded lower jaw
long narrow face with lack of development of the maxilla
flaccid muscles of the lips and neck
elongation of the nose and abnormal airway path
lips which do not touch without contracting the chin
muscles
abnormal muscle contraction during thrusting which
causes the face to prematurely wrinkle due to
hyperactivity of the facial muscles
narrow, abnormal development of the palate
an open bite, where the front teeth do not contact...
Why do you want to stop the abnormal swallow? Because thrusting
delays completion of your orthodontic treatment by forcing the teeth
apart or forward. After the braces are removed, thrusting will ruin the
results. It is a habit, just like sucking the thumb. Thrusting is a
negative force. Thrusting will destroy your straight teeth.

It's the STUPID tongue!!!!!