Reviewed by Dr. Chau McGovern
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Reading Time: Four Minutes
A child’s tongue position plays an important role in how their bite develops. When the tongue consistently pushes forward during swallowing instead of resting against the roof of the mouth, it can gradually affect tooth alignment and the way the front teeth come together.
Table of Contents
What Is the Tongue Thrust Reflex?
The tongue thrust reflex, also known as the extrusion reflex, is a normal swallowing pattern in infants where the tongue pushes forward during feeding. This reflex supports early feeding but is expected to change as oral muscles develop.
As children transition to solid foods and their oral motor skills develop, swallowing should shift to a mature pattern:
- The tongue rests against the palate
- The lips remain closed
- Minimal pressure is placed on the incisors
If this transition does not occur, the reflex can persist as a habit.
What Causes Tongue Thrusting in Children?
Tongue thrusting can develop when the tongue does not transition to a mature swallowing pattern. This is often influenced by habits, breathing patterns, or oral muscle development.
Contributing factors can include:
- Prolonged thumb sucking or pacifier use, which reinforces forward tongue positioning.
- Mouth breathing, often related to nasal congestion or airway concerns.
- Enlarged tonsils or adenoids, which can affect tongue posture.
- Delayed oral motor development, where coordination for proper swallowing takes longer to develop.
In many cases, more than one factor is involved.
How Tongue Thrusting Affects Teeth and Bite
When the tongue pushes forward during swallowing, it places repeated pressure on the front teeth. This pressure can affect how the upper and lower front teeth come in, how they are positioned, and how the bite fits together.
Common effects include:
- Anterior open bite, where the upper and lower front teeth do not touch even when the back teeth are together.
- Proclination of incisors, where the front teeth begin to tilt forward due to repeated tongue pressure.
- Narrowing of the maxillary arch, meaning the upper jaw becomes more constricted. This can happen when the tongue does not rest against the roof of the mouth, where it normally helps guide the upper jaw to grow wider.
These changes can become more noticeable over time if the pattern continues.
How Do You Stop Tongue Thrusting?
Tongue thrusting is managed by correcting tongue posture and addressing its underlying cause. The goal is to guide the tongue to rest against the palate instead of pushing against the front teeth.
Methods used to support proper tongue posture:
- Eliminate contributing habits such as thumb sucking or prolonged pacifier use by gradually limiting use to certain times, like bedtime, and reducing frequency over time.
- Encourage proper tongue placement by reminding your child to keep their tongue resting on the roof of the mouth, just behind the upper front teeth, instead of pushing forward.
- Address mouth breathing by observing if your child sleeps with their mouth open or snores and discussing possible nasal congestion or airway concerns with a pediatric provider.
- Monitor dental development by watching for early signs like the front teeth not touching or shifting forward, especially as permanent incisors begin to erupt.
If the habit continues past age 4 to 5, a pediatric dental evaluation is recommended, particularly if changes in bite or speech are observed. Early intervention helps reduce the risk of long-term changes in tooth alignment.
Monitoring Oral Development With Akoya Pediatric Dentistry
At Akoya Pediatric Dentistry, Dr. Joanna Theodorou, DMD, and Dr. Chau McGovern, DDS, evaluate how the tongue functions during swallowing and affects tooth position and jaw development to determine whether a tongue thrust pattern is impacting the bite.
Care may include assessing how the maxillary and mandibular incisors come together, observing tongue position at rest and during swallowing, and identifying contributing habits or airway-related factors. Alignment is monitored as permanent teeth erupt.
If needed, a habit-breaking appliance may be recommended to guide proper tongue positioning. In some cases, referral for speech therapy may also be considered to support proper tongue function and swallowing patterns.
Pediatric Dentist in Southwest Ranches, FL
To book a dental exam at our pediatric dental office in Southwest Ranches, FL, call (954) 799-6212 or visit us at 15761 Sheridan St., Suite A, Southwest Ranches, FL.
FAQs
Can tongue thrusting go away on its own?
It can improve naturally as oral muscles develop, especially in younger children. However, if the pattern continues beyond early childhood or begins to affect how the front teeth meet, it is less likely to resolve without guidance and should be evaluated.
Does tongue thrusting affect speech?
Yes. Forward tongue positioning can interfere with sounds that require precise placement against the palate, such as “s,” “z,” and “th.” This may result in a lisp or air escaping between the teeth during speech.
Is a dental appliance always needed?
No. Most cases are first managed with habit correction and monitoring. A dental appliance is only considered when tongue thrusting begins to affect tooth position or bite development and has not improved with other approaches.
