Tongue Thrust and Orofacial Myofunctional Disorders

You may need tongue thrust therapy if you answer “yes” to any of the following questions:

Has your dentist or Orthodontist diagnosed you with “Tongue Thrust”?

Are your teeth or your bite out of alignment?

Is your dentist concerned that tongue thrust will effect your child’s eruption of teeth and the alignment of their teeth and bite?

Are there concerns about the effectiveness of braces or the retention of your straight teeth after orthodontic treatment?

Are you experiencing slow or ineffective therapy for a lisping pattern? 

Do you or does your child suck their thumb, bite their nails, or other objects?

Does tongue thrusting draw negative attention to your speech and interfere with your social or professional life?

What is tongue thrusting?

Tongue thrust is the most common orofacial myofunctional disorder (OMD). Orofacial Myofunctional Disorders are anatomical and physiological differences of the oral and facial structures (lips, teeth, tongue, jaw, cheeks, and palate) that are noticeably different; interferes with normal dentofacial, speech, physical or psychosocial development; or is of cosmetic concern. This includes lip and tongue rest, swallow and speech posture differences. (Hale, Kellum, & Gross ’91) Research has found an 81% prevalence of OMD disorders in children exhibiting speech problems (Maul, et. Al, 1999) compared to a prevalence of 38% in the general population (Kellum, 1992)

Why should you be concerned about tongue thrusting?

Orofacial myofunctional disorders (OMD) may have a negative effect on the development of the dentition and speech. The pattern of when teeth erupt and/or the alignment of the teeth and jaw may be negatively affected. The function of the temporomandibular joint may be negatively influenced.  For patients in orthodontic treatment, OMD therapy can help stabilize the orthodontic result and help in the retention of the treatment. 

Speech disorders often co-exist with OMD. Some children develop sound errors as a result of OMD. OMD most often causes sounds like s,z,sh, zh, ch, and j to sound differently than they usually do. For example the word “sink” may sound like “think”. Because of weak tongue tip muscles, the t,d,n, and l sounds may be misarticulated. Not all children with an OMD such as tongue thrust have an associated speech disorder. If tongue thrusting and sound errors exist, remediation of the tongue thrusting pattern is essential to correcting the speech.

 Some people who have a tongue thrusting pattern can be observed to have difficulty maintaining a closed mouth during chewing and swallowing and loose control of the foods in their mouth. This is often considered offensive to others and can contribute to poor self esteem. 

What causes tongue thrusting and Orofacial Myofunctional Disorders (OMD)?

- Oral habits such as excessive thumb or finger sucking, lip/cheek and fingernail biting, lip licking, and teeth clenching and grinding.

- Family heredity can be involved in determining such factors as the size of the child’s mouth, the arrangement and number of teeth, and the strength of lip, tongue, mouth, and facial muscles.

-  Restricted nasal airway due to enlarged tonsils and adenoids may create an open-mouth breathing pattern. Environmental factors that contribute to airway difficulties include allergies.

- Neurological or developmental abnormalities

- Abnormally large tongue, short lingual fermium (tongue-tie) or other structural or physiological abnormalities.

What is the treatment for OMD?

The success of a therapy program is dependent on several factors and a team effort is essential. A licensed speech-language pathologist can evaluate and treat open-mouth posture, swallowing disorders and speech misarticulations that result form OMD. Speech-language pathologists specialize in evaluating lip, palate, tongue, and facial muscles both at rest and during the complex movements needed to produce clear speech and adequate swallowing. Other team members may include the pediatrician, ENT doctor, dentist, orthodontist, and in the case of a child the parents play an essential role.

Is their scientific evidence that OMD therapy is effective?

Recent scientific studies have shown that treatment for OMD can be 80-90% effective in correcting swallowing and rest posture function. These corrections are retained years after completing therapy (Hahn & Hahn, 1992). Some insurance companies cover OMD therapy as a necessary medical intervention.

How do I find out more about tongue thrust therapy and OMD treatment?

Many questions can be answered during an evaluation with a private, licensed, speech language pathologist. A Tongue Thrust disorder is not considered “educationally relevant” and therefore a child will not be eligible for the public school speech therapy service for tongue thrusting. Contact us to schedule a no cost phone conference.