Tongue Thrust Therapy

What Is a Tongue Thrust?

A tongue thrust - also called a reverse swallow or immature swallow pattern - is an orofacial myofunctional disorder where the tongue pushes forward against or between the teeth during swallowing, speaking, or at rest. While infants naturally swallow with a forward tongue movement, most children transition to a mature swallowing pattern by age 4-6. When this transition doesn't happen, the result is a persistent tongue thrust.

A tongue thrust is not a sign of laziness or something your child is doing on purpose. It's an automatic muscle pattern - most people with a tongue thrust are completely unaware they are doing it. That's why it requires structured therapy to retrain the muscles and establish a new pattern.

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What Causes Tongue Thrust?

Tongue thrust can develop from a variety of causes, often in combination:

• Prolonged pacifier use or bottle feeding - may prevent the transition to a mature swallow
• Chronic thumb or finger sucking - changes the resting position of the tongue and alters dental development
• Enlarged tonsils or adenoids - can force the tongue forward to maintain an open airway
• Chronic allergies or nasal congestion - mouth breathing pushes the tongue into a low, forward position
• Tongue-tie (ankyloglossia) - restricted tongue movement can prevent proper tongue elevation
• Hereditary factors - jaw shape, tongue size, and facial structure can contribute
• Neurological factors - in some cases, differences in oral motor development play a role

Understanding the cause helps us design the most effective treatment plan. During your evaluation, our COM-certified specialists assess all potential contributing factors.

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Tongue Thrust Symptoms in Children and Adults

Tongue thrust can be present in both children and adults. Common signs include:

• Tongue is visible between teeth when swallowing
• Tongue pushes forward when speaking
• Open bite (front teeth don't meet when back teeth are closed)
• Gap between front teeth that persists or returns after orthodontics
• Lisp or lisping sounds (especially s, z, sh, ch, j)
• Tongue rests forward or between teeth at rest
• Messy eating or difficulty managing certain foods
• Teeth shifted after orthodontic treatment (relapse)
• Chronic lip licking or chapped lips
• Forward head posture

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Tongue Thrust in Adults vs. Children

While tongue thrust is often identified in children, many adults have an undiagnosed tongue thrust that has been present since childhood. The good news: tongue thrust can be successfully treated at any age.

Tongue Thrust in Children

• Often identified by dentists or orthodontists during routine exams
• May contribute to open bite, speech sound errors, and messy eating
• Therapy is typically most effective starting around age 7-8, when a child can follow structured exercises
• Ideally addressed before or during orthodontic treatment for the best outcomes

Tongue Thrust in Adults

• Often discovered after orthodontic relapse - teeth shift back despite years of braces
• May cause chronic jaw tension, TMJ discomfort, or persistent lisping
• Adults are often highly motivated and can progress quickly through therapy
• It is never too late to correct a tongue thrust - adult patients achieve excellent results

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Why Tongue Thrust Treatment Matters

Your tongue exerts significant pressure with every swallow - and you swallow approximately 500-2,000 times per day. When that pressure pushes against your teeth instead of the roof of your mouth:

• Teeth shift out of alignment over time
• Orthodontic treatment fails or teeth relapse after braces
• Speech sounds are affected by incorrect tongue placement
• Dental problems including open bite develop or worsen
• Facial development can be affected in growing children

Braces and aligners can move teeth, but they can't change how you swallow. If the underlying tongue thrust isn't corrected, teeth often move right back. This is why orthodontists increasingly refer patients for myofunctional therapy before, during, or after orthodontic treatment.

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Tongue Thrust and Braces: What You Need to Know

Tongue thrust is one of the most common causes of orthodontic relapse - when teeth move back to their pre-treatment positions after braces or aligners are removed. If your child (or you) is investing in orthodontic treatment, addressing tongue thrust is critical to protecting that investment.

Before Orthodontics

Starting myofunctional therapy before braces can help teeth move more efficiently and reduce overall treatment time. When the tongue is in the correct position, it supports the orthodontist's work rather than working against it.

During Orthodontics

Concurrent tongue thrust therapy and orthodontic treatment is often ideal. The orthodontist aligns the teeth while the myofunctional therapist retrains the muscles, creating lasting results.

After Orthodontics (Relapse)

If your teeth have shifted after braces, a tongue thrust may be the reason. Myofunctional therapy can stop further shifting and stabilize your dental alignment. Many adults seek tongue thrust therapy specifically for this reason.

Our COM-certified specialists work closely with orthodontists throughout the Kansas City metro to coordinate treatment timing and maximize results for every patient.

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Tongue Thrust Exercises: What Therapy Looks Like

Tongue thrust therapy uses a systematic series of exercises to retrain the muscles of the tongue, lips, and face. Here's what the process involves:

Phase 1: Awareness and Assessment

• Identifying your current swallowing and resting patterns
• Assessing tongue strength, range of motion, and coordination
• Establishing baseline measurements to track progress

Phase 2: Muscle Strengthening

• Exercises to build tongue tip strength and elevation
• Lip seal exercises for proper lip closure at rest
• Exercises targeting the back of the tongue for correct swallowing

Phase 3: Swallow Retraining

• Learning the correct tongue position for swallowing (tongue tip to the "spot" behind the upper front teeth)
• Practicing the new swallow pattern with water, then soft foods, then all foods
• Building the new pattern into automatic habit

Phase 4: Habit Integration

• Correct tongue resting posture becomes automatic
• New swallow pattern is used consistently throughout the day
• Speech sounds improve as tongue placement normalizes

Daily home practice is essential - typically 5-10 minutes per day. The exercises are simple and straightforward, and progress is motivating. Most patients see significant improvement within 3-4 months, with full habit change established by the end of the program (typically 6-12 months).

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What to Expect from Treatment at BSPS

Comprehensive Orofacial Myofunctional Evaluation

We assess your swallowing pattern, tongue posture, oral habits, breathing pattern, and related functions to understand the full picture. We also evaluate whether contributing factors like tongue-tie, mouth breathing, or oral habits need to be addressed alongside the tongue thrust.

Individualized Therapy Program

Most programs include:

• Weekly therapy sessions (typically 6-12 months)
• Daily home exercises (5-10 minutes)
• Progressive skill building from awareness to automatic habit change
• Regular progress assessments with measurable outcomes
• Coordination with your orthodontist or dentist when applicable

Before and After: What Results Look Like

With consistent therapy and home practice, patients typically achieve:

• Correct tongue resting position (on the roof of the mouth, not against teeth)
• Proper swallowing pattern without forward tongue movement
• Improved speech clarity, especially for s, z, sh, ch sounds
• Stable dental alignment that supports orthodontic results
• Improved lip seal at rest (no more open mouth posture)

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Why Choose BSPS for Tongue Thrust Therapy?

• COM-certified orofacial myologists — The highest credential in orofacial myology, and the only private practice in Kansas City with this certification
• Founded by Mary Billings, MS, CCC-SLP, COM — A nationally recognized educator who trains other clinicians in myofunctional therapy through her continuing education courses
• Specialized expertise — Tongue thrust therapy is one of our core specialties, not an afterthought
• Collaborative approach — We coordinate directly with Kansas City orthodontists, dentists, and ENTs
• Two convenient locations — Lee's Summit and Overland Park, plus teletherapy

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When to Seek Tongue Thrust Treatment

Before orthodontics: Address tongue thrust before braces to support treatment success

During orthodontics: Concurrent therapy helps teeth move more efficiently

After orthodontics: If teeth have relapsed, therapy prevents further shifting

Adults: It's never too late to correct a tongue thrust - adults achieve excellent results

Children age 7+: When they can follow structured exercises consistently

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Frequently Asked Questions