“Dr. Courey, I just don’t understand why I had braces twice and I still have all of these spaces in my teeth!” Frustrated new patient Lisa from Freehold, NJ was at her wits end for the answer to her dental dilemma.
Lisa did wear her retainer for a year, and even had braces twice, but her condition had relapsed. Two thoughts went through my mind – either bruxism (grinding teeth) or tongue thrusting. By checking the wear pattern of Lisa’s teeth as well as performing muscle palpitations revealed the true nature of her problem!
Teeth grinding or bruxism has gained professional and public awareness in recent years, but tongue thrusting is still a mostly unfamiliar word for most of both the professional dental world and the public. Let’s have a discussion about this interesting phenomenon!
Tongue thrusting is an orofacial muscular imbalance during which the tongue protrudes through the teeth. Also called a reverse or immature swallow, this can lead to a misaligned bite, a lisp-orientated speech impediment or even reversed orthodontic work.
Although nearly all children experience tongue thrusting, it is usually self-corrected at age six. 20 – 80% of all orthodontic patients exhibit some form of tongue thrust, many without even knowing it. Some children never lose the habit however, which creates an oral problem later in life. Because we swallow up to 2,000 times a day, pressure exerted on the teeth from a protruding tongue at each swallow can create constant force on the teeth, pushing teeth out of alignment.
Generally, there are several contributing factors which can lead to tongue thrusting. Certain types of artificial nipples used in feeding infants, and thumb sucking, occurring during early childhood, can cause “tongue thrusting” later in life. In adulthood, allergies or nasal congestion causing the tongue to lie low in the mouth due to breathing obstruction, large tonsils, hereditary factors or ankyloglossia (a tongue tie requiring a frenectomy to correct. can also cause “tongue thrusting.” A laser frenectomy is the most advanced treatment for alleviating a tongue tie.
Possible treatment includes a training appliance, as well as myofunctional therapy– a proactive approach which trains a group of muscles in the tongue to swallow properly. With proper training and exercise, the problem can be resolved, alleviating airway obstructions, even body posture!
Surprised by what you’ve read? Call Dr. Courey or Dr. Zagami for an evaluation.