Tongue thrust in children and adults How to detect and treat it quickly

Have you ever noticed your child pushing their tongue against their teeth while speaking or swallowing? Or maybe you’ve observed this habit in an adult? This phenomenon, known as tongue thrust, is not just a strange habit—it can be a sign of underlying issues with teeth, speech, or swallowing. If left untreated, it can affect oral health, the alignment of teeth, and speech patterns.we’ll explore the causes of tongue thrust in both children and adults, its signs, potential risks, and the latest treatment methods using exercises or orthodontic approaches, so you can address the problem effectively and promptly.

1. Is tongue thrust normal in my young child?

Yes, during breastfeeding and early teething, pushing the tongue forward is normal. The issue arises only if it persists after around age 3.

2. Are exercises effective for my child?

Absolutely. If your child follows the exercises regularly under the guidance of a speech therapist or orthodontist, you can expect results within a few weeks to months.

3. How often should the child do the exercises?

Usually 3–4 times a day, with 10–15 repetitions per session depending on the exercise.

4. Are the exercises painful?

No, the exercises are simple and safe, aiming to strengthen oral muscles and improve tongue posture without causing any pain.

5. Does my child need braces along with exercises?

If there is a noticeable gap or misalignment in the teeth, your child may need orthodontic treatment during or after the exercises.

For adults:

Are exercises helpful after years of tongue thrust?
Yes, exercises are very effective for adults, but they require more patience and consistency than in children.
How often should exercises be done?
Usually 3–4 times a day, with 10–20 repetitions per session depending on the exercise.
Are exercises alone enough?
Often, exercises need to be combined with speech therapy or orthodontics if there are dental or jaw issues for best results.
Will I see results quickly?
Most people notice improved tongue posture and clearer speech within 4–8 weeks of regular practice.
However, correcting bite or teeth alignment may take longer, depending on dental and jaw conditions.
Can exercises be done without a specialist?
Yes, but consulting a speech therapist or orthodontist is important to ensure proper technique and monitor progress.

Causes of tongue thrust

In children:

Early oral habits:

Prolonged thumb or pacifier sucking after age 2.
Extended bottle feeding.

Dental or jaw issues:

Front teeth are open or spaced (Open Bite), causing tongue to push forward.

Muscle or speech development issues:

Weak oral or tongue muscles.
Speech delays or disorders.

Breathing problems:

Mouth breathing due to nasal blockage or allergies.
Problems with palate or gums affecting tongue posture.

Neurological or developmental factors:

Some children have difficulty controlling tongue movement due to delayed neuromuscular development.

In adults:

Habits carried from childhood:

Continuing thumb sucking or tongue pushing habits.

Dental or jaw problems:

Front teeth open or crooked.
Missing back teeth affecting swallowing.

Muscle or neurological issues:

Weak tongue or oral muscles.
Injuries or neurological events affecting tongue control.

Chronic breathing problems:

Nasal blockage or chronic snoring forces mouth breathing and alters tongue posture.

Speech issues:

Difficulty pronouncing certain sounds may lead to tongue thrust while speaking.

Signs and symptoms of tongue thrust

In children:

Visual and oral signs:

Tongue pushes against front teeth during swallowing.
Mouth opens noticeably when swallowing.
Gaps between front teeth (Open Bite) or spacing.

Speech signs:

Difficulty pronouncing sounds like s, sh, z, t, d.
Air escape or a whistling sound while speaking.
Substituting certain sounds due to improper tongue placement.

Other signs:

Difficulty chewing or swallowing normally.
Excessive saliva while speaking or swallowing.
Relying on mouth instead of nose for breathing in some cases.

In adults:

Visual and oral signs:

Tongue continues to push against front teeth while speaking or swallowing.
Wear or shifting of front teeth over time.
Gaps or bite problems.

Speech signs:

Difficulty or altered pronunciation of certain sounds.
Whistling or unclear speech.

Other signs:

Jaw or facial pain from muscle pressure.
Excess saliva during speech.
Difficulty swallowing food normally.

Types of tongue thrust

Anterior Tongue Thrust:

Tongue fully pushes forward to front teeth during swallowing or speech.
Signs: Open Bite, excess saliva, difficulty pronouncing s, sh, z.
Causes: Prolonged oral habits, dental growth issues.

Partial Tongue Thrust:

Part of the tongue touches front teeth or edge during swallowing.
Signs: Minor speech changes, occasional saliva escape.
Causes: Weak oral muscles or partial jaw growth.

Lateral Tongue Thrust:

Tongue moves to the side of teeth during swallowing.
Signs: Pressure on side teeth, sometimes tilting teeth.
Causes: Back teeth issues or muscle weakness.

Open Mouth Tongue Thrust:

Tongue presses on front teeth while mouth is noticeably open.
Signs: Front teeth protrusion, excess saliva, unclear speech.
Causes: Mouth breathing or chronic nasal blockage.

Posterior Tongue Thrust:

Tongue pushes against back teeth instead of front teeth.
Signs: Difficulty swallowing, jaw pain, teeth grinding.
Causes: Jaw issues or weak posterior tongue muscles.

Stages of tongue thrust

Early / Developmental stage:

Age: 0–2 years (from breastfeeding to early teething).
Description: Forward tongue movement during feeding is normal; the tongue helps with swallowing.
Note: This stage is normal and not a problem. The issue appears if thrust persists after age 2–3.

Stage Two: Transitional / After Teething

Age: 2–6 years

Description:

The child begins normal swallowing using the back of the tongue.
Some children may still push the tongue forward partially or with an open mouth.

Notes:

If tongue thrust continues after age 3–4, it can affect teeth and speech.
Intervention by a speech therapist or orthodontist is often needed.

Stage Three: Chronic / Adults

Age: After childhood

Description:

Persistence of childhood habits or dental/jaw problems.
The tongue pushes against front or side teeth during speech and swallowing.
Speech difficulties or swallowing issues may appear.

Notes:

This stage is more challenging to treat.
Usually requires muscle exercises + orthodontics + speech therapy.

Stage Four: Long-Term Complications

Description:

Front teeth may become spaced or tilted.
Jaw problems, facial pain, or headaches may occur.
Speech may be unclear, and chewing or swallowing food becomes difficult.

Risks of Tongue Thrust

Children:

A. Teeth and jaw:

Protruding or spaced front teeth (Open Bite).
Tilting or misalignment of teeth.
Difficulty in normal bite closure.

B. Speech:

Difficulty pronouncing sounds like s, sh, z, t, d.
Whistling or unclear speech.
Delayed speech development if tongue thrust persists long-term.

C. Swallowing and digestion:

Difficulty swallowing food normally.
Excess saliva while speaking or swallowing.

D. Daily habits:

Mouth breathing instead of nose breathing.
Potential development of other oral habits like thumb or pacifier sucking.

Adults:

A. Teeth and jaw:

Wear of front teeth due to continuous tongue pressure.
Jaw problems like pain or facial headaches from muscle tension.
Disturbed normal bite.

B. Speech:

Altered pronunciation of some sounds.
Whistling or unclear speech.
Communication difficulties due to speech problems.

C. Swallowing and digestion:

Difficulty swallowing food or drinks normally.
Drooling during speech or swallowing.

D. Psychological & social effects:

Embarrassment due to speech or teeth appearance.
Loss of confidence from teeth appearance or speech difficulties.

Diagnosis of Tongue Thrust

Children:

A. Clinical observation:

Observe swallowing of food and drink.
Look for tongue pushing against front teeth or open mouth during swallowing.
Check breathing habits (mouth vs. nose).

B. Speech assessment:

Evaluate pronunciation of s, sh, z, t, d.
Listen for whistling or unclear speech.

C. Dental/jaw examination:

Check for Open Bite or tilted teeth.
Assess overall teeth and jaw alignment.

D. Specialist consultation:

Speech therapist: Evaluate tongue function during speech and swallowing.
Dentist/orthodontist: Assess effect of tongue thrust on teeth and jaw.

Adults:

A. Clinical observation:

Observe swallowing and speech for tongue pushing on teeth.
Check for excess saliva or open mouth during speech.

B. Speech assessment:

Evaluate pronunciation and affected sounds.
Identify whistling or unclear speech.

C. Dental/jaw examination:

Assess bite, front teeth, any wear or tilt from tongue pressure.
Evaluate jaw function, pain, or teeth grinding.

D. Specialist consultation:

Speech therapist or oral motor therapist: Correct tongue posture during speech and swallowing.
Dentist or orthodontist: Correct dental or jaw issues caused by chronic tongue thrust.

Surgery and Tongue Thrust: Is it necessary?

Most cases are treated with functional exercises + speech therapy + orthodontics.
Surgery is rarely required and is reserved for severe structural issues in the mouth, jaw, or palate.

Cases that may require surgery:

Palate or oral structure abnormalities:
- Cleft palate or congenital issues causing tongue pressure on teeth.
- Surgery corrects structure to allow proper tongue posture.
Severe jaw or dental problems:
- Extreme bite problems or very small/misaligned upper or lower jaw.
- Orthognathic surgery may adjust the jaw and improve teeth positioning.
Rare muscle or ligament issues:
- Severe tongue muscle weakness or restrictive lingual ligaments.
- Procedures to release a short lingual frenulum (Ankyloglossia) affecting swallowing and speech.

Important notes:

Surgery is not the first option except in severe structural cases.
Most children and adults improve with exercises, speech therapy, and orthodontics without surgery.
Post-surgery, exercises are usually required to retrain proper tongue posture.

Tongue Thrust Exercises for Children and Adults

1. Exercises for children

A. Correct tongue posture:

Place tip of tongue on the gum behind upper front teeth when swallowing.
10–15 repetitions, 3 times daily.

B. Swallow exercise:

Place tongue on the roof of the mouth and swallow gently without pushing forward.
Trains normal swallowing.

C. Oral muscle strengthening:

Make child smile, close lips tightly, or blow into a small balloon.
Strengthens muscles to prevent forward tongue thrust.

D. Speech exercises:

Practice difficult sounds (s, sh, z, t, d) with correct tongue posture.

2. Exercises for adults

A. Tongue on upper gum:

Tip of tongue behind upper front teeth when swallowing, lips closed.
10–20 repetitions, 3–4 times daily.

B. Gentle pressure exercise:

Press tongue against the roof of the mouth for 5 seconds, then relax.
Strengthens posterior tongue muscles.

C. Speech exercises with correct tongue posture:

Read texts or words with s, sh, z, t, d while monitoring tongue position.
Practice regularly to improve speech.

D. Oral and lip exercises:

Wide smile, press lips for 5 seconds.
Blow into a balloon or use a straw to strengthen surrounding muscles.

3. Important exercise tips

Consistency: Key for success, especially for children, to make correct tongue posture habitual.
Combine treatments: Exercises are often combined with speech therapy and orthodontics for best results.
Early intervention: The sooner the treatment begins, the faster and more effective the results.