Tongue thrust also called as reverse swallow or immature swallow. In recent years the tongue thrust problems and the resultant oral features have come to the forefront of the progressive, clinical orthodontist’s attention. If the tongue was observed thrusting between and the teeth did not close in centric occlusion during swallowing, it was specified that a tongue thrust was present.
The tongue protrudes through the upper front teeth during swallowing, speech and while the tongue is at rest. Tongue thrust is the habit of sealing the mouth for swallowing by thrusting the top of the tongue forward against the lips.
Tongue thrust is normal in infants until approximately the age of 6 months. The loss of this normal infant behavior is one of the signs that the baby is ready to begin eating baby food. During infantile swallow the tongue is placed between the gum pads. After 6 months of age, several maturation events occur that alter the functioning of the orofacial muscles.
With the arrival of incisors the tongue assumes a retracted posture if the transition of infantile to mature swallow does not take place with the eruption of teeth then it leads to tongue thrust swallow. In a thrusted swallow the tongue is pushed up and forward and in mature swallow the tongue is pushed up and back. As a child develops a more mature swallow the back and sides of their tongue begin growing stronger and gain more control of movement.
A child exhibits a tongue thrust pattern from birth, because it is an infantile swallowing pattern. It is acceptable to have this swallowing pattern up to the age of four years. Most children will outgrow the infantile pattern and develop the mature pattern of swallowing, not developing a problematic tongue thrust. If the child has not naturally outgrow the pattern by age four, the thrust is strengthened becomes an issue, and will require a training program to correct the thrusting pattern.
During a normal swallow, the mid tongue should be placed on the roof of the mouth, not between the teeth. Placing the tongue between the teeth pushes the teeth apart and out.
Tongue thrust can adversely affect the teeth and mouth. The affects are depends on intensity, duration, frequency and type of tongue thrust.
Type 1-non deforming
Type2-deforming anterior tongue thrust
Type3-deforming lateral tongue thrust
Type4-deforming anterior and lateral tongue thrust
Another classification
The most proven and effective technique to solve the tongue thrust problem is by oral habit training. This is an exercise that reeducates the muscles associated with swallowing by changing the swallowing pattern. This method must be taught by a trained speech therapist.