Effective Tongue Thrust Treatment for Adults
Tongue thrust is a condition that can affect both children and adults, leading to dental misalignment, speech difficulties, and even social anxiety. The good news is that there are effective tongue thrust treatment options and strategies for adults that could help them regain oral health control and speech confidence.
In this article, we'll explore the world of adult tongue thrusting, its causes, diagnosis, and various personalized therapy options to improve oral health and well-being.
Understanding Adult Tongue Thrust
Identifying the Signs of Tongue Thrust in Adults
The Root Causes Behind Adult Tongue Thrust
Personalized Therapy Options for Correcting Tongue Thrust
The Efficacy of Online Speech Therapy and Orofacial Myofunctional Therapy for Tongue Thrust
Managing Expectations: Timeline Tongue Thrust Treatment Success
Tips to Break Free from Tongue Thrust
How Can Connected Speech Pathology Help With Tongue Thrust Therapy
Understanding Adult Tongue Thrust
Problematic tongue thrust is a condition where the tongue pushes against or between the teeth during swallowing, speaking, or at rest, causing dental and speech issues in adults. The tongue thrusting habit is sometimes referred to as orofacial myofunctional disorder (OMD).
Appropriate Tongue Positioning: A Guide to Oral Harmony
In proper tongue placement, the tip rests gently against the hard palate (the bony ridge behind your upper front teeth), with the sides of the tongue gently touching the inner surfaces of the upper molars. This neutral position optimizes swallowing, speech, and oral health.
During swallowing, the tongue elevates posteriorly (towards the back of the mouth) and presses against the palate, propelling food into the esophagus. Proper tongue placement allows for clear articulation of all sounds, particularly consonants, by facilitating precise contact with the teeth and alveolar ridge (the bony bump behind your upper front teeth).
The tongue naturally cleans the teeth and palate during swallowing, contributing to good oral hygiene.
Misaligned Tongue Positions: A Detour from Oral Harmony
Several misaligned tongue positions can occur, each with potential consequences:
Anterior thrust: The tongue pushes excessively against the front teeth, potentially causing dental malocclusion (misaligned teeth), speech distortions, and gum recession.
Posterior retraction: The tongue retracts excessively in the mouth, leading to muffled speech and difficulty forming certain sounds.
Lateral protrusion: The tongue protrudes to one side, potentially contributing to facial asymmetry and speech difficulties.
Elevated posture: The tongue rests too high in the mouth, possibly impacting swallowing and speech clarity.
These misaligned positions can stem from various factors, including anatomical limitations (lingual tethering or tongue tie), oral motor dysfunction, or compensatory habits.
Identifying the Signs of Tongue Thrust in Adults
While often associated with childhood speech development, tongue thrusting can linger into adulthood, impacting countless individuals.
Here are some potential signs indicating you might have a tongue thrusting habit:
Physical Signs:
Constant awareness of your tongue position: Do you often feel your tongue pressing against your front teeth, even when not swallowing or speaking?
Visible tongue protrusion: Does your tongue poke out between your teeth at rest or during speech?
Mangled speech: Do you struggle to pronounce certain sounds, especially consonants, and find your speech sounds muddy or slurred?
Open bite: Do your front teeth have difficulty touching even when you close your mouth?
Gaps between teeth: Have you noticed new gaps or widening gaps between your front teeth?
Receding gums: Do your gums appear inflamed, or have they pulled away from your teeth, exposing more tooth surfaces?
Jaw pain or clicking: Do you experience discomfort or clicking in your jaw joints, especially while chewing or speaking?
Speech and Communication Signs:
Difficulty swallowing: Do you struggle to swallow food or liquids smoothly?
Frequent drooling: Do you drool more than usual, especially as an adult?
Mouth breathing: Do you primarily breathe through your mouth instead of your nose?
Muffled articulation: Do people often ask you to repeat yourself because they can't understand what you're saying?
Social anxiety or hesitation: Do you feel hesitant or anxious about speaking in public or social situations due to concerns about the clarity of your speech?
Unseen Impacts: The Ripple Effect of Tongue Thrust
An uncorrected tongue thrust habit extends its consequences far beyond mere speech challenges. Its persistent presence can trigger a cascade of negative impacts on various aspects of one's well-being:
1. Dental Damage: The chronic pressure exerted by the tongue against the teeth can lead to gradual misalignment, creating gaps, malocclusion, and even gum recession. This can compromise both oral health and aesthetics.
2. Communication Difficulties: Muddled speech, a common symptom of tongue thrusting, can significantly hinder clear communication. Unclear communication can lead to frustrations during everyday interactions and negatively impact personal and professional relationships. Misunderstood words and misinterpreted messages can create social barriers and hinder effective communication.
3. Facial Repercussions: Over time, the persistent pressure from the tongue can subtly reshape the jawline and chin structure. This can lead to noticeable changes in facial appearance, potentially impacting an individual's self-image and confidence.
4. Psychological Impact: The inability to communicate effectively due to tongue thrust can foster feelings of social anxiety and hinder self-assuredness. Struggling to be understood in daily situations, such as presentations or even casual conversations, can chip away at confidence and create fear of being misjudged.
5. Social Isolation: The difficulties presented by unclear communication can make social interactions challenging, leading to feelings of isolation and disconnection. Jokes might fall flat, emotions might be misconstrued, and meaningful connections might remain elusive. This can negatively impact an individual's social well-being and quality of life.
Individuals can prioritize seeking appropriate intervention by understanding the diverse and widespread ramifications of unaddressed tongue thrust. By addressing the root cause and correcting tongue placement, individuals can reclaim control over their oral health, communication clarity, and social well-being.
The Root Causes Behind Adult Tongue Thrust
While the physical manifestation of tongue thrust is evident in the pushing of the tongue against the teeth, its origins lie deeper, often interwoven with a combination of anatomical, neurological, and environmental factors.
1. Lingual Tethering: This congenital condition restricts the natural movement of the tongue due to a shortened frenulum, the tissue connecting the tongue to the floor of the mouth. This is sometimes referred to as a tongue tie. In some cases, this limitation persists into adulthood, contributing to persistent tongue thrust as the tongue struggles to find proper positioning.
2. Oral Motor Dysfunction: Neurological conditions impacting muscle control or coordination can affect the delicate muscle movements involved in swallowing and speech. This can lead to an imbalance in oral motor function, manifesting as tongue thrust as the tongue compensates for weakness or incoordination.
3. Habitual Factors: Early childhood habits like thumb sucking or prolonged pacifier use can train the tongue into a forward position. If not addressed, these habits can morph into unconscious patterns, persisting into adulthood as tongue thrust.
4. Chronic Nasal Obstruction: Enlarged adenoids or tonsils can obstruct the natural breathing passage through the nose, forcing individuals to mouth breathe. An altered breathing pattern may change tongue placement and muscle changes activation, eventually triggering tongue thrust.
5. Myofunctional Disorders: In some cases, tongue thrust can be a symptom of a larger myofunctional disorder, where the muscles of the face and jaw lack proper coordination or function. This can be caused by a variety of factors, including genetics, developmental delays, or even head injuries.
Who Diagnoses Tongue Thrust?
Evaluating for a tongue thrust necessitates a team effort. Three dedicated professionals join forces to diagnose and guide you toward effective treatment:
Speech-Language Pathologists (SLPs): The masters of oral motor function and speech production, SLPs conduct a comprehensive assessment of tongue movement, muscle tone, and coordination during swallowing and speaking. They analyze speech intelligibility and identify any articulation errors linked to tongue thrust.
Dentists: Dentists assess tooth alignment, bite patterns, and potential damage caused by tongue pressure. They may utilize X-rays or other imaging techniques to evaluate jaw positioning and skeletal structures.
Orthodontists: Orthodontists play a crucial role when misaligned teeth or bite problems are present alongside tongue thrust. They provide expertise in evaluating the relationship between teeth and jaw positioning, and their insights contribute to creating an effective treatment plan that addresses both tongue behavior and any underlying structural issues.
Benefits of a Unified Approach
This three-pronged collaboration ensures a holistic diagnosis, encompassing the anatomical, functional, and structural aspects of tongue thrust. By combining their expertise, these professionals can:
Pinpoint the precise cause: Whether it's anatomical limitations, neuromuscular dysfunction, habitual patterns, or a combination, the specific origin of tongue thrusting is identified for targeted treatment.
Develop a tailored plan: A personalized treatment plan is crafted considering the individual's unique needs, severity, and potential structural issues. This may involve a combination of myofunctional therapy, orthodontic treatment, or even surgery.
Monitor progress and adjust: Throughout the journey, progress is monitored by all three professionals, allowing for adjustments to the plan if needed to ensure optimal outcomes.
Personalized Therapy Options for Correcting Tongue Thrust
Treatment options for tongue thrust include speech therapy, orofacial myofunctional therapy (OMT), and orthodontic intervention for proper tongue posture.
We will focus on these therapy options, detailing their functioning and benefits in addressing and rectifying tongue thrust.
Orofacial Myofunctional Therapy:
OMT is delivered by a speech pathologist who has completed specialized training in orofacial myology, focusing on the muscles and movements of the face and mouth. They often work with tongue thrust cases, strongly emphasizing tongue placement, muscle function, and retraining oral motor patterns.
Targeted exercises: This cornerstone therapy utilizes a series of exercises to strengthen weak muscles, improve tongue mobility and coordination, and promote proper placement during swallowing and speaking. Examples include lip blocks, tongue swallows, and jaw stretches.
Sensory retraining: Techniques like oral stimulation and massage can enhance neural input and proprioception, improving the tongue's awareness of its position and movement.
Habituation training: Breaking unhelpful habits like thumb sucking reinforces proper tongue behavior through regular reminders and positive reinforcement.
Speech Therapy Techniques:
Speech-language pathologists (SLPs) without OMT training typically focus on the speech and language aspects of tongue thrust, addressing articulation errors and improving overall communication clarity.
Articulation training: Speech therapy can help treat tongue thrust. SLPs guide individuals in practicing sounds typically affected by tongue thrust, such as consonants, to achieve clear and accurate pronunciation.
Oral motor exercises: Similar to myofunctional therapy, specific exercises are employed to address oral weakness and improve airflow patterns during speech production.
Communication strategies: Strategies like slowing down speech pace, enunciating clearly, and utilizing visual cues can be practiced to compensate for any remaining speech difficulties.
Orthodontic Treatment:
Braces or aligners: When malocclusion (misaligned teeth) or jaw positioning contributes to tongue thrust, orthodontic appliances can gradually shift teeth and jaw structures, creating a more supportive environment for proper tongue placement.
Auxiliary appliances: Tongue cribs or habit-breaking appliances can be used with orthodontics to physically restrict unwanted tongue movements and reinforce correct positioning.
Surgical Intervention:
Lingual frenectomy: In rare cases where a shortened lingual frenulum restricts tongue movement, surgical release of the frenulum may be necessary to improve tongue mobility and facilitate proper placement.
Jaw surgery: In severe cases with significant skeletal discrepancies impacting tongue position, corrective jaw surgery may be considered as a last resort.
Choosing the Right Path
The optimal treatment approach depends on the severity and underlying causes of tongue thrust. Dentists, SLPs, and orthodontists collaborate to evaluate individual needs and recommend a personalized treatment plan that may involve a combination of these interventions. Consistent effort and adherence to therapy recommendations are crucial for successful outcomes.
The Efficacy of Online Speech Therapy and Orofacial Myofunctional Therapy for Tongue Thrust
While research and clinical experience primarily focused on in-person treatment, the effectiveness of online interventions for tongue thrust is gaining traction. Both speech therapy and orofacial myofunctional therapy (OMT) show promising results when adapted to a virtual setting, with several factors influencing their success:
Advantages of Online Therapy:
Increased accessibility: Individuals in remote locations or with limited mobility can access specialized care previously unavailable.
Convenience and flexibility: Sessions can be scheduled around individual needs and time constraints, potentially improving adherence.
Cost-effectiveness: Online delivery may offer reduced costs compared to traditional in-person therapy.
Technology advancements: Telehealth platforms equipped with video conferencing, screen sharing, and interactive tools facilitate visualization and personalized instruction.
Considerations for Optimal Outcomes:
Therapist expertise: Choose a therapist experienced in both tongue thrust treatment and online delivery methods.
Patient engagement: Active participation, regular practice of prescribed exercises, and open communication with the therapist are crucial for success.
Technology setup: A reliable internet connection, adequate camera and microphone equipment, and a quiet environment are essential for clear communication and accurate assessment.
Treatment structure: Structured virtual sessions with clearly defined goals, personalized exercise plans, and regular progress monitoring are key to maintaining motivation and achieving desired outcomes.
Research Evidence:
Studies indicate that online OMT, when delivered by qualified therapists and combined with self-directed practice, can achieve improvements in tongue placement and speech clarity similar to in-person therapy.
Research on online speech therapy for tongue thrust is emerging but shows promising preliminary results, particularly when combined with additional support and monitoring mechanisms.
Managing Expectations: Timeline Tongue Thrust Treatment Success
Embarking on the journey to correct tongue thrust requires understanding the realistic timeline and potential challenges. Setting realistic expectations can pave the way for a positive and successful treatment experience.
Understanding the Timeline:
Initial Assessment: This initial evaluation by dentists or SLPs can take 1-2 appointments to analyze the severity and underlying causes of tongue thrust.
Treatment Duration: Speech therapy typically requires dedicated practice, with noticeable improvements often occurring within 3-6 months, but potential refinement may continue for longer depending on individual needs.
Orthodontic Treatment: Braces or aligners usually require 12-24 months of wear, with adjustments and monitoring throughout the process. Surgical interventions, if necessary, have their own specific recovery timelines.
Embracing the Effort:
Active Participation: Success hinges on consistent effort and adherence to therapist recommendations. Regular practice of exercises and maintaining proper tongue placement are crucial for lasting change.
Challenges and Setbacks: Occasional setbacks or plateaus are normal during treatment. Persistence, positive reinforcement, and communication with your therapist are essential to overcome these hurdles.
Lifestyle Adjustments: Addressing factors like mouth breathing or unhelpful habits may require adjustments to daily routines to foster optimal outcomes.
Celebrating Milestones and Progress:
Monitoring Improvement: Regular evaluations by your therapist will track progress and adjust the treatment plan as needed.
Focus on Positive Changes: Celebrate small victories and acknowledge the gradual improvements in speech clarity, oral comfort, and overall well-being.
Long-Term Maintenance: Once goals are achieved, maintaining proper tongue placement and practicing exercises periodically can ensure lasting results and prevent relapse.
Tips to Break Free from Tongue Thrust
Conquering tongue thrust extends beyond therapy sessions and appointments. By incorporating these practical strategies into your daily routine, you can actively reinforce proper tongue placement and address underlying habits:
Breaking Long-Term Sucking Habits:
Identify the triggers: Analyze what situations or emotions prompt thumb sucking, finger sucking, or other oral habits that contribute to tongue thrust.
Develop substitutes: Replace sucking habits with healthy alternatives like chewing sugar-free gum, tapping your foot, or fidgeting with stress balls.
Positive reinforcement: Reward yourself for successfully resisting the urge to suck, celebrating milestones and gradual progress.
Seek professional support: If breaking the habit proves challenging, consult a therapist for additional guidance and support techniques.
Encouraging Nose Breathing over Mouth Breathing:
Awareness is key: Pay close attention to your breathing patterns throughout the day, noticing if you primarily breathe through your mouth or nose.
Nasal dilation strips: These temporary adhesives gently widen nasal passages, improving airflow and encouraging nasal breathing.
Humming exercises: Humming engages the diaphragm and promotes nasal breathing while strengthening your vocal cords as a bonus.
Sleeping aids: Consider nasal strips or specialized pillows designed to support nasal breathing during sleep, especially if breathing through your mouth is habitual at night.
Address underlying causes: If allergies or anatomical issues contribute to mouth breathing, seek medical evaluation and treatment options to improve nasal airflow.
Additional Tips for Lasting Success:
Practice tongue exercises regularly: Reinforce proper tongue placement and strengthen muscles through exercises prescribed by your therapist, even after formal therapy ends.
Stay hydrated: Drinking plenty of water throughout the day keeps your mouth moist, reducing the urge to mouth breathe and promoting comfortable swallowing patterns.
Monitor progress: Regularly assess your tongue placement, speech clarity, and overall comfort to identify areas needing further attention.
Celebrate milestones: Acknowledge and celebrate every improvement, no matter how small. Positive reinforcement fuels motivation and keeps you on track.
Frequently Asked Questions
1. What are the signs of tongue thrusting in adults?
Signs may include teeth misalignment, articulation issues, and incorrect swallowing techniques. Additionally, conditions like an open bite, where upper and lower teeth do not meet when the mouth is closed, can indicate tongue thrust. Recognizing these signs is crucial for seeking timely treatment.
2. How to stop tongue thrusting?
Tongue thrust correction necessitates a collaborative approach involving dentists and speech-language pathologists. Treatment typically involves myofunctional therapy exercises to retrain tongue placement and potentially braces or surgical intervention in specific cases, depending on the cause and severity.
3. How is tongue thrusting diagnosed in adults?
Diagnosing adult tongue thrust involves a two-pronged approach: dentists assess tooth alignment and potential dental damage, while speech-language pathologists analyze tongue movement and speech clarity during swallowing and speaking. This comprehensive evaluation, often including X-rays or instrumental tools in complex cases, pinpoints the root cause and severity of tongue thrust for effective treatment planning.
4. What is orofacial myofunctional therapy, and how does it address tongue thrusting?
Orofacial myofunctional therapy is a form of neuromuscular re-education that focuses on improving swallowing, tongue movement, and oral breathing. The therapy includes myofunctional exercises to strengthen tongue muscles, promote efficient airflow, and establish correct swallowing patterns.
5. Is online speech therapy effective for tongue thrusting?
Yes. Online speech therapy and OMT appear to be increasingly viable options for addressing tongue thrust. Their effectiveness hinges on choosing qualified therapists, employing appropriate technological tools, and maintaining patient engagement with structured personalized treatment plans.
How Can Connected Speech Pathology Help With Tongue Thrust Therapy
Connected Speech Pathology is proficient in providing effective tongue thrust treatment for adults. We understand the challenges individuals face with tongue thrust and its impact on oral health, speech clarity, and self-confidence. That's why we offer teletherapy and orofacial myofunctional therapy (OMT), making specialized care accessible and convenient for individuals regardless of location.
Our team of experienced and qualified speech-language pathologists (SLPs) are trained in the latest evidence-based treatment approaches for tongue thrust. We conduct a thorough initial assessment to determine your specific case's severity and underlying causes. This assessment utilizes advanced telehealth tools like high-definition video conferencing and specialized oral visualization software to accurately analyze tongue movement and function during swallowing and speaking.
Following the assessment, we develop a personalized treatment plan tailored to your individual needs and goals. This plan might include a combination of:
Targeted tongue exercises: These exercises, practiced daily under the guidance of your therapist, aim to retrain muscle function and promote proper tongue placement during swallowing and speaking.
Speech clarity training: For cases where tongue thrust affects speech, your SLP will guide you through exercises to improve articulation and pronunciation, fostering clearer communication.
Collaboration with other healthcare professionals: We may collaborate with your dentist or orthodontist to ensure a comprehensive approach that addresses any underlying structural issues contributing to tongue thrust.
Our teletherapy platform offers several advantages:
Convenience: Schedule appointments at your own pace and comfort from the privacy of your own home.
Accessibility: Expand your access to specialized care, especially for individuals in remote locations or with mobility limitations.
Technology: Utilize advanced tools for visualization, exercise guidance, and progress monitoring, enhancing the effectiveness of therapy.
Cost-effectiveness: Teletherapy may offer a more cost-conscious option compared to traditional in-person therapy.
We strongly believe that active patient engagement and therapist support are crucial for successful outcomes. Therefore, we prioritize clear communication, regular progress monitoring, and ongoing adjustments to your treatment plan as needed.
We also understand the importance of a supportive environment and are happy to provide resources and guidance to help you integrate proper tongue placement into your daily life.
Connected Speech Pathology is here to help if you are struggling with tongue thrust. We offer effective online treatment solutions tailored to your unique needs, empowering you to take control of your oral health and improve your communication skills in a way that is convenient and accessible.
Summary
In conclusion, tongue thrust is a condition that affects adults, causing dental misalignment, speech difficulties, and social anxiety. Understanding the signs, causes, and treatments for adult tongue thrust is essential for improving oral health and well-being.
By working with a speech-language pathologist and consistently practicing exercises and techniques learned during therapy, individuals can overcome tongue thrust, regain control over their oral health, and enjoy improved speech confidence. Don't let tongue thrust hold you back; seek professional help and take control of your oral health today.
About the Author
Allison Geller is a speech-language pathologist (SLP) and the owner of Connected Speech Pathology. She obtained her Bachelor’s and Master’s degrees from the University of Florida in Speech-Language Pathology. Allison has practiced speech therapy in a number of settings including telepractice, acute care, outpatient rehabilitation, and private practice. She has worked extensively with individuals across the lifespan including toddlers, preschoolers, school-aged children, and adults. She specializes in the evaluation, diagnosis, and treatment of a variety of communication disorders including receptive/expressive language disorders, articulation disorders, voice disorders, fluency disorders, brain injury, and swallowing disorders.
Allison served as the clinical coordinator of research in aphasia in the Neurological Institute at Columbia University Medical Center in New York. She is on the Board of Directors for the Corporate Speech Pathology Network (CORSPAN), a Lee Silverman Voice Treatment (LSVT) certified clinician, and a proud Family Empowerment Scholarship/Step-Up For Students provider. Allison is passionate about delivering high quality-effective treatment remotely because it’s convenient and easy to access. What sets us apart from other online speech therapy options is—Allison takes great care to hire the very best SLPs from all over the country.
