Recognizing the Signs of Tongue Thrust in Adults: Symptoms & Solutions
Tongue thrust, a condition in which the tongue pushes against teeth or protrudes between them during swallowing and speaking, can significantly affect adults' oral health. In this article, we'll explore the symptoms, causes, and treatment options for tongue thrust in adults, emphasizing the importance of early detection and intervention.
Identifying Tongue Thrust in Adults: Key Symptoms
The Impact of Tongue Thrust on Oral Health
Diagnosing Tongue Thrust: A Collaborative Effort
Effective Treatment Options for Tongue Thrust in Adults
Identifying Tongue Thrust in Adults: Key Symptoms
Adults with tongue thrust may experience various symptoms, including difficulty swallowing, imprecise articulation and speech impediments, and dental misalignment. These symptoms can lead to more complex oral health issues if left untreated.
Comprehending the primary signs of tongue thrust enables individuals to pursue suitable treatment, warding off further complications.
Difficulty Swallowing
Tongue thrust can have a significant impact on swallowing. Difficulty swallowing, or dysphagia, can occur in individuals with tongue thrust, a swallowing pattern characterized by excessive anterior tongue protrusion during deglutition (the act of swallowing). This atypical movement interferes with the delicate coordination of muscles and structures involved in safe and efficient swallowing.
During normal swallowing, the tongue forms a bolus (food mass) on the hard palate and propels it towards the pharynx (throat) with a wave-like muscular contraction. In tongue thrust, however, excessive forward movement disrupts this coordinated sequence.
The alteration in the swallowing mechanism can lead to issues with tongue movement necessary for chewing and swallowing, potentially causing drooling and other swallowing difficulties.
Individuals with this condition often experience difficulty swallowing various textures and consistencies of food, leading to nutritional challenges and impaired quality of life.
Early identification and intervention by a speech-language pathologist or healthcare professional for specific dietary guidelines can assist in mitigating the negative consequences of tongue thrust on swallowing function and overall health.
Imprecise Articulation
Adults with tongue thrust can exhibit imprecise articulation, impacting their speech clarity and intelligibility. It occurs due to the atypical tongue positioning and movement patterns during speech production.
Normal speech articulation relies on precise coordination between the tongue, lips, and jaw to produce phonemes (basic units of sound). However, the tongue's excessive anterior protrusion disrupts this delicate interplay in tongue thrust. It can lead to several consequences:
Phonemic distortions: The altered tongue placement and movement can distort the formation of specific sounds, particularly those requiring precise lingual contact with particular areas of the oral cavity. Common examples include lisping due to the interdentalization of fricatives like /s/ and /z/ or slurred consonant sounds due to inadequate tongue-alveolar contact.
Reduced intelligibility: The distorted pronunciations and potential difficulty maintaining consistent sound placement can make speech less clear and understandable for listeners. It can impact communication abilities and social interactions.
Phonological processes simplification: As a compensatory strategy, adults with tongue thrust may inadvertently simplify their speech patterns by dropping or modifying sounds that require complex tongue movements. This further reduces speech clarity and may impact vocabulary choice and sentence structure.
Furthermore, the muscular effort required to maintain the atypical tongue position during speech can lead to:
Fatigue and tension: Constant tongue protrusion can fatigue the lingual muscles, impacting speech endurance and fluency. Additionally, compensatory adjustments in other speech structures, like the lips and jaw, can create tension and discomfort.
Oral motor incoordination: The atypical tongue movement patterns can disrupt the fine motor control necessary for precise and coordinated articulation, leading to inconsistencies in sound production and difficulty with rapid speech.
As you can see, tongue thrust in adults can significantly impact speech clarity and intelligibility through imprecise articulation, phonological simplification, and muscular strain. Addressing this condition through comprehensive intervention targeting tongue placement, neuromuscular control, and compensatory strategies can improve speech production and overall communication.
Dental Misalignment
Dental misalignment, such as an open bite or crooked teeth, is another consequence of tongue thrust. The constant pressure from the tongue pushing against the teeth affects their position, leading to overbites, open bites, and general misalignment.
Tongue thrust and malocclusion: The constant, forceful pressure exerted by the anteriorly thrusting tongue against the upper and lower teeth can gradually alter their position and alignment. Pressure can cause:
Protrusion of the upper incisors: The tongue pressing against the back of the front upper teeth can push them outwards, leading to an overbite or open bite.
Retroclination of the lower incisors: The thrusting tongue may push against the lingual (tongue-facing) surface of the lower incisors, causing them to tilt inwards towards the tongue, which can create a deep bite or crowding of the lower teeth.
Interdentalization: The persistent pressure of the tongue tip against the front teeth can create gaps between them, particularly between the upper central incisors.
Open bite: In some cases, the tongue thrust can prevent the complete closure of the upper and lower teeth during swallowing or speech, resulting in an open bite.
Malocclusion and tongue thrust: Misaligned teeth can obstruct proper tongue placement and function, potentially reinforcing or triggering tongue thrust habits. For example:
Crowded teeth: When teeth are overcrowded, the tongue may struggle to find its natural resting position within the oral cavity, leading to compensatory protrusion.
Open bite: An open bite can make it difficult for the tongue to properly contact the hard palate during swallowing, potentially leading to a more forward tongue position.
Crossbite: A misaligned bite pattern where some upper teeth bite inside the lower teeth can disrupt normal swallowing mechanics and encourage tongue thrust as a compensatory strategy.
The interplay between tongue thrust and malocclusion necessitates a holistic approach to treatment. Orthodontic interventions to address misaligned teeth can create a more favorable environment for correct tongue function. At the same time, speech-language therapy can target tongue thrust habit modification and promote proper oral motor control.
This integrated approach is crucial for achieving optimal oral health and function in individuals with this complex interrelationship. Sustaining correct tongue posture is necessary for preserving the results of orthodontic treatment. Prompt intervention and suitable treatment can aid in correcting tongue thrust and averting dental misalignment, making it essential to treat tongue thrust effectively.
Causes of Adult Tongue Thrust
Tongue thrust in adults can have various causes, including untreated childhood habits, anatomical factors, and neurological conditions. Grasping the possible causes of tongue thrust can guide individuals toward suitable treatment and address the condition's root causes.
Untreated Childhood Habits
Untreated childhood habits, such as thumb-sucking, prolonged pacifier use, or mouth breathing, can lead to tongue thrust persisting into adulthood. These habits can cause changes in tongue muscle function and oral habits, negatively impacting teeth, jaw, and mouth development.
In turn, this may result in the tongue pushing against the back of the teeth when swallowing, causing an abnormal orthodontic condition called an open bite. When the tongue pushes forward, it can exacerbate this issue.
It is recommended that thumb-sucking habits cease by age five to prevent potential adult tongue thrusts. Similarly, extended pacifier use in early years can lead to tongue thrust later in life, as it has been associated with changes in dental occlusion, a risk factor for tongue thrust.
Anatomical Factors
Anatomical factors, such as tongue-tie or jaw misalignment, can contribute to the development of tongue thrust in adults. Tongue-tie, also known as ankyloglossia, can lead to a low tongue position and tongue thrusting, forming a high and narrow palate.
Jaw misalignment can also significantly impact the development of tongue thrust in adults. This misalignment can alter the alignment of the teeth and the tongue's position, increasing pressure on the teeth and disrupting the natural resting position of the tongue. This, in turn, can form a tongue-thrusting habit and potentially cause speech impediments.
Oral Motor Dysfunction
Neurological conditions, such as cerebral palsy or Down syndrome, can cause tongue thrusting in adults. In children with cerebral palsy, tongue thrust is one of the most commonly observed issues, leading to orofacial issues such as tongue thrusting and drooling.
Individuals with Down syndrome may also experience tongue thrust due to poor muscle tone, smaller airway space, and affected tongue muscle tone. Seeking specialized treatment for tongue thrust in individuals with neurological conditions can help address their unique challenges.
The Impact of Tongue Thrust on Oral Health
One of the primary concerns associated with tongue thrust is its potential to contribute to malocclusion, a misalignment of the teeth. The constant pressure exerted by the tongue against the teeth can lead to an open bite, overbite, or underbite. These misalignments affect the aesthetics of one's smile and pose functional challenges, such as difficulty in biting and chewing.
If left untreated, tongue thrust can lead to dental issues, jaw pain, and TMJ disorders, all of which can worsen over time. Tongue thrust can also impact the longevity of dental restorations. Individuals with this habit may experience increased wear and tear on dental appliances, such as braces or retainers. This additional stress on dental structures may result in the need for more frequent repairs or adjustments, potentially increasing the overall cost of dental care.
Seeking early intervention and professional guidance is crucial to mitigate these effects and promote optimal oral health throughout one's lifetime.
Diagnosing Tongue Thrust: A Collaborative Effort
Diagnosing tongue thrust isn't a solitary endeavor but a collaborative process involving various healthcare professionals, each contributing their expertise to form a complete picture. The initial point of contact often falls to dentists or orthodontists during routine examinations.
They visually assess the oral cavity at rest and during swallowing, noting tongue posture, tooth alignment, and any potential disruptions in dental occlusion. They may also observe speech articulation patterns for clues of phonemic distortions commonly associated with tongue thrust.
Speech-language pathologists (SLPs) use their specialized knowledge of swallowing and speech production to observe swallowing and speech, looking at tongue movement patterns and potential coordination disruptions.
The SLP gathers information about past feeding difficulties, oral habits, medical history, and the impact of swallowing or speech difficulties on daily life to help understand the tongue thrust's potential origins and functional consequences.
Collaboration with other healthcare professionals, such as otorhinolaryngologists (ENTs) and neurologists, may be necessary if underlying medical conditions or neurological issues are suspected as contributing factors.
Combining observations from various specialists alongside instrumental data and the patient's personal experience allows for a comprehensive diagnosis and the development of an individualized treatment plan tailored to the specific needs of each individual.
Effective Treatment Options for Tongue Thrust in Adults
For adults experiencing tongue thrust, several effective treatment options are available, including speech therapy, myofunctional therapy, and orthodontic appliances. These treatments can help retrain the tongue and correct oral muscle imbalances, improving oral health and well-being.
Speech Therapy
Speech therapy can benefit adults with tongue thrust by focusing on:
Changing tongue placement
Correcting the habit of pushing the tongue against the teeth during swallowing and speech
Strengthening the muscles involved in swallowing
Improving overall oral rest posture
By addressing these areas, speech therapy can help individuals overcome the swallowing and speaking patterns associated with tongue thrust.
Collaboration with a registered speech and language pathologist is necessary for the most efficient tongue thrust treatment. They can offer customized exercises and treatments to meet each person's unique needs, assisting them in overcoming the speech and swallowing challenges brought on by tongue thrust.
Myofunctional Therapy
Myofunctional therapy is a specialized treatment that focuses on correcting functional issues with the tongue and face through targeted exercises. This therapy promotes healthy breathing and swallowing habits, strengthens facial muscles, and improves oral health. It is considered one of the most effective treatments for tongue thrust.
Exercises used in myofunctional therapy for tongue thrust include various exercises to help strengthen the tongue muscles and promote proper tongue posture, addressing the functional issues contributing to tongue thrust. Generally, it takes approximately six months to observe the effects of myofunctional therapy.
Orthodontic Appliances
Orthodontic appliances, such as a tongue crib, habit correctors, and tongue thrust appliances, can help correct dental misalignment and bite disorders caused by tongue thrusting. These custom appliances are designed to retrain the tongue muscles and support the tongue to sit and move properly, addressing the harmful habits associated with tongue thrust.
Typically, orthodontic appliances for tongue thrust are removable and should be worn for a few hours daily and during sleep. Wearing these appliances to correct tongue thrust can vary from several months to a year. Collaboration with dental professionals is necessary to guarantee these appliances' correct use and efficacy.
Preventive Measures for Tongue Thrust
Preventive measures for tongue thrust include:
Early detection
Breaking detrimental oral habits
Promoting correct swallowing and speech habits
Seeking multidisciplinary treatment when necessary
Proactively tackling a common oral issue called tongue thrust allows individuals to avert the onset of more serious oral health issues and uphold overall well-being.
Frequently Asked Questions
1. What does tongue thrust look like in adults?
Tongue thrust in adults is characterized by pushing the tongue against the teeth while speaking or swallowing, drawing the tongue back into the mouth after a swallow, smacking lips together after a swallow, and having the tongue visible at rest during speech, especially when protruding between the teeth.
2. Can tongue thrust be corrected in adults?
Tongue thrust can be corrected in adults through orofacial myology therapy. This therapy successfully corrects the lips, jaw, and tongue placement, ultimately correcting swallowing habits and open mouth posture.
3. How do you know if you're tongue thrusting?
Tongue thrusting is identified through various symptoms, such as protruding the tongue between or against teeth when forming certain sounds, a frequent open mouth resting position with lips parted, mouth breathing, messy and loud eating, and the tongue being visually near the front of the mouth or between the teeth while speaking and swallowing.
4. What does an abnormal tongue thrust cause?
An abnormal tongue thrust can lead to an open bite, which may affect the growth and development of the front teeth, leading to flaring out or an open bite when the jaws close.
How Connected Speech Pathology Can Help You
Connected Speech Pathology specializes in recognizing and effectively treating tongue thrust in adults, even remotely, through secure online video conferencing. Our certified speech-language pathologists begin with a thorough assessment to identify the signs of tongue thrust in you, including open-mouth posture, improper tongue placement during speech and swallowing, and potential dental issues.
By understanding your unique symptoms and their impact, we tailor a personalized intervention plan to address the root cause and improve your oral-motor function.
Our evidence-based treatment for tongue thrust involves re-educating your oral-motor patterns and enhancing speech and swallowing function through:
Targeted exercises: We prescribe specific exercises to strengthen oral motor muscles, improve tongue posture, and establish proper swallowing patterns.
Remote access: Enjoy the convenience and flexibility of therapy sessions from the comfort of your home through secure online video conferencing.
Personalized approach: We recognize that each individual's needs are unique and adjust our program based on your progress and feedback.
Continuous support: Our dedicated team provides ongoing support and guidance throughout your journey to ensure you achieve your goals.
By choosing Connected Speech Pathology, you gain:
Improved oral-motor function: Strengthen your facial muscles and achieve proper tongue placement for speech and swallowing.
Enhanced speech clarity: Speak confidently and clearly without worrying about tongue thrust affecting your pronunciation.
Increased confidence: Overcome the challenges associated with tongue thrust and express yourself freely.
Convenient and flexible therapy: Receive effective treatment from the comfort of your own home, on your own schedule.
Ready to take control of your oral health and communication skills? Contact Connected Speech Pathology today for a free consultation and learn how we can help you overcome tongue thrust and achieve your speech goals.
Summary
In summary, tongue thrust in adults can have significant implications for oral health if left untreated. Individuals can effectively address tongue thrust and prevent further complications by recognizing the symptoms, understanding the causes, and seeking appropriate treatment options. Don't let tongue thrust impact your oral health – take action today to improve your well-being.
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.
