Tongue Thrust Disorder: What Treatment Options are Best?
"...tongue thrust is a highly treatable condition, once the reason for the tongue thrust is identified..."
If you or your child are exhibiting symptoms of a tongue thrust disorder, you’re not alone. Tongue thrust, sometimes also known as reverse swallow, is incredibly common among babies and young children, as well as adults.
The good news is that tongue thrust is a highly treatable condition, once the reason for the tongue thrust is identified with a comprehensive evaluation. Infants and toddlers may also be seen for a tongue thrust, which may impact their feeding, facial muscle development and later their speech when the tongue is seen to push out of the mouth. It is best to consult a licensed speech language pathologist or certified orofacial myologist to determine and treat the cause of the issue. Look for someone who attends continuing education courses in breathing, feeding, swallowing and courses that are related to dental and orthodontic development. You can find one near you at
What is Tongue Thrust Disorder?
Tongue thrust disorder is a condition that causes the tongue to rest low and forward in the mouth, instead of on the palate and push either against or between the upper and lower front teeth, during breathing, eating and swallowing or during speech. It may create a malocclusion—in other words, your top and bottom teeth don’t meet properly. While tongue thrusting most often impacts the anterior bite – that is the front teeth, if the thrusting occurs bilaterally – into the side of the mouth, the malocclusion can occur in the lateral or side teeth.
As with any Orofacial Myofunctional Disorder (OMD), tongue thrusts are involuntary and can happen at rest, while swallowing or even during speech. When the thrusting occurs during speech, it can cause a speech impediment, most commonly in the form of a lisp. Only a licensed speech language pathologist can evaluate and treat speech disorders, and those who are trained and preferably certified in orofacial myofunctional disorders are best to address articulation disorders that may be present. The sounds most affected are “s, z, sh, ch, j, zh and r”.
Causes of Tongue Thrust Disorder
Tongue thrusting and other OMDs can be attributed to 3 major factors, including prolonged sucking habits, breathing issues and tethered oral tissues (TOTs), also known as tongue tie or ankyloglossia. Other factors include congenital or inherited conditions.
First, sucking habits such as thumb sucking or extended use of a pacifier or bottle may promote a tongue thrust. For those with a thumb or other digit sucking habit, treatment with an orofacial myofunctional therapist may begin at age 4 of 5 if the child is ready and willing. Working with a feeding therapist who is a certified orofacial myologist may help with infants and toddlers to transition from a bottle or sippy cup to an open cup or straw drinking and exercises to improve the movements of the tongue.
Next, difficulties breathing through the nose may be due to allergies or other structural issues which may result in open mouth breathing. Soft tissue inflammation such as enlarged tonsils or adenoids result in mouth breathing, or mouth breathing may cause the inflamed soft tissue. An orofacial myofunctional therapist would be able to identify the need for a referral to an allergist or ENT in order to determine airway difficulties that might need to be addressed in addition to orofacial myofunctional therapy.
The final major cause of a tongue thrust is TOTs or tethered oral tissue, including an upper lip tie and sublingual or posterior tongue tie. A tongue tie may influence the position and restrict the movement of the tongue. It is a membrane made of collagen that has little stretch to it, that limits the proper resting posture of the tongue and causes a person to develop compensations that lead to abnormal muscle movements or even abnormal growth patterns of the jaw. If left untreated, the behavior can potentially lead to long-term breathing, swallowing and even speech issues—into adulthood.
What to Do if You Suspect Tongue Thrust Disorder
While the symptoms vary from person to person, there are a few key indicators of tongue thrusting, such as mouth breathing, an open bite or a lisp. If you suspect tongue thrust disorder, orofacial myofunctional therapy by a certified orofacial myologist often supports the work of an orthodontist or an airway centric dentist. Orthodontics to fix a malocclusion without orofacial myofunctional therapy can sometimes fail to address the root of the problem, causing orthodontic relapse.
Working with a licensed speech language pathologist that is certified in orofacial myology is the best option to effectively diagnose and treat tongue thrust disorder, as these individuals are able to address the specific muscle patterns causing the behavior and thus provide a long-term solution. You can find one near you at
Start the Road to Recovery with Alliance
At Alliance Speech & Language Center, our speech language pathologists and oral facial myologists employ a personalized approach to speech, language, breathing and swallowing issues, ensuring your needs are addressed quickly and comprehensively. We work closely with orthodontists, allergists, ENTs and oral surgeons to develop an effective treatment plan that facilitates a permanent recovery for you or your little one.
To learn more about Alliance Speech & Language Center and the conditions we treat, or to schedule an appointment with one of our speech therapists, please contact us.