Infants learn to swallow by thrusting their tongue forward, and this is normal for them to be able to nurse efficiently. As babies grow into toddlers and learn to drink from cups and glasses, the way they swallow usually changes. (With normal swallowing, the tongue pushes against the roof of their mouth.)

Most children learn how to swallow normally by the time they are 6 years old. But sometimes they have difficulty with changing how they swallow, and they continue to push their tongue against their teeth. The result is a disorder called tongue thrust.

Tongue thrusting may seem like harmless behavior, but when you consider that people may swallow up to 2000 times each day, the accumulating pressure from the tongue can force the teeth out of alignment.

Identifying tongue thrust

Researchers have identified several factors that may contribute to tongue thrusting, including:

·       Excessive thumb sucking: This habit also leads to an open bite or abnormalities with the teeth coming together properly.

·       Heredity: The facial structure of nerves, muscles, and bones may affect the tendency for tongue thrusting. For example, an inherited tendency for a long, narrow face may increase the chances to have tongue thrusting, due to how the mouth develops.

·       Physical development: Problems with the child's natural facial and oral development may have an impact on tongue thrusting. It also may develop due to a shortened lingual frenum (the tissue beneath the tongue), an enlarged tongue, large tonsils or adenoids.

If you are concerned that your child may be tongue thrusting, watch for these behaviors:

·       Problems with swallowing: Does your child have problems with swallowing? Does your child make a face or purse the lips when swallowing?

·       Mouth breathing: Does your child tend to breathe through the mouth? Does your child frequently suffer from allergies, throat infections or nasal congestion?

·       Speech: Does your child have difficulty with pronouncing s and z sounds?

·       Open mouth: When relaxing (for example, while sitting and reading or watching TV), does your child's mouth hang open with the tongue forward?

When your child comes in for a regular dental examination, we may be able to identify tongue thrust symptoms early on, particularly if your child is developing an open bite. We will be happy to discuss treatment options to help this problem.

Treating tongue thrust problems

Some dental treatment options for your child may include:

·       Exercises for the lips, tongue and jaw to train your child to swallow and pronounce correctly

·       Appliances to help prevent tongue thrusting or to help expand the palate as it develops

·       Orthodontic procedures to realign the teeth and adjust the bite

Some people may question orthodontic treatment for young children. However, it's important to understand that by the time children are 5 years old, their faces have 70% of their adult proportions. By the time they are 12 to 14 years old, children's faces have nearly 100% of their adult proportions. The American Association of Orthodontists recommends that children have their first orthodontic examination by the age of 7, to help prevent problems from developing later.

We may also recommend that you consult a speech pathologist. A good speech pathologist can help your child with oral exercises to improve both the physical and pronunciation problems associated with tongue thrusting.