Know About Tongue Thrust In Newborns And Children: Causes, Symptoms And Treatment

Tongue thrust is an orofacial muscular imbalance disorder in which the tongue pushes outward against or between the front teeth while you are swallowing, speaking or eating.

The condition is often referred to as a habit and has been called by various names like a reversed swallow, deviate swallow, oral myofunctional disorder, abnormal swallow, infantile swallowing or deviant deglutition. [1]

Tongue thrust is common in breastfeeding babies and they usually outgrow this habit over time when their orofacial muscles develop. However, if the condition continues during infancy, it may lead to oral, sleeping and eating problems.

Let's talk about tongue thrust in detail.

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Tongue Thrust In Newborns

Tongue thrust is normal in newborns as their tongue lies between the gum pads and the facial muscles stabilise the jaws during swallowing. It helps babies with breast and bottle feeding.

As the baby grows and reaches six months, the tongue thrust usually disappears due to the eruption of primary teeth causing the positioning of the tongue high on the roof of the mouth and behind the upper teeth, with no cheek and lip activity during swallowing.

Losing tongue thrust is a normal sign of development in babies. However, in some children, especially those with a history of allergies or chronic nasorespiratory disease, enlarged tonsils or throat problems, tongue thrust persists during infancy and cause potential oral issues.

Tongue thrust in babies could also occur due to structural physiological abnormalities like abnormally large tongue or small jaws. Developmental issues like Down Syndrome and Cerebral Palsy can also cause tongue thrust in children.

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Types Of Tongue Thrust

• Anterior Thrust: Here, the tongue protrudes past the lips which are at rest or during swallowing. It is a common type of tongue thrust.
• Unilateral Thrust: Here, the tongue pushes unilaterally or one side against the teeth while swallowing, instead of forward. This may cause an open bite on the sideways.
• Bilateral Thrust: It occurs mainly due to a large tongue, when it pushes between the back teeth on both sides.

Symptoms Of Tongue Thrust In Children

Some of the symptoms of tongue thrust in babies are:

• Coming out of tongue while speaking, resting, swallowing or eating.
• Mouth breathing.
• Issues while chewing food.
• Unable to close the lips completely.
• Speech problems like lisping.
• Teeth clenching.
• Cheek or nail-biting.

Complications Of Tongue Thrust

If left untreated for long, tongue thrust can cause complications like: [2]

• Open bite, a condition in which some of the top teeth don't make contact with the bottom teeth, leading to biting problems.
• Lisp, a condition in which the tongue protrudes between the teeth while making the "S" sound, resulting in a "th" sound.
• Labial inclination of the four front teeth in both the lower and upper jaws.
• Excessive eruption of posterior teeth.

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Diagnosis Of Tongue Thrust

Tongue thrust can easily be diagnosed by a general practitioner who may further refer to a paediatrician, dentist or orthodontist. They may suggest certain therapies to improve the orofacial muscular imbalance and make sure that the teeth are developed properly and speech problems do not occur. [3]

Treatments Of Tongue Thrust

Studies say that treatment of tongue thrust depends on the age of the children, their needs and will. Some of the treatments and management of the condition may include:

1. Habit-breaking tools such as tongue cribs that may help prevent the outward movement of the tongue.
2. Treatment of misaligned teeth by the use of braces or surgery.
3. Myofunctional therapy to teach correct swallow and correct the tongue positioning at rest. It includes:

• Exercise of the facial and cervical muscles.
• Resistance training to prevent outward movement of the tongue.
• Lip exercises like ballooning or bubbles-blowing exercise for proper lip closure.
• Gum-drop exercise. [4]
• Spoon-holding exercise with lips.
• Using wind instruments like trumpet to strengthen the lip muscles.
• Tongue exercise.
• Teeth counting exercise.

To Conclude

Tongue thrust is a condition that can easily be treated with full recovery. However, an early diagnosis does help prevent the risk of some oral problems. If you think your child may be developing tongue thrust, consult a medical expert as soon as possible.

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