Dental issues for tongue thrusters

I am a speech-language pathologist. Many children on my caseload tongue thrust (TT). I am interested to know what you recommend to parents regarding this problem. I have mentioned orthodontics to one family because their daughter has an incredible overbite due to her tongue thrust. They didn't seem aware of either problem. Once I help her correct the TT, should she seek orthodontic services?

Question:

It is estimated that about 97% of newborns will tongue thrust. As children mature both skeletally and muscularly, this figure declines. In fact, studies have shown that approximately 3% of these children still tongue thrust at the age of 12 years. It is difficult to determine when the infantile tongue thrust ends because maturation of the swallowing process occurs gradually over several years.

Some would argue that tongue thrusting is the cause of an open bite, while others might argue that the open bite causes the tongue thrusting. Tongue thrust can be a compensatory habit, especially in children who have difficulty bringing the upper and lower lip together. Strong muscular contractions of the lips and tongue thrusting may help to obtain a good seal for swallowing. While some clinicians blame large tonsils or adenoids for tongue thrust, studies have shown that removing these tissues does not necessarily correct the problem.

Where the tongue is placed during swallowing is not as important as where it is positioned on a routine basis. If the tongue is constantly positioned between the upper and lower teeth, this can cause problems with tooth eruption and an open bite. Treatment would include orthodontic correction. Orthodontic treatment is best initiated after all the permanent teeth, except the wisdom teeth, have erupted. After treatment, the tongue will naturally adapt to the repositioned teeth. This approach reduces the need for myofunctional therapy.

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