Tongue thrusting: Should you be concerned?
My 5 year-old son has been diagnosed with a tongue thrust. His speech is very clear, with the exception of the "th" sound. My dentist has recommended treatment with a speech therapist, but my pediatrician has said his thrusting is mild and he will grow out of it. Could exercises help correct the problem without the need for a speech therapist?Question:
Speech and myofunctional therapy is usually not necessary to correct tongue thrust. About 97% of newborns have a tongue thrust when they swallow. This figure declines to about 80% between five and six years-old and to 3% by the age of 12 years. Children usually grow out of tongue thrust swallowing.
The tongues of newborns have very restricted movements. Over the next several weeks of life, the tongue develops backward movements, depression and forward movements. Between two and three years, a child is able to lick their lips from one side to the other. With increased control of the tongue and growth of the lower jaw, swallowing mechanics transition from the infant swallow to the adult swallow. This transition time varies in individual children.
Tongue thrusting and related habits have been said to cause an open bite between the upper and lower front teeth. Some recent studies have shown this is not necessarily true, however. Studies comparing the number of children with anterior open bites versus the number of children with tongue thrusts show a one in ten ratio of malocclusions versus tongue thrust swallowing. These studies conclude that tongue patterns do not necessarily lead to malocclusions.
Although the tongue can exert large amounts of force, tongue thrusting does not have the frequency or duration of forces necessary to cause open bites. A person swallows about 1,000 times per day. Each swallow takes a little over one second. Accordingly, tongue thrust forces only happen about 20 minutes daily. For teeth to move, a force must be applied for at least 8 to 14 hours per day.
If a patient has an open bite, the tongue may rest between the upper and lower teeth. This position could affect tooth orientation both vertically and horizontally. The best treatment is to correct the malocclusion with orthodontic appliances. Since the recommended time for orthodontic treatment varies, you should consult an orthodontist before your son reaches seven years of age.
Braham et al., Textbook of Pediatric Dentistry, B.C. Decker Inc. (1988).
Proffit et al., Contemporary Orthodontics, Mosby Year Book (1993).Answer: