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Understanding and Treating Tongue Thrust Swallowing

From Detection to Correction: Journey Through Tongue Thrust Therapy

Interview with Edit Juhász-Vedres, FirstMed’s Speech Therapist

When teenager Alexandra visited FirstMed for a health check, her pediatrician noticed she pushed her tongue forward, against, or between the teeth when speaking. She suggested that they have a speech therapist evaluate the child because this could indicate a possible tongue thrust swallowing pattern.

Alexandra’s parents were concerned about the possibility of a speech disorder. So they made an appointment with Edit Juhász-Vedres, FirstMed’s speech therapist, for a detailed diagnosis. She has worked with children and adults with speech disorders for over 20 years and has significant experience treating tongue thrust swallowing patterns.

Tongue thrust swallowing is a common condition in children, and treatment should be started as early as possible, above the age of ten. It can remain even in adulthood, causing speech or dental problems if missed. If orthodontic treatment were to take place, its success would depend on the development of correct swallowing techniques. Early detection and timely therapy are the key to preventing possible complications.

We asked Edit to explain tongue thrust swallowing and how it is treated. Take your time, educate yourself, and stay ahead of the game.

Can you explain briefly what tongue thrust swallowing is?

Tongue thrust, or, as we often refer to it, facial myofunctional disorder, means a condition in which the tongue presses too far forward in the mouth during swallowing, talking or even while at rest. Instead of the usual pattern, where the tongue presses against the roof of the mouth, it pushes against or between the teeth. While this is a natural habit in early childhood, if it persists into teenage years or later, it may lead to speech disorders, like lisping, or dental problems, like overbite or crossbite.

What causes tongue thrust swallowing?

Tongue thrusting is part of the natural process of growth and development in babies and little children. It begins as an infant’s instinctive way of breastfeeding, and by the age of six to eight, it usually evolves into a regular swallowing pattern.

However, some factors might lead to its persistence:

  • Extended use of bottles and pacifiers beyond the recommended age can reinforce the forward movement of the tongue.
  • Thumb sucking can shape the mouth and affect swallowing patterns.
  • Allergies or nasal congestion: When noses are blocked, breathing through the mouth can change tongue position and function.
  • Structural issues such as enlarged tonsils or a restricted frenulum (the small fold of tissue under the tongue) may also cause incorrect swallowing techniques.

Can tongue thrust swallowing occur in adults, or is it only formed in childhood?

In rare cases, tongue thrust swallowing can also develop in adulthood. A typical cause could be an injury or trauma to the mouth or face. It can happen by getting hit by a baseball, falling down stairs, or suffering an accident. Other reasons may be dental problems such as missing teeth or having an overbite (when the upper teeth overlap the lower teeth more than they should).

What symptoms could indicate tongue thrust swallowing?

Common signs that may indicate this condition in children or adults are:

  • Speech issues such as lisp;
  • Difficulty swallowing:
    • If the child cannot close their lips properly when swallowing and forces food back into their mouth instead of down their throat;
    • If the child doesn’t chew food properly before swallowing it,
  • Mouth-breathing;
  • Altered facial development, especially in children.

Pay attention to these symptoms to know when to seek the help of a specialist.

Also note that treatment for tongue thrust swallowing should be started only after age 10. This is mainly because younger children typically outgrow this phase as their oral muscles mature. Earlier intervention may not be as effective and could potentially interfere with the natural progression of a child’s development.

How tongue thrust is detected and diagnosed at FirstMed?

At FirstMed, we follow a holistic approach involving family practitioners or pediatricians, our patients’ first point of contact, and our speech therapist in the examination. Furthermore, dentists or orthodontists may also recognize this condition.

Generally, diagnosis can happen in various ways, like:

  • Thorough examination of the mouth, including the tongue and teeth;
  • Speech-language evaluation by a speech therapist;
  • Dental assessment by an orthodontist or pediatric dentist.

If necessary, we involve other specialists to detect the reason behind tongue thrusting.

How is tongue thrust treated at FirstMed, particularly through speech therapy?

We use a complex treatment method to address tongue thrust swallowing. In Alexandra’s case, her pediatrician referred her to me for speech therapy. In the speech therapy sessions, I guided her through tailored exercises on how to swallow correctly.

To offer optimal care, we collaborated with Fürstner Dentistry, our in-house dental partner, and their orthodontist practitioner, Dr. Anikó Sipos. Orthodontic treatment efficiently supplements speech therapy because improper swallowing may lead to the realignment of the teeth and jaw. While orthodontics corrects the teeth and jaw position, speech therapy helps to retrain the tongue.

Joint efforts of speech therapy and orthodontics eventually eliminated this disorder.

What are the possible consequences of not treating this condition?

If left untreated, it can lead to severe oral disorders. These could be:

  • Misaligned teeth,
  • Chewing difficulties,
  • Speech problems, or
  • Changes in the facial structure.

In conclusion

Speech therapy is an important part of the treatment for tongue thrust. It helps to retrain the muscles in the mouth and throat so that they work together properly. This will help in eating, speaking, and swallowing more easily.

If you think you or your child may have tongue thrust, do not hesitate to book a speech therapy consultation with Edit Juhász-Vedres. She will happily discuss your concerns and provide a comprehensive treatment plan if necessary.


Edited by: Dorottya Fekete

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