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Tongue Ties & Tethered Oral Tissues

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What is proper

tongue posture?

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Proper tongue posture involves the placement and resting position of your tongue in your mouth. The ideal position for your tongue is pressed against the roof of your mouth rather than letting it rest in the bottom of your mouth or pressed against the back of your teeth. The tip of the tongue should rest on the incisive papilla, the bump of tissue behind the two front teeth on the hard palate. The “SPOT” is located just behind that bump, it can be found by making an /N/ sound. The tongue should contact the three points on the palate indicated on the picture below.

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Why is proper tongue

posture important?

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Maintaining the right tongue posture has a number of oral health benefits:

Improves oral development
Promotes proper airway development
Maintains straighter teeth alignment
Prevents teeth grinding
Prevents your tongue from blocking airway
Prevents snoring and sleep apnea
Prevents mouth breathing
Improves support for your cheekbones and jaw so that they remain prominent with age

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What is a

tongue thrust?

Tongue thrusting is a myofunctional disorder in which muscular imbalance leads to the tongue pressing too far forward in the mouth during speech, swallowing, and even when the tongue is at rest. It may also be called also called reverse swallowing or immature swallow. During a normal swallow, the tip of the tongue presses firmly against the roof of the mouth slightly behind the front teeth, the rest of the tongue is pulled up into the palate. The lips should be closed with the teeth slightly touching. There should be NO additional muscle movements or contractions from the chin or face.

It is estimated a person swallows a total of 1,200 to 2,000 times every 24 hours with about four pounds of pressure per swallow. This constant pressure of the tongue will force the teeth and arches out of alignment. Aside from the pressure exerted while swallowing, nervous thrusting also pushes the tongue against the teeth while it is at rest. This is an involuntary, subconscious habit that is difficult to correct.

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Why is tongue

posture a concern?

Incorrect tongue posture can often cause misalignment, crowded teeth, crossbite, and open bites. This problem may lead to difficulties in biting, chewing, swallowing, and TMJ dysfunction. These problems can also include snoring, sleep apnea, clenching/grinding, nasal blockages, and enlarged tonsils or adenoids.

Other concerns including the following:

Delayed or impaired tooth eruption
Headaches, grinding, or clenching of the teeth
Stomach distress from swallowing air or incomplete chewing of food
Forward head posture
MIddle ear drainage issues

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What are the signs

of improper

tongue posture?

Tongue protrusion between or against the teeth when forming /s, z, t, d, n, l, sh/
Frequent open mouth resting position with lips parted
Mouth breathing
Messy and/or loud eating
Tongue visually near front of mouth or between teeth while speaking and/or swallowing
Lips often cracked, chapped, and sore from frequent licking
TMD (jaw or jaw joint) pain
Orthodontic relapse
Protruding teeth
Open bite

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What can cause a

tongue thrust?

Thumbsucking / sippy cups
Some artificial nipples used for feeding infants
Being “tongue tied” – a short or restricted lingual frenum
Mouth breathing can cause the tongue’s posture to be very low in the mouth
Nasal congestion, allergies, adenoids, frequent sore throats, or enlarged tonsils
The angle of the jawline or other hereditary factors within a family
Muscular, neurological, or other physiological abnormalities
An exceptionally large tongue
Narrow, vaulted palate

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How can myofunctional

therapy help?

Treatment starts with education regarding the importance of proper tongue and lip postures when at rest and when swallowing. Then awareness training to establish appropriate resting postures for the lips and tongue finally exercises to develop an appropriate swallow movement. This can help eliminate tongue thrusting habits. It is important to correct a tongue thrust habit because it can have a lasting negative impact on a person’s general health, speech, dental health, swallowing, and breathing throughout life. It can also affect the results of orthodontic treatment.

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Click here for a great video by Dr. Dan Hanson describing tongue thrusts and their dysfunctional effects.

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