A tongue thrust swallow, also known as an infantile swallow, reverse swallow, or immature swallow, and an oral facial Myofunctional disorder.It is a pattern of swallowing where the tongue pushes forward against the front teeth instead of pushing up and back against the roof of the mouth. 

This can cause the front teeth to become pushed into a forward position and misaligned leading to dental problems known as an open bite shown or an overbite.

Tongue thrust swallow is a common swallowing pattern in infants, but most children outgrow it by the age of 6 or 7. However, in some cases, tongue thrust swallow may persist into adulthood, leading to ongoing dental problems, speech difficulties, sleep and behavioral issues.

Muscles Move Teeth!

The muscles of our mouth and face are nature’s orthodontic stabilizers. They can have an influence on the movement and position of our teeth.

Teeth are ever-changing,  they can be altered and moved by muscular influence from the jaws, lips, cheeks and  tongue. This is why early intervention is important. Form Follow function.

The same forces used by wearing braces can also be used by the tongue to move teeth. We swallow 1200- 2000 times per day. If your tongue pushes forward, it is putting 1 pound of pressure against the teeth every time you swallow. You can see how if not corrected your teeth will keep moving. 

Any imbalances can affect the growth, comfort, position of the teeth, jaw and shape of the face.

Ideally, a balance of forces exists between the lips and cheeks on the outside of the teeth, and the tongue on the inside of the teeth.

A “tongue thrust” or “reverse swallow.” is cause the most significant type of muscular imbalance to affect the oral and facial structures as a child grows.

If you have braces, a tongue thrust can be a problem because:

  • It can slow down your orthodontic treatment, keeping your braces on for a longer time.
  • It can make your teeth move again, after your braces are taken off.
  • It can make moving your teeth and closing spaces much more difficult for your orthodontist.

 When the muscles of your mouth and face are not in balance, solving orthodontic problems is much more challenging.

How do you know if you have a tongue thrust?

There are many characteristics to look for in order to determine if you, or your child, have a tongue thrust. 

Below are 4 of the most common signs to recognize:

  1. Mouth breathing and open mouth posture are the most common signs. The mouth is open at rest, and the tongue is often forward or sticking out. The picture with this blog shows one way the bite may be open.
  2. Speech Concerns, especially lisping, can be a sign of a tongue thrust. If there is difficulty pronouncing “T, D, L, N, R,  and S” sounds, this is another indicator. General problems with articulation, rate of speech, and voice quality and clarity may also be present.
  3. Sucking habits, past or present, can cause a tongue thrust to develop. The formation of the mouth and position of the tongue are changed by the thumb or finger during a sucking habit. Even if the child quits the habit, the damage caused to the function of the tongue, facial musculature, and other structures often still remains once the structure has been affected.
  4. Open Bite having front or side teeth unable to bite together is an excellent sign of a swallowing dysfunction.


How do you treat a tongue thrust swallow?

Treating a tongue thrust swallow typically involves retraining the tongue to move in the correct swallowing pattern, through exercises and therapy, which involves pushing the tongue up and back against the roof of the mouth instead of pushing forward against the front teeth. 

In severe cases, orthodontic treatment may be necessary to correct any dental problems caused by the tongue thrust swallow.

Treatment may include:

  1. Tongue exercises: A speech-language pathologist or an orofacial myologist can teach you exercises to strengthen the tongue and retrain it to move in the correct swallowing pattern.
  2. Myofunctional therapy: This type of therapy focuses on retraining the muscles of the face, tongue, and mouth to correct the swallowing pattern.
  3. Orthodontic treatment: In some cases, orthodontic treatment may be necessary to correct any dental problems caused by the tongue thrust swallow, such as misaligned teeth or an open bite.
  4. Behavior modification: Making certain changes to your daily habits can also help correct a tongue thrust swallow. For example, avoiding sucking on straws, chewing gum, or biting your nails can help prevent the tongue from pushing forward against the teeth.
  5. Counseling: Counseling may be necessary if a tongue thrust swallow is related to an underlying emotional or behavioral issue.

It is important to seek the advice of a qualified healthcare professional, such as a speech-language pathologist, dentist, or orthodontist, to determine the best course of treatment for a tongue thrust swallow.

What can happen if you do not have treatment for a tongue thrust swallow?

If a tongue thrust swallow is not treated, it can lead to several potential complications, including:

  1. Dental problems: The repeated pushing of the tongue against the front teeth can cause misalignment of the teeth, leading to issues such as an open bite, overbite, or other orthodontic problems.
  2. Speech difficulties: A tongue thrust swallow can interfere with normal speech patterns, causing speech difficulties such as lisping or difficulty pronouncing certain sounds.
  3. Swallowing difficulties: A tongue thrust swallow can also lead to difficulty swallowing, particularly with larger pieces of food.
  4. Choking: In severe cases, a tongue thrust swallow can lead to choking, particularly when eating or drinking.Who treats a tongue thrust swallow
  5. Self-esteem issues: Dental and speech problems caused by a tongue thrust swallow can lead to self-esteem issues, particularly in children and adolescents.


It is important to seek the advice of a qualified healthcare professional, such as a speech-language pathologist, dentist, or orthodontist, to determine the best course of treatment for a tongue thrust swallow to prevent these potential complications.

Who can treat a tongue thrust swallow?

A tongue thrust swallow can be treated by several healthcare professionals, including:

  1. Speech-Language Pathologist: A speech-language pathologist (SLP) is a healthcare professional who specializes in evaluating and treating communication disorders, including tongue thrust swallow. SLPs can provide exercises and therapy to retrain the tongue to move in the correct swallowing pattern.
  2. Orofacial Myologist: An orofacial myologist is a healthcare professional who specializes in the treatment of oral and facial muscles. They can provide therapy to retrain the tongue and other oral muscles to correct the swallowing pattern.
  3. Dentist: A dentist can evaluate the teeth and oral structures for any damage or misalignment caused by a tongue thrust swallow. They can also provide orthodontic treatment if necessary to correct any dental problems.
  4. Orthodontist: An orthodontist is a specialist in the diagnosis, prevention, and treatment of dental and facial irregularities. They can provide orthodontic treatment to correct any dental problems caused by a tongue thrust swallow.
  5. Pediatrician: A pediatrician can evaluate children for a tongue thrust swallow and refer them to a speech-language pathologist or other specialist for further evaluation and treatment.

Orthodontists have struggled over the years, fighting the strength of the tongue while trying to provide the best orthodontic treatment. Years ago orthodontists would install barbaric looking appliances to try to curb a tongue habit. Today, orthodontists refer to myofunctioanl therapists to treat tongue thrust swallowing. We first assess the underlying causes of the tongue thrust swallow such as tongue tie, tongue space, oral habits, airway or breathing problems. Once underlying causes of the tongue thrust swallow are addressed your therapist will teach correct tongue posture and correct swallowing patterns which are then habituated into your daily life.  

Oral Myofunctional Therapy is another method used for eliminating a tongue thrust. It is an exercise-based treatment that teaches patients how to use their tongue and facial muscles normally.

An Oral Myofunctional Therapist (OMT) can be an instrumental figure in helping a patient learn to retrain the facial muscles and eliminate a tongue thrusting habit. OMTs are skilled at helping children and adults gain control over muscular habits, including those involved in a tongue thrust. For children and adults who struggle with tongue thrusting, stopping the habit is not always easy. This is because all of the muscles of the face and mouth have been programmed over the course of many years. The person’s body does not know how to use the tongue and facial muscles correctly, and needs help.

A consultation with an oral myofunctional therapist can be very valuable. If the muscles are not re-trained, your orthodontic treatment and final result may be compromised.

Besides affecting your braces, a tongue thrust can also have a lasting negative impact on a person’s general health, speech, dental health, swallowing and breathing throughout life.

If your tongue is not resting correctly in your mouth due to a jaw issue or tongue-tie, things can get out of alignment in your mouth and the rest of your body.

What is a posterior tongue tie?

A posterior tongue-tie is a relatively new concept to many people in the dental field but I’m seeing a lot of patients with posterior tongue-ties in my practice, so I thought I’d go into some detail about this condition.

We’ve been hearing a lot about tongue-ties lately as modern medicine starts to recognize the negative health effects of a tongue-tie, but did you know that there are two types?

Anterior tongue-ties are obvious. This is the kind of tongue-tie that’s most easily diagnosed and treated. We can see right away that the underside of the tongue is connected too tightly to the floor of the mouth, and that the range of motion is restricted.

A tongue-tie, also known as ankyloglossia, is a condition that develops in babies in utero and is present at birth. Tongue-ties restrict the movement of the tongue and limit its range of motion in the mouth.

Tongue-ties can negatively impact a baby’s ability to eat and swallow. Other consequences of a tongue-tie for infants include:

  • Difficulty breastfeeding, often resulting in early termination of breastfeeding
  • Negative impacts on milk supply
  • Diagnosis of failure to thrive
  • Poor sleep
  • Difficulty adjusting to solid foods

Children with tongue-ties also experience issues such as:

  • Difficulty eating solid foods
  • Gagging or choking
  • Unwillingness to try new foods; only eating certain foods
  • Drooling
  • Speech delay or speech issues like deterioration in speech or difficulty articulating
  • Behavior problems, including ADD/ADHD, ODD, depression and mood swings
  • Dental issues such as crowded teeth
  • Behaviors to compensate for tongue-tie that may be hard to break

And, if these issues remain untreated into adulthood, other issues can develop. These issues can directly impact how you feel about yourself, how you relate or interact with others, and your dental and overall health.

Adults with tongue-ties frequently experience issues including:

  • The inability to open the mouth and restricted tongue movement that widely affects speech and eating habits
  • Speech impediments; stress over having to focus on speaking properly
  • An inability to speak clearly
  • Noisy jaw joints (creaking, clicking, grating or popping of the jaw)
  • Pain in the jaws at rest or when in use
  • Headaches
  • Jaw development issues
  • Poor oral health, including tooth decay and gingivitis
  • Stress or sensitivity about appearance

Tongue-ties can also affect your posture. If there is a tongue-tie present, the head tends to be tilted low and forward.

Forward head posture related to tongue-tie can also stress the sternocleidomastoid muscle (SCM) and the trapezius muscle, as well as muscles in the back and neck, and contribute to:

  • Jaw conditions, such as TMD
  • Neck and back pain
  • Headaches/migraines
  • Pain in the shoulder

Tongue-ties can also affect your breathing (causing mouth breathing), the stability of your pelvic floor and even how you walk.

If you notice these effects in yourself or your child, it is time to talk about treating that tongue-tie. While you may think it’s relatively harmless, the fact is that this condition can affect the entire body and overall health.

Tongue-ties and complications are treated with myofunctional therapy and surgery to release restricted tissue. Many individuals treated for their tongue-tie find immediate relief from their symptoms, including improved posture.

It is important to seek the advice of a qualified healthcare professional to determine the best course of treatment for a tongue thrust swallow and tongue ties.

Sheree offers patients myofunctional therapy to retrain their tongue and orofacial muscles before and after their tongue-tie is treated and for Tongue thrust swallow. Learn more about our service here.


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 Does insurance cover therapy?

The coverage of tongue thrust therapy by insurance may vary depending on the individual insurance plan and the provider’s diagnosis. In general, speech therapy for speech and language disorders is often covered by insurance, including treatment for tongue thrust. However, it is important to check with your specific insurance provider to confirm coverage for tongue thrust therapy.

It may also be helpful to check with the speech-language pathologist or orofacial myologist who will be providing the therapy to see if they accept your insurance and if they can provide information about the insurance coverage for tongue thrust therapy.

If insurance does not cover tongue thrust therapy, there may be other options for financial assistance, such as government-funded programs, grants, or payment plans offered by the healthcare provider.