Gal Levy, M.Sc., CCC-SLP | Article

Tongue thrust and treatment of subsequent articulation disorders.

Dear Doctor / Colleague,

This letter will shed some light on:
Tongue thrust and treatment of subsequent articulation

What is tongue thrust?
Tongue thrust (also called "reverse" or "immature" swallow) is the common name given
to orofacial muscular imbalance, a human behavioral pattern in which the tongue protrudes
through the anterior incisors during swallowing, speech and while the tongue is at rest. Nearly all
young children exhibit a swallowing pattern involving tongue protrusion, but by the age of 6 most
have automatically switched to a normal swallowing pattern. (Wikipedia).

Why is it a concern?
Dentists and orthodontists are concerned with the effects of the tongue and facial
muscles on the occlusion (how teeth fit together) of teeth because of the evidence proving that
too much tongue pressure against the teeth on the inside and an unequal amount of facial muscle
pressure from the outside - as is the case with a tongue thrust swallow and/or incorrect tongue
resting posture - may result in a malocclusion or misalignment of the teeth - the resting posture of
the tongue and facial muscles play an even more vital role: If the tongue is constantly resting
against the front teeth and the upper lip in short or flaccid (weak and flabby), the front teeth will be
pushed forward.
Thus, correcting this tongue thrust using special speech techniques will play a crucial role in any
good orthodontic treatment, making the treatment's results long lasting and much easier to

What are some signs of having a tongue thrust problem?
One or more of the following conditions may clearly indicate tongue thrust disorder and
should be investigated further with an evaluation of speech pathologist
1. Tongue protruding between or against the upper and/or lower "front teeth" when
forming /s/, /z/, /t/, /d/, /n/, /l/, or /sh/
2. Frequent open-mouth resting posture with the lips parted and/or the tongue resting
against the upper and/or lower teeth
3. Lips that is often cracked, chapped, and sore from frequent licking
4. Frequent mouth breathing in the absence of allergies or nasal congestion

Treatment of tongue thrust and subsequent articulation disorders.
To correct tongue thrust, speech pathologists prescribe exercises designed to promote a
normal swallowing pattern, as well as correct speech production. In the evaluation session the
patient will be given swallowing and articulation inventory tests. If only “pure” tongue thrust is
found without any articulation errors then usually three sessions are enough.
At this evaluation session the patient will be given the main set of drills against tongue
thrust that he has to do on a daily basis for 60 days following this session. A second session will
be scheduled 4 weeks later to follow up on the results of this oral physiotherapy and consider
adding another set of drills for the next 4 weeks after which the third session is scheduled with
follow up on the results.
If the patient has misarticulated consonants (usually the high pitched ones: /s/ , /z/ , /sh/ ,
/ch/ , /ts/) - then each sound will have to be corrected in a 8-session weekly speech therapy while
doing the same oral physiotherapy for 60 days - as well as specially designated speech drills to
correct each sound…The good news are that by successful correction of one sound we may
correct another (for example: correcting the /s/ may solve the problem with the /ts/ sound).