Tongue Habits


Certain Orthodontic problems are caused by tongue habits. Teeth position is related to the forces that moved them there and keep them there.  The tongue is probably the single-most powerful environmental force affecting the stability and position of teeth.  Pound-for-pound, the tongue is one of the strongest muscles in the human body.  When the tongue position is habitually out-of-place, it causes a variety of devastating orthodontic problems.



Anterior Open Bites, Lateral Open Bites, Posterior Open Bites, Spacing between the teeth, and Certain Cross Bites are caused by abnormal tongue positioning.



Reverse Overjet, Crossbites, and other uncomfortable bites commonly causes a person to NOT WANT THEIR UPPER AND LOWER TEETH TO TOUCH each other whenever possible.  These patients use their tongue as a “cushion” or “pillow” between their upper and lower teeth, to avoid bite contact.  This scenario is known as “tongue cushioning” or “tongue pillowing.”  I am commonly diagnosing this type of behavior in my office as part of my treatment planning for the patient.  It is critical that patients understand that they must alter their tongue habits in order to have terrific long-lasting orthodontic results.



While most patients are able to be trained in our office for tongue habit problems, some patients are not able to follow our advice, usually due to muscular coordination limitaitons.  For these patients, we refer them to “tongue therapists” known as Oral Myofunctional Therapists (OMT).  A good OMT will begin by showing a patient their habits compared to good habits, and will then give the patient tongue exercises to strengthen certain aspects of the tongue muscle so that new tongue postures are habituated.



Many people think that a “Tongue Thrust” (an active movement) is what their problem is.  Most of the time, the “Tongue Thrust” is not the primary issue.  The primary issue is typically “Tongue Posture” when the tongue is not moving.  The “Thrust” is usually present when the “Posture” is wrong.  But it is important to focus on the PASSIVE “Tongue Posture” as the primary problem, since that is occurring over 20 hours a day, whereas the ACTIVE “Tongue Thrust” is more of a SYMPTOM of  a bad “Posture” that occurs for only a few hours a day, during speech or eating.  FOCUS ON “POSTURE,” not thrust so much.

If a tongue habit is not corrected, the results of orthodontic treatment will be temporary.  That is not acceptable to us as dedicated orthodontists.  Our goal is to give patients long-lasting results.



When not speaking or eating, the tongue should be sucked up to the roof of the mouth.  It should not hang over the biting surfaces of any of the upper or lower teeth.  The point is to “suck” the tongue to ther roof of the mouth and NOT “Hold” it up in the roof of the mouth.

For more information, and for helpful videos, go to www.tongethrust.com.  You can even do online real-time training on this site.



To understand why “sucking the tongue up” to the roof of mouth is normal, it helps to understand where this tongue posturing habit is learned.  It is learned during breastfeeding or pacifier use (when an “orthodontic pacifier) is used.  During Breastfeeding, the infant positions the mother’s nipple between the roof of the mouth and the top of the tongue.  The infant then creates a suction in the “sandwiched” nipple, and draws milk out of the nipple and over the top of the tongue, followed by swallowing.  This developmental process creates the habit of keeping suction between the top of the tongue and the roof of the mouth.

Most pacifiers today are “orthodontic” pacifiers.  It is difficult to even find a pacifier that is not “orthodontic.” Some premature babies need “non-orthodontic” pacifiers, which are usually provided by the Neonatal Intensive Care Unit of the delivering Hospital.  But most over-the-counter pacifiers are “Orthodontic.”

Parent’s are often confused by the term “orthodontic pacifier,” because their infants do not even have teeth in many cases.  But the purpose of an “orthodontic pacifier” is to develop normal tongue habits, so that when the child does develop teeth, the position of the teeth will not be harmed by destructive tongue habits.  I should point out that it is not appropriate for a child to have a pacifier past 2 1/2 year old.  Try to wean the child of a pacifier by 2 years of age.

While we have discussed infant tongue habit development extensively here, the point of providing this background is to help the reader to understand tongue posture and its how it is normally developed.  This is meant to aid the reader in comprehending proper tongue positioning, and why a “normal” position exists in the majority of the human population.

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