Woman in blue sweater demonstrating tongue thrust, a common adult issue.

Signs of Tongue Thrust in Adults And How to Treat It

Reviewed by Dr. Joyce Richardson, PhD.

Swallowing seems like a simple task, right? You take a sip of water, your tongue pushes against the roof of your mouth, and down it goes. But for some adults, their tongue decides to take a different route and pushes forward or against their teeth instead, showing common signs of tongue thrust in adults.

It’s not just a problem for kids – adults can struggle with it too.

In this article, we’ll talk about tongue thrust in adults: how to spot it and what you can do to tackle it head-on.

What Is Tongue Thrusting?

To put it simply, tongue thrusting is an oral habit characterized by the tongue pushing against or between the teeth during swallowing, speaking, and even while at rest. You may also have heard it called habitual swallowing or reverse swallowing.

While it is very commonly seen in infants and children, it can also persist into adulthood if not adequately addressed or corrected during earlier stages. 

For example, as children, someone may have received traditional orthodontic treatment without addressing the underlying tongue-thrusting habit.

While not as common, tongue thrusting habits can also develop later in life maybe because of things like nasal congestion, mouth breathing, or dental conditions.

The bottom line is, tongue thrust—whether in a child or an adult—can lead to several issues. These include the shifting of aligned teeth, speech problems, and even jaw pain or temporomandibular joint (TMJ) disorders. That’s why early recognition and intervention are essential.

Let’s take a look at all of that in more detail.

Why Tongue Thrust Matters: Potential Consequences if Left Untreated

While it might seem like just a bit annoying to have your tongue push against your teeth when you swallow, the reality is that it can have significant effects on your oral health and overall well-being.

Domino effect demonstrating consequences of untreated tongue thrust.

Let’s break down some of the broader implications tongue thrust might bring.

  • Impact on Oral Health: When your tongue pushes against your teeth with each swallow instead of the roof of your mouth, it can gradually push them out of alignment. This can lead to issues like crooked teeth, or, in individuals who have previously undergone orthodontic treatment, a relapse of their corrected alignment, bite problems, and even temporomandibular joint (TMJ) disorders, which can cause jaw pain and clicking.
  • Speech Impediments: Your tongue plays a crucial role in forming sounds when you talk and the improper positioning of the tongue during speech can result in difficulties articulating certain sounds or even a lisp. This can impact your communication skills and even your confidence when speaking.
  • Other Potential Complications: Let’s not forget about potential jaw pain or temporomandibular joint (TMJ) disorders. The constant strain placed on the jaw due to tongue thrusting habits can lead to discomfort, pain, and even more serious TMJ issues if left unchecked. It can also lead to other complications like open bite (where your front teeth don’t touch when your mouth is closed), difficulty chewing and swallowing, and chronic swelling of the tonsils.

Needless to say, tongue thrust can snowball into bigger issues if left untreated. You’ll want to explore treatment options to get your oral health back on track.

Prevalence of Tongue Thrust in Adults

As babies, it’s totally normal for us to swallow in a different way and thrust our tongue forward. But as we get older, usually between 12 to 15 months, and our back teeth start coming in, it tends to go away.

By the time we’re 3 to 5 years old, about 55% of us stop doing it, and as we become older children and adults, the numbers drop even more to between 5% and 15%.

However, for some older kids and grown-ups, tongue thrust can stick around and cause issues. Sometimes, habits like sucking on a pacifier for too long or not being able to move our tongues properly can keep the tongue thrust going.

Cases of tongue thrust developing in adulthood are rare but can also happen.

What Causes Tongue Thrust in Adults?

Since most tongue-thrusting habits develop in childhood, and are found in adults later in life if they were never properly corrected, it may be easier to identify what causes tongue thrust in children than in adults.

Older boy with braces, smiling. Reflecting causes of tongue thrust in adults.

Imagine a scenario where a child undergoes traditional orthodontic treatment to correct their crooked teeth, but the child never worked with a speech therapist to address the underlying tongue-thrusting habit. If this habit isn’t addressed concurrently, it can persist into adulthood.

There are, however, a few other ways an adult may find their tongue thrusting all of the sudden. 

Let’s look at some potential culprits.

Anatomical and Physiological Factors

Certain physiological factors may contribute to the development of tongue thrust in adults. Nasal congestion, for instance, can lead to mouth breathing, altering the tongue’s resting position and potentially triggering tongue thrusting habits.

Similarly, individuals with certain dental conditions may also be predisposed to tongue thrust as their oral anatomy differs from the norm.

Tongue-tie, a condition where the tongue’s movement is restricted due to a tight frenulum, is one of the common reasons young babies and children become tongue thrusters. Depending on the severity of the tongue tie, it can sometimes correct itself. Other times, your doctor may recommend a procedure to cut the tongue tie so that it doesn’t get in the way of eating or swallowing.

Neurological Conditions

Although less common, neurological conditions can cause tongue thrust because conditions like cerebral palsy, Down syndrome, and Autism spectrum disorder can disrupt normal tongue movements, leading to tongue thrust.

Habits

Habits developed during childhood, such as thumb sucking or prolonged use of pacifiers or bottles, can contribute to tongue thrust. These habits, if persisting into adulthood, can continue to affect tongue positioning and swallowing patterns.

Toddler sucking thumb, potential early sign of tongue thrust.

Lifestyle Factors

Stress, anxiety, and poor oral habits acquired over time can also contribute to tongue-thrusting tendencies in adults. These habits may become ingrained and habitual, exacerbating the issue if not addressed.

Chronic Allergies

Believe it or not, chronic allergies can cause swelling of the adenoids and tonsils, which can cause the tongue to thrust forward when swallowing. If this behavior becomes a habit, you may become a tongue thruster.

Signs of Tongue Thrust in Adults

Recognizing the signs of tongue thrust in adults is crucial for early intervention and prevention of potential complications.

Here are some key indicators to watch out for:

  • Difficulty Swallowing: Adults with tongue thrust may find swallowing challenging, often feeling as though the tongue obstructs the natural swallowing process.
  • Speech impediments: Trouble pronouncing certain sounds, like s, z, or ch, can indicate tongue thrust in adults.
  • A Visible Tongue: In some cases, adults with tongue thrust may have a visible tongue resting posture, where the tongue rests against the teeth or protrudes between the lips when the mouth is closed.
  • Mouth Breathing: Chronic mouth breathing, often resulting from nasal airway obstruction or habitual tongue posture, can be linked to tongue thrust in adults.
  • Facial and Jaw Pain: The strain exerted by tongue thrust on the facial and jaw muscles can lead to discomfort or pain in these areas for adults.
  • Messy Eating: Tongue thrust can affect how you eat, leading to messier eating habits than usual.
  • Open Bite: Notice a gap between your front teeth when your mouth is closed. That’s called an open bite and can be a result of tongue thrust pushing against your teeth.
  • Orthodontic Relapse: If you’ve had orthodontic treatment in the past and notice your teeth shifting back out of alignment, tongue thrust might be to blame.
Man showing signs of jaw pain, related to tongue thrust in adults.

How Is Tongue Thrust Diagnosed in Adults?

If you notice any signs of tongue thrust, you will want to consult with a professional right away to get properly diagnosed.

You can consult with either a physician, a dentist, or a qualified speech therapist. You might want to consult with several of these professionals for a thorough evaluation of your situation and the best way to go about treating it.

The process of your diagnostic might look a little something like this:

  1. Notice signs of tongue thrust.
  2. Seek evaluation from a healthcare provider.
  3. Provider conducts oral examination.
  4. Provider observes tongue movements during speech and swallowing.
  5. Speech tests may be administered.
  6. Diagnosis and treatment guidance are provided by the healthcare provider.

A physician or a dentist will want to conduct a thorough oral examination to observe if there are any abnormalities of the mouth or occlusions contributing to tongue thrust

They’ll check to see if the tongue pokes out during certain sounds or while swallowing. They might even ask you to eat or drink something during the consultation to see it in action.

If you are consulting with a speech and language pathologist, they will do a targeted speech test where they ask you to pronounce certain words and sounds to pinpoint any speech problems tied to tongue thrusting. They’re listening to see if any sounds are distorted because of how the tongue moves.

Tongue Thrust’s Impact on Speech

We mentioned that if left untreated, tongue thrust can significantly affect speech.

Some potential speech problems it can cause are:

  • Lisp: Tongue sticks out between teeth during speech, affecting S and Z sounds.
  • Nasal Air Escape: The tongue fails to block air from the nose, affecting M and N sounds.
  • Hypernasal Speech: Excessive nasal airflow during speech due to incomplete closure of the soft palate, making sounds overly nasal.
  • Monotone or Flat Vowel Production: The tongue is too far back in the mouth, affecting certain vowel sounds.
  • Hyponasality: Reduced nasal airflow during speech, usually due to blocked nasal passages, makes speech sound less nasal.

If you’re experiencing any of these issues or your speech is struggling because of a tongue thrust, it’s important for it to be treated by a speech and language pathologist.

They can help you overcome these challenges and more to improve your communication abilities.

Close-up of a smiling woman showing tongue thrust impact on speech.

Treatment for Tongue Thrust in Adults

Tongue thrust is definitely treatable. If you catch it early, intervention can be highly effective.

A combination of orthodontic treatment, tongue thrust speech therapy, and myofunctional therapy are most commonly used together to treat the causes of tongue thrust and its symptoms.

These approaches all work well together and complement each other because they target both the structural and functional aspects of tongue thrust.

Orthodontic treatment

Orthodontic interventions are a cornerstone of tongue thrust treatment, especially when misaligned teeth or jaw issues contribute to the condition. Braces or aligners can help realign teeth.

In some cases, you may need a tongue crib which is an orthodontic apparatus that keeps your tongue off your teeth and in the right place.

Speech Therapy

Once any orthodontic causes of tongue thrust have been addressed, retraining the tongue to function correctly becomes equally as important. This is where speech therapy for tongue thrust comes into play.

While working with a speech therapist, individuals can learn techniques to speak and move their tongue properly and overcome the negative impact tongue thrust can have on speech.

Myofunctional Speech Therapy

The speech therapist might also bring in methods from Myofunctional therapy.

Myofunctional therapy is this special treatment focused on fixing how your mouth muscles work and how you swallow.

Basically, it’s a bunch of exercises and tricks meant to teach your tongue, lips, and jaw to position themselves in the right way.

Here are some myofunctional techniques commonly used to treat tongue thrust:

ExerciseDescription

Lip Exercises

Lip closure and competencyClose lips tightly and hold a piece of cardboard/popsicle stick between upper and lower lip for 5 seconds.
Lip puffingPuffing out lips as much as possible and force air between lips and teeth.
Lip movements and “oo-ee”Spread lips and purse them to make an exaggerated “oo-ee”.
Blowing up balloonsBlow into a balloon until full, release air, repeat.
Blowing bubblesUse lips to blow bubbles with a plastic bubble wand.
Button pullHold a big button between lips and teeth, resisting while the therapist pulls an attached thread.
WhistlingWhistle using either the lips or a whistle.
Lip stretchingStretch upper lip in a down and out motion.
Card pullHold paper/cardboard tightly between lips, and try to pull the cardboard in an outward motion.
Drinking out of a strawDrink through a straw to exercise lip, cheek, and tongue muscles.
Spoon-holdingHold a spoon handle between lips, parallel to the floor.
Exercise by wind instrumentsPlay wind instruments like trumpet to strengthen lip muscles.
Other lip exercisesMake fish face, hold lips in an “O” shape, open mouth wide, practice lip “kisses.”

Tongue Exercises

Tongue spotLocate the spot behind the upper incisors on the palate and hold it there for 10 seconds.
Tongue clickPlace the tongue against the roof of the mouth and snap it down to make a clicking or popping noise.
Swallowing thin liquidHold water in mouth keeping the tongue at the spot behind upper incisors.
Swallowing thick liquidSame as above but with a thick liquid like a milkshake.
4s’ exerciseSpot, salivate, squeeze, and swallow. Hold the tongue behind the maxillary incisors while salivating, then squeeze the spot and then swallow.
Touch-noseStick tongue out and try to touch nose tip.
Touch chinStick your tongue out and try to touch the bottom of your chin.
Tongue-sideways movementStick tongue out and move it right and left, hold each direction for 10 seconds.
Tongue-rollingRoll your tongue like a taco shell, and stick it out. Hold for 10 seconds.
Hold and pullStretch lingual frenum by holding tongue against hard palate while slowly opening the mouth.
Tongue-exercise with foodLick sticky food (like peanut butter or yogurt) placed in the mouth to increase tongue strength.
K sound and swallowPronounce the “K” sound and pay attention to tongue placement.
Tongue bladesHold two popsicle sticks against lower teeth, try to lift the tongue against resistance.
Tongue exercise with spoonHold a spoon in front of your lips, push your tongue against it for 10 seconds.
Tongue retractionTouch back of tongue to palate, hold for 3 seconds.
Tongue-extensionStick tongue out between lips, hold for 3-5 seconds.
Tongue-pullGently pull the tongue outside and hold it with your hands.
Tongue around the worldMove tongue around teeth in circles.
Tongue push-upsPush tongue up against spoon/popsicle stick 10 times.
Monkey facePut the tip of your tongue over your front teeth and under your upper lips, hold for 10 seconds.
Vibrating toothbrushA vibrating toothbrush can stimulate tongue movement and act as a strong sensory input.
Teeth countingPatient counts teeth with the tongue to help move the tongue in all directions.

Jaw Exercises

Handheld massagersUse handheld massagers to hold the jaw open for a few seconds to stimulate chewing muscles.
Say “aahh”Open jaw and say “aaahhh.”
Jaw massageMassage the jaw gently toward and away from the lips.

Breathing Exercises

PranayamInhale and exhale air rapidly through the nose keeping the mouth shut, but relaxed.
Balloon blowingTake a deep breath in through the nose and blow it out into the balloon.

Cheek Exercises

Moving waterHold water in the mouth and shift the water sideways.
Moving airPuff air in cheeks and move from one cheek to another. Don’t let air escape from the mouth or nose.
Tongue rollRoll the tongue from one cheek to the other.
Fish facePuff the cheeks with air and blow a fish face.

Miscellaneous

Air-suckingClose back teeth, open lips wide, suck in air, draw tongue back, swallow. Use a mirror to make sure the tongue is pulled back and doesn’t touch the teeth.
Bite and swallowBite on rubber/chewie/soft tube and swallow.
YawningYawning strengthens throat muscles because it pulls the tongue backward, upward, and also toward the back of the throat.
Mirror exerciseExercise the uvula while looking into the mirror to improve the strength and tonicity of muscles in the soft palate and the pharynx.

Choosing the Right Professional

Now that you’re aware of tongue thrust and its potential impact on your oral health, you might be wondering, “What’s next?”

Well, since tongue thrust involves both physical aspects in your mouth and related lifestyle issues such as speech and swallowing, you may need to work with a few different professionals to completely treat the issue.

When you are ready to work with a speech professional, Virtual Speech Therapy LLC is here to help!

With over 50 years of experience in treating both children and adults, our therapists are well-versed in the techniques necessary to address speech problems resulting from tongue thrust.

Your speech therapist will serve as your guide and support system throughout your treatment, providing guidance, encouragement, and adjustments as needed. They’ll monitor your progress and celebrate your milestones along the way.

Don’t hesitate to reach out and begin your journey toward better speech today.