I see many patients that have been informed that they have what is called a “tongue thrust”, and that it is causing issue with their teeth and bite. Specifically, tongue thrust has been claimed to be the cause of open bites (front teeth that are separated from one another), and front teeth that are excessively proclined (tipped forward). I would like to present the key points from an article by Robert M. Mason, D.M.D, Ph.D. from the International Journal of Orofacial Myology, titled, “Myths that Persist about Orofacial Myology”. The key question is- can tongue thrusts move teeth?
- A tongue thrust is different than the resting posture of the tongue. Tongue thrusting is an opportunistic behavior, that finds and fills spaces available in the dentition (such as existing open bites), sometimes when swallowing. There is no proof that tongue trusting causes malocclusions, or misaligned teeth. However, there is much data to support the relationship between abnormal resting posture of the tongue with misaligned teeth and malocclusions.
- A tongue thrust when swallowing does not move teeth! Moving teeth in humans requires a minimum of approximately six hours of continuous pressure. Even if you were to swallow thousands of times a day where the tongue pressed forward against (or between) the teeth, this is not nearly enough to make teeth start to move. Biochemical studies of Davidovich and colleagues demonstrated that hours of continuous forces against the teeth are required for significant amounts of specific enzymes to built up, which activate sequences of periodontal activities that result in tooth movement. Intermittent pressing motions of the tongue, no matter how strong, do not move teeth or cause open bites.
- If the tongue rests in a forward position between the teeth for long periods of time, this continuous position can absolutely cause open bites and protrusion of the front teeth. The key is that the force is continuous, even if the pressure exerted is very light (this is how braces work!). The same can be said for thumb sucking – hours of constant pressure can move teeth dramatically.
If you have any questions about your child and the position of their tongue, please feel free to contact me. Often this is something that can be addressed very successfully. More persistent cases may require the help of an orofacial myologist.
Dr. Dan Rejman is a Board Certified orthodontist, and is the owner of Meadows Orthodontics in Castle Rock, Colorado. There are two locations to serve the residents of the Castle Rock area, one in the Meadows, and one near Founders/Terrain.
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