How to Stop Tongue Thrust – Causes, Signs, Exercises & Treatment
Tongue thrust is stopped by treating the reason the tongue comes forward, not by telling someone to hold it back. Depending on the person, that may mean ending a thumb or pacifier habit, retraining tongue posture and swallowing, correcting an open bite with orthodontic treatment, having a blocked nose assessed, or a combination of these. In many young children it needs nothing more than time and sensible observation.
I see tongue thrust from the dental side: front teeth that do not meet, gaps that reopen, orthodontic results that drift. The visible tongue movement is usually the last link in a chain, and the useful question is what sits earlier in that chain. This guide explains what tongue thrust is, what to look for, what the evidence does and does not support, and when a professional evaluation is worth having.
What Is Tongue Thrust?
Tongue thrust is a pattern in which the tongue pushes forward against or between the teeth during swallowing, during speech, or while at rest. You may also see it called tongue thrusting, tongue thrust swallowing, an atypical or infantile swallow, or an abnormal swallowing pattern.
Speech-language pathologists place it within a wider group called orofacial myofunctional disorders. The American Speech-Language-Hearing Association (ASHA) describes these as patterns of the mouth and facial muscles that affect how the tongue is positioned at rest and during swallowing, breathing and speech.
The important point is that tongue thrust describes what the tongue is doing. It does not tell us why. Two children with the same visible pattern can have completely different reasons for it, and those reasons decide the treatment.
What Is Normal Tongue Posture and Swallowing?
At rest, most people with a comfortable, balanced bite have their lips together without effort, breathe through the nose, keep the teeth slightly apart, and rest the tongue lightly against the roof of the mouth, with the tip just behind the upper front teeth.
During a typical mature swallow, the tip of the tongue stays on that ridge behind the upper front teeth, the body of the tongue presses upward and backward, the back teeth come together lightly, and the lips and cheeks do very little work.
In a tongue thrust swallow, the tongue moves forward or sideways between the teeth instead, and the lips and chin muscles often tighten visibly to help seal the mouth.
There is no single perfect posture that every mouth must match. Jaw shape, arch width and tooth position all vary, and I do not judge anyone on one swallow. What matters clinically is a consistent pattern, and whether that pattern is linked to a dental, speech or breathing concern.
What Are the Signs of Tongue Thrust?
Possible signs include:
- The tongue showing between the front or side teeth during swallowing or speech
- The tongue resting forward, against or between the teeth, often with the lips apart
- An anterior open bite, where the upper and lower front teeth do not overlap when the back teeth are closed
- Spacing or forward flaring of the front teeth
- Difficulty keeping the lips together comfortably, or visible strain around the lips and chin when swallowing
- Habitual mouth breathing
- A lisp on sounds such as “s” and “z” in some patients
- Front teeth that reopen or shift after orthodontic treatment
None of these proves tongue thrust on its own. An open bite can come from thumb sucking or from the way the jaws have grown. A lisp can be a normal stage of speech development. Spacing has many causes unrelated to the tongue. The signs are a reason to look more carefully, not a diagnosis.
How Can You Tell If Your Child Has a Tongue Thrust?
Parents often notice it at the dinner table. A few things are worth watching quietly over a week or two:
- When your child swallows, does the tongue appear between the teeth, or do the lips and chin tighten noticeably?
- Where does the tongue sit when your child is absorbed in a book or a screen?
- Is the mouth open most of the time at rest? Is there regular snoring?
- Do the upper and lower front teeth overlap when the back teeth are together?
- Do “s” sounds come out with the tongue between the teeth?
Home observation is not a diagnosis. Swallowing changes the moment a child knows they are being watched, and pulling the lips apart to look alters the swallow itself. Note what you see and mention it at the next dental visit.
What Causes Tongue Thrust?
Before recommending exercises, I want to understand why the tongue is adopting this position. Usually more than one factor is involved.
Developmental Tongue Thrust
Babies swallow with the tongue forward. That is normal and necessary for feeding. As teeth erupt and a child moves to solid food, the swallow matures gradually, and the timing varies widely. Research cited in the orthodontic literature has found the earlier, forward pattern still present in around half of five-year-olds and about a third of eight-year-olds.
So in a young child, a forward swallow is often a stage rather than a disorder. It is also common for the tongue to fill the gap for a while when the baby front teeth fall out.
Oral Habits
Thumb or finger sucking, prolonged pacifier use and extended bottle feeding hold the tongue low and forward and can prevent the front teeth from meeting. Once a gap exists, the tongue tends to move into it during swallowing. ASHA lists sucking and chewing habits that continue beyond about three years of age among the contributing factors.
Mouth Breathing and Airway Factors
If the nose is blocked, a child has to breathe through the mouth. Allergies, enlarged adenoids or tonsils and structural narrowing of the nose are common reasons. With the mouth open, the tongue sits low and forward to keep the airway clear.
In that situation the tongue posture is an adaptation, not a habit. Asking the child to keep the lips closed and the tongue up is asking them to breathe less comfortably, which is why exercises alone tend not to hold.
Dental and Skeletal Factors
When an open bite already exists, from any cause, the tongue has to come forward to seal the gap so that swallowing can happen. Here the tongue thrust is a consequence of the bite as much as a cause of it.
Some open bites are skeletal: they come from the direction in which the jaws have grown, not from anything the tongue is doing. Less commonly, a tongue that is large relative to the dental arches, or restricted in movement by a tight frenum (tongue-tie), may be relevant. Not every tongue-tie needs treatment, and this needs individual assessment. Conditions that affect muscle tone or coordination are a separate group and are managed with the child’s medical team.
Can Tongue Thrust Affect the Teeth?
Teeth sit in a balance between the tongue on the inside and the lips and cheeks on the outside. Light forces can move teeth if they are sustained for hours. That is how braces work.
A swallow lasts about a second. Even though we swallow many hundreds of times a day, the total time is short. This is why orthodontic thinking, particularly the equilibrium concept associated with Professor William Proffit, places more weight on where the tongue rests than on how it moves during a swallow. What I assess clinically is not just the swallow, but where the tongue spends the remaining hours of the day.
A tongue that habitually rests forward against or between the teeth can be associated with spacing, flaring of the front teeth or an open bite in some patients. But the claims need to stay in proportion. Most crowding and most crooked teeth are not caused by the tongue. Gaps between teeth have many causes, including tooth size, missing teeth and the lip frenum. In adults, front teeth that have started to flare or space out should be checked for gum disease before the tongue is blamed.
What Is the Relationship Between Tongue Thrust and Open Bite?
It runs in both directions.
A tongue that sits between the front teeth can stop them from erupting fully, which may contribute to an open bite or keep one from closing. Equally, an open bite created by a sucking habit or by jaw growth leaves a gap the tongue has to fill. The orthodontic literature itself describes the exact cause-and-effect relationship as controversial.
One thing I look for when assessing a child with an open bite is which factor appears to be driving the other. An open bite linked to a habit in a growing child often improves once the habit stops. A skeletal open bite will not close with tongue exercises, however diligently they are done.
Can Tongue Thrust Correct Itself?
In young children, often yes. The swallow matures with age, and an open bite caused by a sucking habit frequently improves on its own once the habit stops while the child is still growing.
Self-correction becomes less likely when:
- The pattern persists after the permanent front teeth have fully erupted
- The tongue rests forward throughout the day, not only during swallowing
- Mouth breathing continues
- The open bite is skeletal
In teenagers and adults, an established tongue thrust rarely resolves without some form of treatment.
I often explain to parents that not every childhood tongue thrust needs treating. Many need a careful look, a note in the records and a review as the permanent teeth come through.
How Is Tongue Thrust Diagnosed?
There is no single test. Diagnosis is a clinical assessment of how the teeth, jaws, muscles and airway are working together. In a tongue thrust evaluation I look at:
- Tongue resting posture
- The swallowing pattern, with saliva, water and food
- Lip competence, meaning whether the lips meet comfortably at rest
- Breathing pattern and any signs of nasal obstruction or mouth breathing
- The bite, including anterior open bite, overjet and overbite
- Dental arch development and the width of the palate
- Thumb, finger, pacifier or other oral habits, past and present
- Tongue mobility
- Speech, where there is a concern
- Age, dental stage and any previous orthodontic treatment
- Gum health in adults
Photographs, digital scans and X-rays are taken only when they are needed for planning, usually when orthodontic treatment is being considered.
Sometimes the outcome of this assessment is reassurance and a review date. That is a perfectly good result.
How to Stop Tongue Thrust
There is no single method that works for everyone. In my experience, simply telling a child to keep the tongue back rarely addresses the underlying problem. Tongue thrust treatment is built from the components below, and most patients need only some of them.
Habit and Behaviour Modification
If a thumb, finger or pacifier habit is still present, that comes first. Positive, age-appropriate approaches work better than scolding: explaining why, agreeing on reminders, rewarding progress. Where a habit persists and is affecting the bite, an orthodontist may discuss a habit appliance, such as a tongue crib, as a reminder.
Tongue Posture Training
This means teaching the resting position: tongue tip on the ridge just behind the upper front teeth, lips together, breathing through the nose. It sounds simple, but it depends on awareness and repetition through the day, and it only works when the nose is clear enough to breathe through.
Orofacial Myofunctional Therapy
Orofacial myofunctional therapy is a structured programme of exercises for the tongue, lips and facial muscles, aimed at a better resting posture, a retrained swallow and nasal breathing. It is usually delivered by a speech-language pathologist or a trained orofacial myofunctional therapist and relies on daily practice over a period of months. It is an option for selected patients, not a guaranteed fix. The evidence is discussed below.
Orthodontic Treatment
When a malocclusion is present, orthodontic treatment addresses the structural side. Braces or clear aligners can close an anterior open bite, close spaces and correct protruding front teeth. In growing children, an orthodontist may also consider widening a narrow upper arch or guiding jaw growth in selected cases.
Closing the open bite removes the gap the tongue was sealing, and in some patients the swallow adapts once the teeth meet. In adults with a skeletal open bite, orthodontics combined with jaw surgery may be discussed.
When Combined Treatment May Be Needed
If the tongue continues to rest forward after the bite has been corrected, the result is at greater risk of relapse. In these patients, coordinating orthodontic treatment with posture and swallowing retraining is a reasonable approach. Studies of combined management in open-bite patients are encouraging, although the research has clear limitations.
When an ENT Evaluation May Be Appropriate
Habitual mouth breathing, regular snoring, restless sleep, a persistently blocked nose or visibly enlarged tonsils are reasons to involve an ENT specialist. A dentist can notice these signs but cannot diagnose or treat airway obstruction. Not every patient with tongue thrust needs an ENT opinion, but where the airway is part of the picture, retraining the tongue without addressing it is unlikely to last.
Are Tongue Thrust Exercises Effective?
They can help selected patients. They are not reliably effective on their own, and they are not a substitute for diagnosis.
The research is worth stating plainly:
- A 2010 study in the American Journal of Orthodontics and Dentofacial Orthopedics compared open-bite patients who had myofunctional therapy alongside orthodontics with patients who had orthodontics alone. The combined group showed far less relapse. It was not a randomised trial, so it cannot prove the therapy was the reason.
- A 2014 systematic review concluded that myofunctional therapy combined with orthodontic treatment appeared effective, but it could include only four studies.
- A 2018 systematic review and meta-analysis of treatment in growing children found a lack of high-quality evidence, with the included studies rated at high or unclear risk of bias.
- ASHA treats tongue thrust as something that needs individual assessment by a collaborative team, not a standard exercise sheet.
In practical terms, tongue thrust exercises make most sense when the nose is clear, the person is old enough and motivated enough to practise daily, the problem is functional and not skeletal, and a trained professional is supervising. They make little sense as the only treatment when a thumb habit continues, the nose is blocked or the open bite comes from jaw growth.
So I am cautious about videos and articles promising that a handful of exercises will cure tongue thrust. Exercises have a place. They work best as part of a plan.
Tongue Thrust in Children
Most parents who ask about tongue thrust in children need less intervention than they fear.
In preschool children, a forward swallow is usually developmental. The useful steps are gentle help with any thumb or pacifier habit and attention to nasal breathing. Orthodontic associations commonly advise a first orthodontic check by around age seven, and that is a sensible time to have the bite and tongue posture looked at if there has been any concern.
A professional evaluation is appropriate if:
- An open bite remains after the permanent front teeth have come through
- A sucking habit continues beyond about three to four years of age
- Your child breathes through the mouth most of the time, or snores regularly
- Speech sounds are not developing as expected, in which case a speech-language pathologist is the right person to assess
- Your child is self-conscious about their teeth or speech
Early assessment does not mean early treatment. Often it means knowing what to watch and when to act.
Tongue Thrust in Teenagers and Adults
Tongue thrust that has persisted into the teenage years or adulthood can still be assessed and treated. It is unlikely to change on its own, but adults are capable of learning a new resting posture with deliberate practice.
Adults usually find out in one of three ways: an open bite that has always been there, front teeth that have spaced or reopened after earlier braces, or a dentist noticing the pattern during a routine examination.
Points that matter at this age:
- Orthodontic planning should take tongue posture into account from the start, not after the braces come off
- Open bite is recognised as one of the less stable orthodontic corrections, so retention with well-maintained retainers is essential
- Functional retraining of posture and swallowing may be recommended alongside adult orthodontic treatment with braces or aligners
- A skeletal open bite in an adult may need a combined orthodontic and jaw surgery opinion
- Cosmetic work to close gaps in the front teeth should come only after tongue posture and gum health have been checked, because closing a space without addressing what opened it is poor planning
Jaw joint pain or clicking is a separate issue. Tongue thrust is not a diagnosis of a TMJ problem, and jaw symptoms deserve their own assessment.
How Long Does Tongue Thrust Treatment Take?
It depends on what is being treated:
- Stopping a childhood habit can take a few weeks to a few months
- Myofunctional therapy is generally measured in months of regular practice, with follow-up to check that the new pattern has become automatic
- Orthodontic correction of an open bite commonly takes one to two years or longer, depending on complexity, followed by retention
A realistic timeline can only be given after an assessment. Be wary of fixed promises made before anyone has examined the bite.
Can Tongue Thrust Come Back After Treatment?
Yes. Teeth settle where the forces around them balance. If the bite is corrected but the tongue still rests between the teeth, or mouth breathing returns, or a habit resumes, the teeth can drift back.
This is why, in selected patients, both sides are addressed: the dental structure through orthodontics and the function through posture and swallowing retraining. Retainers, worn as advised, and periodic reviews matter more for open-bite patients than for almost any other orthodontic group.
When Should You See a Dentist?
A dental evaluation is worthwhile if:
- Front teeth do not meet, or a gap between upper and lower front teeth is developing
- Spaces are opening between the front teeth
- Teeth are shifting after orthodontic treatment
- A child’s sucking habit is proving hard to stop
- There is persistent mouth breathing or snoring
- You are planning braces, aligners or cosmetic treatment and suspect a tongue habit
None of this is an emergency. It is a routine consultation, and the earlier the pattern is understood, the simpler the decisions tend to be.
Tongue Thrust Treatment at V R Dental in Hyderabad
V R Dental Maxillofacial Surgery & Implant Center has cared for families in Hyderabad since 2017. Our approach to tongue thrust treatment starts with assessment, not with an appliance or an exercise sheet. If observation is all your child needs, we will say so.
Where the bite needs orthodontic evaluation, this is carried out by our consultant orthodontist, Dr. Shiva, MDS (Orthodontics). Adults whose concerns involve spacing or restoration of the front teeth are seen by Dr. CH Vyshnavi, BDS, MDS (Prosthodontics & Implantology). Where a jaw-related or surgical opinion is relevant, such as a skeletal open bite, Dr. Ram Mohan S, BDS, MDS (Oral & Maxillofacial Surgery), is involved.
Speech therapy and ENT care sit outside dentistry. Where they are indicated, we will tell you and share our findings with the professional you choose to see.
V R Dental Kukatpally
Road No. 2, Kamalaprasanna Nagar, Vivekananda Nagar Colony, Kukatpally, Hyderabad 500072. Open every day from 10 AM to 8 PM. Phone: 77804 75090. The clinic is convenient for families from Kukatpally, KPHB, Miyapur, JNTU and Allwyn Colony.
V R Dental Bowrampet
Vijay Chowk, Plot B181-184, Simhapuri Colony Main Road, Bowrampet, Hyderabad 500043. Open Monday to Saturday from 10 AM to 8 PM. Phone and WhatsApp: 90001 03610. The clinic is convenient for families from Bowrampet, Bachupally, Nizampet, Pragathi Nagar and Mallampet.
Frequently Asked Questions About Tongue Thrust
What is tongue thrust?
Tongue thrust is a pattern in which the tongue pushes forward against or between the teeth during swallowing, speech or at rest. It is normal in infants and usually matures during childhood. When it persists, it may be associated with an open bite, spacing or certain speech sounds.
How do I know if my child has tongue thrust?
You may see the tongue between the teeth when your child swallows or speaks, an open mouth at rest, or front teeth that do not overlap. These are signs, not proof. A dentist or orthodontist can confirm the pattern and, more importantly, look for the reason behind it.
How do you stop tongue thrust?
By treating its cause. Depending on the person, this can involve stopping a sucking habit, tongue posture training, swallowing retraining, myofunctional therapy, orthodontic treatment for an open bite, or an ENT evaluation for mouth breathing. Young children often need observation only.
Can tongue thrust move teeth?
A tongue that rests forward against the teeth for long periods can be associated with spacing, flaring or an open bite in some patients. The brief pressure of swallowing alone is thought to be less important than resting posture. Many tooth-position problems have nothing to do with the tongue.
Can tongue thrust cause an open bite?
It may contribute to one or keep one from closing, but the relationship works both ways. An open bite caused by thumb sucking or jaw growth also makes the tongue come forward to seal the gap. Working out which is driving which needs a clinical assessment.
Can tongue thrust correct itself?
In young children it often does, as the swallow matures and sucking habits stop. It is less likely to resolve on its own once the permanent front teeth are in, if the tongue rests forward all day, or if mouth breathing continues. In adults it rarely resolves without treatment.
Are tongue thrust exercises effective?
They can help selected patients, particularly alongside orthodontic treatment, but the research is limited and results are not guaranteed. Exercises work best when they are individualised, supervised by a trained professional and combined with treatment of any underlying cause.
Does tongue thrust need orthodontic treatment?
Only when there is a bite problem to correct, such as an anterior open bite or significant spacing. Some patients need no orthodontic treatment. Others benefit from orthodontics together with posture and swallowing retraining.
Can adults have tongue thrust?
Yes. Some adults have had it since childhood without knowing. It is often noticed because of an open bite, gaps reopening after braces, or a dentist’s observation. Adults can be assessed and treated.
How long does tongue thrust treatment take?
Habit correction may take weeks to months. Myofunctional therapy usually runs over several months. Orthodontic correction of an open bite commonly takes one to two years or more, followed by retainers.
Can tongue thrust come back?
Yes. If the tongue’s resting posture has not changed, or mouth breathing or an old habit returns, the teeth can move again. Retainers and follow-up reviews reduce this risk.
When should I take my child to a dentist?
If the front teeth do not meet once the permanent incisors have erupted, if a sucking habit continues beyond three to four years of age, if your child mostly breathes through the mouth, or if you are simply unsure. A check by around age seven is a sensible baseline.
Book a Consultation for Tongue Thrust Evaluation
If you have noticed a persistent tongue thrust in your child or yourself, a single evaluation will usually tell you whether it needs treatment, monitoring or nothing at all. You can book a consultation at V R Dental in Kukatpally on 77804 75090 or in Bowrampet on 90001 03610, and get your child’s bite assessed by a specialist-led team.
References
- American Speech-Language-Hearing Association. Orofacial Myofunctional Disorders. ASHA Practice Portal.
- Smithpeter J, Covell D Jr. Relapse of anterior open bites treated with orthodontic appliances with and without orofacial myofunctional therapy. American Journal of Orthodontics and Dentofacial Orthopedics. 2010;137(5):605–614.
- Homem MA, Vieira-Andrade RG, et al. Effectiveness of orofacial myofunctional therapy in orthodontic patients: a systematic review. Dental Press Journal of Orthodontics. 2014;19(4):94–99.
- Koletsi D, Makou M, Pandis N. Effect of orthodontic management and orofacial muscle training protocols on the correction of myofunctional and myoskeletal problems in developing dentition: a systematic review and meta-analysis. Orthodontics & Craniofacial Research. 2018.
- Van Dyck C, et al. The effect of orofacial myofunctional treatment in children with anterior open bite and tongue dysfunction: a pilot study. European Journal of Orthodontics. 2016;38(3):227–234.
