Have you ever heard of a tongue thrust swallow pattern? Many patients are ‘tongue thrusters’. Often these people also lisp when they speak, and this lisping is what tends to heighten their awareness of the problem. The biggest orthodontic concern with the tongue thrust swallow is that most patients with a tongue thrust tend to have ‘open bites’ – a dental term used to describe a situation that exist when a patient is biting down and the upper and lower front teeth do not come together.
Orthodontists and Pediatric Dentists often use an appliance called a tongue crib to help to break the tongue thrusting habit and to help to re-establish a more proper biting pattern. These appliances tend to work extremely well when placed in the mouth, and most of the time the appliance is cemented in semi-permanently. In addition to the tongue crib habit appliance, it is often helpful to do ‘tongue retraining’, with or without the help of a speech therapist. Below, you will follow what our office calls a Tongue Retraining Cheat-sheet. We ask our patients with or without tongue cribs to use this cheat-sheet to try to retrain their tongues to swallow more functionally.
Tongue Retraining Cheat-sheet
For The Correction of Tongue Thrust Swallowing
Directions you are to follow in learning to swallow correctly:
- Close the teeth firmly in contact with one another.
- Place the tip of the tongue against palate or gum ridges with the tip touching the papilla or spot position. This is the rest position of the tongue at all times.
- With the tip of the tongue in the spot position, suck rest of tongue flat against the roof of the mouth, slide tongue back and swallow vigorously.
- SWALLOW again as in number 3.
- Again close teeth firmly, lips lightly with the tongue flat against roof of the mouth and suck hard and swallow.
- Use mirror to watch for facial movements when practicing. Muscles around mouth should be completely relaxed and should never move when swallowing.
- Never curl the tongue.
- Practice on small bits of food, small swallows of liquids. Do not blow, but suck, when swallowing.
- Keep lips closed lightly, and use a card or wax paper between the lips as a reminder to keep the lips closed.
- Repeat the above many times a day, and the following exercises to learn to swallow correctly.
- Place the tongue on the papilla in the rest or spot position and press many times a day.
- Place the tip of the tongue on the palate in the rest position and remember to keep it there while studying, reading, working, playing, watching television, or in school or work. Remember, your tongue is in the rest position at all times except when you chew your food, talk, or in the finishing of the Swallowing Act.
NIGHT TIME SUGGESTIONS
- Place the tip of the tongue on the palate at the spot position when you go to bed and try to keep it there until you fall asleep.
- When you awaken in the morning, again place the tip of the tongue on the palate in the rest position and try to keep it there.
- Follow the above basic steps of swallowing when you eat breakfast, lunch, snacks and dinner.
- Always think of the four basic steps used in correct swallowing whenever you eat or drink.
- Save this cheat-sheet, keep it with you and study it until you have committed it to memory.
Derek E. Brown, D.D.S., M.S.