Pediatric Dentist Explains: Tongue Thrusting

The tongue thrust reflex is normal in infants, but it should gradually disappear as children grow and begin eating solid foods. When the reflex continues past early childhood, it can affect oral development, speech, and tooth alignment. Understanding when tongue thrusting is normal and when intervention is needed helps prevent long term dental issues.

What Is the Tongue Thrust Reflex?

The tongue thrust reflex is a natural reflex that helps infants feed safely. Babies push their tongue forward when something touches their lips. This reflex supports feeding with breast milk and bottles during the first months of life.

As babies begin transitioning to solid foods, the reflex typically fades. Most children outgrow the tongue thrust reflex between 4 and 6 months of age. By this time, oral motor skills develop and swallowing patterns change.

When the reflex does not disappear, the tongue continues to press forward during swallowing, speaking, or even at rest. This pattern is called tongue thrusting.

When Tongue Thrusting Becomes a Concern

Tongue thrusting becomes a concern when it continues beyond early childhood. At this stage, the tongue should rest on the roof of the mouth and move backward during swallowing.

Persistent tongue thrusting can interfere with:

• Tooth alignment
• Jaw growth
• Speech development
• Oral muscle coordination
• Breathing patterns

Children with prolonged tongue thrusting may develop dental problems such as open bites, spacing between teeth, or orthodontic issues later in life.

What Causes Tongue Thrusting in Children

Several factors can contribute to tongue thrusting. In many cases, more than one factor is involved.

Prolonged Bottle or Sippy Cup Use

Extended use of bottles or sippy cups can reinforce infant swallowing patterns. This may delay development of mature swallowing habits and oral muscles.

Children who frequently drink from sippy cups may keep the tongue positioned forward, encouraging tongue thrusting.

Mouth Breathing

Mouth breathing is one of the most common causes of tongue thrusting. When a child breathes through the mouth, the tongue often rests low and forward.

Mouth breathing may be caused by:

• Enlarged tonsils
• Enlarged adenoids
• Chronic allergies
• Nasal congestion

These conditions affect tongue posture and oral muscle development.

Tongue Tie

A tongue tie can limit tongue movement and alter swallowing patterns. Some children compensate by pushing the tongue forward instead of lifting it properly. This compensation can contribute to tongue thrusting and speech development challenges.

Premature Babies and Oral Development

Premature babies may take longer to develop oral motor skills. The tongue thrust reflex may persist longer in these children. Delayed oral muscle coordination can also increase the likelihood of tongue thrusting.

Signs of Tongue Thrust in Children

Tongue thrusting is not always obvious. Some children show subtle signs that develop gradually.

Common signs include:

• Tongue visible between teeth when swallowing
• Difficulty chewing solid foods
• Open bite or spacing between front teeth
• Mouth breathing
• Speech difficulties
• Gag reflex sensitivity
• Prolonged thumb sucking
• Tongue resting between teeth

These signs may appear early or become more noticeable as permanent teeth begin to erupt.

How Tongue Thrusting Affects Teeth and Speech

Persistent tongue pressure against the teeth can influence how the teeth and jaw develop.

Dental issues linked to tongue thrusting include:

• Open bite
• Spacing between teeth
• Protruding front teeth
• Bite misalignment
• Need for orthodontic treatment

It can also affect speech development. Children may have difficulty producing certain sounds, including:

• S sounds
• Z sounds
• T sounds
• D sounds

In these cases, evaluation by a speech-language pathologist may be recommended. Speech therapy can help retrain tongue movement and improve articulation.

How To Stop Tongue Thrusting

Treatment depends on the cause and severity of tongue thrusting. In many cases, a combination of approaches provides the best results.

Myofunctional Therapy

Myofunctional therapy focuses on strengthening oral muscles and improving tongue posture. Exercises help retrain swallowing patterns and resting tongue position.

This therapy can improve:

• Tongue placement
• Oral motor skills
• Swallowing patterns
• Breathing habits

Myofunctional therapy is often recommended alongside orthodontic treatment when necessary.

Address Mouth Breathing

Treating mouth breathing is an important first step. This may involve:

• Allergy management
• Evaluation for enlarged tonsils
• Breathing exercises
• ENT referral when needed

Improving breathing patterns supports better tongue posture.

Limit Sippy Cups and Thumb Habits

Prolonged sippy cup use and thumb sucking can reinforce forward tongue movement and delay development of mature swallowing patterns. These habits may contribute to tongue thrusting and affect oral muscle development.

Transition to an open cup as your child grows and work toward limiting thumb sucking to support proper tongue posture and oral development.

Monitoring Oral Development as Your Child Grows

Regular dental visits help identify tongue thrusting and other oral development concerns early. The American Academy of Pediatric Dentistry recommends scheduling your child’s first dental visit by age one, or within six months of the first tooth erupting. 

At Stanley Pediatric Dentistry, Dr. Kate Stanley monitors oral development at every visit and provides guidance on habits to avoid and best practices as children grow. Early monitoring helps reduce the risk of future dental issues and supports healthy speech and oral development.

Pediatric Dentist in Overland Park KS

We are always accepting new patients! To book an appointment at our pediatric dental office in Overland Park, call (913) 345-0331 or visit us at 8575 W 110th St Suite 310, Overland Park, KS.

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