Tongue Thrusting: How a Hidden Habit Causes Gaps, Flared Teeth and Gum Recession, and How We Fix It
You swallow somewhere around 1,000 to 2,000 times a day, mostly without noticing. Each time, your tongue presses somewhere in your mouth. If it presses against the back of your front teeth instead of the roof of your mouth, that small push, repeated all day, every day, can gradually move teeth out of place.
This habit is called tongue thrusting, and it's one of the most overlooked causes of gaps between teeth, flared front teeth and even gum problems. At Fallsgrove Orthodontics, Dr. Boroun treats both the teeth and the habit behind them, so results look great and stay that way.
What is tongue thrusting?
Tongue thrusting, also called an orofacial myofunctional disorder or "reverse swallow," happens when the tongue pushes forward against or between the front teeth during swallowing, speaking or at rest. In a healthy pattern, the tip of the tongue rests on the roof of the mouth just behind the upper front teeth.
Babies naturally swallow with a forward tongue, and most children outgrow it. When the pattern continues, it may be linked to long-term thumb sucking or pacifier use, mouth breathing from allergies or enlarged tonsils, a tongue-tie, or simply a habit that never changed.
Common signs include:
• The tongue visible between the teeth when talking, swallowing or resting
• Lips apart at rest, or mouth breathing
• A lisp, especially on "s" and "z" sounds
• Messy eating, or pushing the lips or chin tight when swallowing
• Front teeth that don't touch when the back teeth are closed (an open bite)
Tongue thrusting affects adults too. Many adults don't realize they have it until their teeth begin to spread apart or their gums start to change.
How tongue thrusting affects your teeth and gums
Spacing between teeth
The steady forward pressure of the tongue can gradually push teeth apart, creating gaps, especially between the upper and lower front teeth. For some adults, gaps appear or get bigger years after they were closed, sometimes even after previous orthodontic treatment.
Flared front teeth
As the tongue keeps pushing, the front teeth can tip forward and fan outward. Flared teeth change the look of the smile and the lip profile, and teeth that stick out are more prone to chipping or breaking in a fall or sports injury.
Gum recession
The bone and gum tissue covering the front of the lower and upper front teeth is often very thin. When teeth are pushed forward, they can move toward the edge of that thin bone. This can make the gums more likely to recede, exposing more of the tooth and root. Receding gums can lead to sensitivity, a "long tooth" look and, over time, a higher risk of root cavities and gum problems. Gum health also depends on other factors, such as brushing technique, gum tissue thickness and gum disease, so a proper exam matters.
Open bite and bite problems
When the tongue rests between the teeth, it can keep the front teeth from meeting, creating an open bite. That can make it harder to bite into foods like sandwiches or apples, and puts more chewing stress on the back teeth.
Treating the teeth and the habit together
Closing gaps with orthodontics alone isn't enough if the tongue keeps pushing. Without addressing the habit, teeth can slowly drift back to where they were. That's why Dr. Boroun combines orthodontic treatment with myofunctional therapy for patients who tongue thrust.
Step 1: Orthodontic treatment moves the teeth into place
Depending on your age and needs, Dr. Boroun may recommend:
• Removable options. Clear aligners or removable appliances can close spaces and bring flared teeth back into a healthier position. They're discreet and easy to clean around, but they only work when worn as directed.
• Fixed lingual braces. Lingual braces are bonded to the back surfaces of the teeth, so they're invisible from the front. They work full time without relying on the patient to wear them. For tongue thrusters, they have an added benefit: because the brackets sit on the tongue side of the teeth, they act as a built-in reminder that helps the tongue stay back where it belongs.
• Habit appliances. For younger patients, a small appliance behind the front teeth can gently discourage the tongue from pushing forward.
Moving flared teeth back over their supporting bone can also create a healthier environment for the gums. When recession is already present, Dr. Boroun may coordinate with your dentist or periodontist to protect your gum health during and after treatment.
Step 2: Myofunctional therapy retrains the tongue
Myofunctional therapy is a series of simple, guided exercises that teach the tongue, lips and facial muscles new habits. Patients learn to:
• Rest the tongue on the roof of the mouth
• Swallow correctly without pushing against the teeth
• Keep the lips closed at rest and breathe through the nose
With practice, the new pattern becomes automatic. When therapy and orthodontic treatment happen together, the teeth move into place and the muscles learn to keep them there.
Keeping your results for life
Once treatment is complete, retainers hold teeth in their new positions. For patients with a history of tongue thrusting, Dr. Boroun may recommend a fixed retainer bonded behind the front teeth, a removable retainer, or both, along with continued practice of the healthy habits learned in therapy. Together, these give your new smile the best chance to stay stable and your gums the best chance to stay healthy.
Think you or your child might be a tongue thruster?
If you've noticed new gaps, front teeth that seem to be moving forward, or gums pulling back from your teeth, it's worth an evaluation. At Fallsgrove Orthodontics in Rockville, Dr. Boroun will look at your teeth, gums and tongue habits and recommend a plan that addresses the cause, not just the symptoms.
Book a consultation with Dr. Boroun or fill out our new patient form to get started.