Bracket Chatter: Habits That Can Hurt

The perils of tongue thrust to successful orthodontic treatment and a beautiful Forever Smile.

We see many challenging orthodontic cases at Forever Smiles, but no case is more disheartening than meeting a new patient whose previous orthodontic treatment did not result in long-term success.

One such factor in the treatment and re-treatment of open bite or malocclusion has at its cause, tongue thrust. Tongue thrust naturally occurs from early infancy to about six months of age, but has been found to exist as a habit in children as old as 5 to 8. It is described as pushing the tongue forward between the upper and lower teeth when swallowing, rather than the proper position against the gum above the upper front teeth. Over time, this tongue thrust can cause an open bite. Left untreated, this can even cause relapse in a once-successful ortho patient and require re-treatment. Other variations of tongue thrust occur when the tongue pushes on one or even both sides of the mouth pushing teeth outward.

“The tongue is a powerful muscle, applying nearly four pounds of pressure every time we swallow. This pressure, when accompanied by a bad swallowing habit is enough to push teeth out of their natural position,” said Dr. Yan Razdolsky. “Even worse, imagine this happening nearly 2,000 times per day!”

Factors that can contribute to tongue thrusting include prolonged thumb sucking or pacifier use, upper airway obstructions such as allergies or nasal congestion which cause the tongue to lie low in the mouth and lead to mouth breathing, and even hereditary factors such as facial structure, large tonsils and macroglossia, or enlarged tongue. What’s more, these habits left untreated can continue through the teens and into adulthood causing relapse in orthodontic treatment.

“There are many telltale signs of tongue thrust that we look for when first diagnosing a patient for orthodontic treatment,” said Dr. Razdolsky. “However, the most important factor in diagnosis and treatment of any patient is getting to know them and helping them to become a part of their own smile treatment.”

So, what do we do? Treatment for tongue thrust can include therapeutic exercises which re-educate the tongue muscles, kind of like physical therapy for the tongue. In some cases, patients may be also prescribed a dental appliance to aid in correction. Either way, Dr. Razdolsky and the Forever Smiles team are here to work with you. Through treatment, when your braces do come off, your teeth will stay in alignment.