Tongues can push teeth with slow, steady pressure. This can open spaces in the mouth. Sometimes, even with orthodontia, these spaces will not stay closed long term if a tongue continues to slowly exert pressure on the teeth. Therapy for tongue thrust can train the tongue to rest in the roof away from the teeth. 
Sometimes just getting the tongue resting and swallowing correctly can make a huge difference in the growth pattern of the jaw. Notice on the bottom photo above that the upper jaw is starting to grow more horizontally and less vertically by retraining the tongue to "behave". 
Getting a tongue "behaving" in the early years can help set the stage for proper horizontally based oral and facial growth and development. If you child is experiencing trouble with a visible tongue or poor oral muscle patterns, an evaluation for an OMD, Orofacial Myofunctional Disorder, i.e., may be warranted.
This is a long term photo history of a child who had approx. 6 months of active orofacial myofunctional therapy after stopping their thumbsucking.They were sent to my office by their orthodontist. Four years later, they still appear to be growing more horizontally, and are ready for their next step...their orthodontia. The average child needs between 12-18 sessions of active therapy, followed by check ins over time. 
When a tongue is not working properly, other muscles of the face and mouth try do the job of the tongue and begin to compensate. One of the main areas to become overworked is the chin, or mentalis muscle. Does your child's chin look like a "golf ball" or "ping pong ball"? It should be smooth & relaxed, like the lower photo post-therapy.
Orofacial Myologists Work With 
Tongue Thrust
If you or your child have been told by your dentist, MD, or speech pathologist that you have a "tongue thrust", you may benefit from a orofacial myofunctional evaluation and ultimately if indicated, oral muscular retraining of these thrusting patterns, which I am able provide. 

It is normal for a child to slowly evolve tongue posture from a more downward position to a more upward positon at about age four. However, in some children, this normal developmental cycle is interrupted. 

Common things that interrupt this cycle are usually related to things that keep a tongue low or forward... basically anything that encourages a low posture of the tongue can prevent the normal tongue transitions that occur at about age four. For example, if a child mouth breathes due to allergies or tonsils and adenoids, or an adult has a deviated septum or allergies, or an individual has a "tongue tie" where the movement of the tongue is restricted, this can keep the tongue in a lowered position and this upward transition is either delayed, interrupted, or even prohibited. Of course, digit sucking is a huge culprit as the tongue is forced in a lowered position with each moment of sucking. The normal transition is impeded. And, even if someone has a normal position through life, if something new develops, like new nasal allergies, or a deviated septum, the tongue can even develop a tongue thrust later in life. 

Finding the cause is crucial, and can take a little detective work. This is where a team effort comes in between your physician, dentist, and other members of your health care team. Getting to the root of the problem, calling on these specialists to help manage the cause, and then retraining the tongue in my office with orofacial myofunctional therapy can get you headed on the right track to success. 

"Tongue thrust", a term that has been around for awhile, is a term that has been used for decades to described the pattern in which a tongue "thrusts" against the teeth or the floor of the mouth when swallowing, or sits against the teeth, or forward and down when it is just at rest. 

The tongue should normally be up resting gently in the roof and away from the teeth. In tongue thrust, (also called an OMD, or Orofacial Myofunctional Disorder), it is not. A tongue that rests in the roof encourages proper growth and development of the face, nose, dental arches, and now as some new research evolves, perhaps even the airway! A tongue that pushes against teeth at rest encourages open bites, poor bites, poor speech patterns, and is often esthetically challenging. 

Over time these challenged patterns can impact the success of long term orthodontic treatment, and also speech correction with a speech pathologist. Teeth can move from the slow and steady pressure of a tongue that is resting improperly against them. That is why I have so many clients in my tongue thrust program that have been sent to see me from their orthodontist's office. Many of them have been told they have a "bite problem" and if the tongue continues to gently apply pressure against the bite, even with orthodontia, the process of correcting the bite can be slow, hindered, or highly challenged until the tongue is "behaving". That is where the team effort between the Certified Orofacial Myologist, Orthodontist, nd General Dentist or Pediatric Dentist really comes in! 

If you have been told you or your child may have a tongue thrust, please know I have been working with tongue thrust clients from ages 4-70 for almost two decades. One third of my tongue thrust clients are adults of all ages. 

In tongue thrust therapy, the COM determines what muscles need to be retrained, and exercises and activities are customized to both the individual needs and lifestyles of each individual. It is usually a balancing act between the patterns of the muscles of the tongue, lips, and the muscles that support the jaw. 

Change takes time and practice, but as my clients who have completed the program will agree, the process is so worth the effort. The average person requires approx. 12-18 sessions on a weekly or twice monthly basis, depending on scheduling. Of course, once we have an in office evaluation, Skype or FaceTime visits are available. However, I do need to see an individual in office for the Tongue Thrust Program so I can observe someone directly and offer the best strategies. 

For more info on tongue thrust, see the FAQ page or the Educational Info page.