What is the cause of oral thrust (tongue thrust)?

From the Guidelines

Oral thrust, also known as tongue thrust, is a habitual movement of the tongue that can be caused by a variety of factors, including oral motor disorders, swallowing disorders, and functional communication disorders, as suggested by the study published in the Journal of Neurology, Neurosurgery and Psychiatry in 2021 1. The exact cause of oral thrust can be complex and multifaceted, involving a combination of physiological, psychological, and environmental factors.

• Some possible contributing factors to oral thrust include:
  • Oral motor disorders, such as those affecting the coordination and movement of the tongue, lips, and jaw
  • Swallowing disorders, such as dysphagia, which can affect the normal movement of food and liquids through the mouth and pharynx
  • Functional communication disorders, such as those affecting speech and language development
  • Psychological factors, such as anxiety, stress, and habit formation
  • Environmental factors, such as oral habits, dietary factors, and socioeconomic status According to the study published in the Journal of Neurology, Neurosurgery and Psychiatry in 2021, treatment of functional communication disorders, including oral thrust, may involve a range of strategies, including education and explanatory approaches, symptomatic approaches, and psychological approaches 1.
• Education and explanatory approaches may involve providing patients with information about the nature of their disorder, the rationale for diagnosis, and the potential benefits of treatment.
• Symptomatic approaches may involve techniques such as reduction of excessive musculoskeletal tension, elimination of secondary or accessory movements, and focusing on normal movements and sounds.
• Psychological approaches may involve addressing psychosocial issues, cognitive features, and maladaptive behaviors, as well as providing counseling and support to help patients manage their symptoms and improve their quality of life. Overall, the cause of oral thrust is complex and multifaceted, and treatment should be tailored to the individual patient's needs and circumstances, as suggested by the study published in the Journal of Neurology, Neurosurgery and Psychiatry in 2021 1.

From the Research

Causes of Oral Thrust (Tongue Thrust)

• The tongue thrust is involved in nearly all open bites, and an open bite can be created by tongue thrust, tongue posture, or mandibular posture 2.
• The weaker the masseter muscles, the more likely an open bite will either be present or may develop during orthodontic treatment, leading to tongue thrust 2.
• Tongue thrust can be caused by abnormal habits like thumb sucking or underlying causes like enlarged adenoids, leading to breathing and speech difficulties, open bite, and protruded teeth 3.
• The development of tongue thrust during orthodontic treatment can be an unrecognized potential roadblock, contributing to poor occlusal intercuspation both during and after treatment 4.
• Skeletal configurations, such as clockwise growers (dolichocephalic facial types), can lend themselves to the development of an open bite, which can then be perpetuated by tongue thrust 2.

Relationship Between Tongue Thrust and Other Factors

• A positive significant relationship has been hypothesized between tongue-thrust swallowing and articulation disorders in children, although the presence of articulation disorders is strongly associated with the anterior open bite present in tongue-thrust swallowers 5.
• The term 'tongue thrust' has been adopted to describe the oral myofunctional disorder, which can be less associated with the act of swallowing and more with the resting posture of the tongue 6.
• Orofacial myofunctional therapy (OMT) can help correct tongue thrust by improving swallow, posture of tongue, improper muscle function, and reducing relapse of previous orthodontic treatments 3.