What is the treatment for oral thrust (tongue thrust)?

From the Guidelines

Oral thrust treatment should involve referral to a pediatric dentist or a general dentist who maintains a high level of competence in the care of children, as they can provide appropriate intervention to prevent or improve dental malocclusion caused by oral habits such as tongue thrusting, as recommended by the American Board of Pediatric Dentistry 1.

Treatment Approach

The treatment approach for oral thrusting should focus on addressing the underlying oral habit and preventing its negative impact on dental malocclusion.

• A pediatric dentist or a general dentist with expertise in pediatric care can assess the child's oral health and provide guidance on how to manage the oral habit.
• The dentist may recommend exercises or maneuvers to help the child change their swallowing physiology and reduce the frequency of tongue thrusting.
• In some cases, the dentist may refer the child to an orthodontist or other specialists for further evaluation and treatment.

Importance of Early Intervention

Early intervention is crucial in addressing oral thrusting and preventing long-term dental problems.

• Children who exhibit oral habits such as tongue thrusting should be referred to a pediatric dentist or a general dentist with expertise in pediatric care for prompt consultation.
• The dentist can provide guidance on how to manage the oral habit and prevent its negative impact on dental malocclusion.
• Regular dental check-ups and good oral hygiene practices can help prevent dental problems and promote overall oral health.

Evidence-Based Recommendations

The recommendation for referral to a pediatric dentist or a general dentist with expertise in pediatric care is based on the guidelines provided by the American Board of Pediatric Dentistry 1.

• The guidelines emphasize the importance of early intervention and referral to a specialist for children who exhibit oral habits such as tongue thrusting.
• The guidelines also highlight the need for regular dental check-ups and good oral hygiene practices to prevent dental problems and promote overall oral health.
• While there is limited evidence on the specific treatment approaches for oral thrusting, the guidelines provide a framework for healthcare providers to follow in managing this condition.

From the Research

Oral Thrust Treatment

• Oral thrust, also known as tongue thrust, is a condition where the tongue persists in an infantile swallow pattern during late childhood, leading to breathing and speech difficulties, open bite, and protruded teeth 2.
• Treatment options for oral thrust include orofacial myofunctional therapy (OMT), which has been shown to have a positive influence on patients treated for tongue thrust, improving swallow, tongue posture, and reducing relapse of previous orthodontic treatments 2.
• OMT techniques can be employed to correct tongue thrust, and exercises can be performed at home under the supervision of the child's parents 2.
• However, some studies suggest that the concept of soft tissue dysfunction as the primary cause of orthodontic abnormalities may not be valid, and that the tongue adapts its function to the abnormal anatomy 3.
• Other treatment approaches, such as combining oral-motor and behavioral interventions, have also been shown to be effective in reducing tongue thrust and improving feeding skills in patients with severe feeding problems 4.
• The efficacy of OMT has been evaluated using validated instruments, such as the Orofacial Myofunctional Evaluation with Scores (OMES) and the Iowa Oral Performance Instrument (IOPI), which have shown significant improvements in orofacial motricity and tongue strength in patients with tongue thrust 5.
• The impact of dentition on the efficacy of OMT has also been explored, with studies suggesting that OMT can improve orofacial motricity and tongue strength in patients with tongue thrust regardless of the type of dentition 5.