Braces use light constant pressure to move teeth slowly over a period of time. Each tooth and surrounding tissues become temporarily mobile as bone breaks down and rebuilds. Eventually the bone fills in around teeth solidifying into their new position.
Muscles around our mouth and face retains our teeth naturally. These muscles influence tooth movement and position. Teeth adapt to forces and move accordingly (how orthodontics work). Muscular force also shifts teeth due to the forces from the jaw, lips, tongue, and cheeks.
A balance of forces should exist between the lips and check on the outside of the teeth and inside with the tongue. Any imbalance will affect growth, comfort, and position of the teeth and jaw. The most significant type of muscular imbalance to affect the oral and facial structures is called a “tongue thrust”.
A tongue trust occurs when the muscles for swallowing have learned to work together incorrectly. The tongue can be very strong. When it constantly rest against the teeth and pushes forward during a swallow, it can cause the teeth to move.
If you have braces, a tongue thrust can be a problem because:
Slows down your orthodontic treatment, keeping you in braces longer.
Will move your teeth again, after your braces are taken off.
Makes moving your teeth and closing spaces more difficult for your orthodontist.
When the muscles of your mouth and face are not in balance, straightening teeth and correcting orthodontic problems is much more challenging.
There are many characteristics that determine if you or your child has a tongue thrust. Below are three of the most common signs:
MOUTH BREATHING is the most obvious one. The mouth is open at rest the tongue is often forward or even between the teeth.
SPEECH CONCERNS especially lisping can be a sign of a tongue thrust. Any difficulty pronouncing “T, D, N, and L” sounds is another indicator. General problems with articulation, rate of speech, and voice quality and clarity may also be present.
SUCKING HABITS past or present, can cause a tongue thrust to develop. The formation of the mouth and position of the tongue are changed by the thumb or finger during a sucking habit. Even if a child quits the habit damage caused to the function of the tongue, facial musculature, and other structures often remain.
Orthodontists have struggled over the years, having to fight the strength of the tongue while trying to provide the best orthodontic treatment. Many appliances have been invented to “tame” the tongue, and an appliance is one option available to help you with the tongue thrust.
For many patients, these appliances are uncomfortable, painful, and chosen as a last resort. While appliances may be helpful when it comes to straightening the teeth, it’s questionable whether they are able to correct a tongue thrust habit over the long-term. It is important to know your options when it comes to correcting a tongue thrust – an appliance may not be enough.
Re-patterning how the muscles function, changing habits slowly over time creates muscle memory that is sustainable.
Marie McElderry BSDH