Tongue thrust is the forward movement of the tongue tip between the teeth to meet the lower lip during deglutition & in sounds of speech, so that the tongue becomes interdental. - Tulley (1969)
Tongue thrust is an oral habit pattern related to the persistence of an infantile swallow pattern during childhood & adolescence & thereby produces an open bite & protrusion of the anterior tooth segments. - Barber (1975)
Type I : Non deforming tongue thrust Type II : Deforming anterior tongue thrust Sub Group 1 : Anterior open bite Sub Group 2 : Anterior proclination Sub Group 3 : Posterior cross bite Type III: Deforming lateral tongue thrust Sub Group 1 : Posterior open bite Sub Group 2 : Posterior cross bite Sub Group 3 : Deep bite
3. Classification III 1. Physiologic Tongue Thrust : During infantile swallow the tongue is placed between the gum pads. After six months of life, several maturational events occur that alter the functioning of the orofacial musculature. With the arrival of incisors the tongue assumes a retracted posture. If the transition of infantile to mature swallow does not take place with the eruption of teeth, then it leads to tongue thrust swallow.
2. Habitual Tongue Thrust : It is present as a habit after the correction of the malocclusion. 3. Functional Tongue Thrust : It develops to achieve an oral seal. 4. Anatomic Tongue Thrust : It occurs due to macroglossia.
4. Ask the child to perform a series of exercises like * w histling
* reciting the count from 60 to 69
* gargling or
* yawning, to tone the respective muscles
b) Use of appliances to correct position of tongue : 1. Pre-orthodontic trainer for myofunctional training . Nance palatal arch appliance
II. Speech therapy * Not indicated before the age of 8 years III. Mechanotherapy * Fixed & removable appliances: can be fabricated to restrain the anterior tongue movements during swallowing * force the tongue downward & backward during swallowing * re-educates tongue position