Maybe you had braces as a child, but your teeth still creep forward. You might speak with a lisp. Or maybe your mouth tends to be open, even when you’re not talking or eating. All of these can be signs of a tongue thrust in adults, also called a reverse swallow.
A tongue thrust can be diagnosed by a dentist, orthodontist, or speech-language pathologist. But can tongue thrusting be fixed as an adult? Or is it too late?
Good news: A speech-language pathologist can treat a tongue thrust at any age. Myofunctional therapy uses evidence-based techniques to retrain your tongue positioning and correct your swallow. As a result, you can improve your dental alignment, speech clarity, breathing—even your sleep quality. Here’s what you need to know.
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Get startedWhat is tongue thrust?
A tongue thrust is also known as a reverse swallow. In a correct swallowing pattern, the tongue tip is placed on the alveolar ridge (the bumpy ridge behind your top two front teeth). You gently bite down, the tongue pushes up against the hard palate, then the tongue pushes back and down to swallow.
In a reverse swallow, the tongue pushes forward against the front teeth during the swallow.
Correct swallowing patterns typically develop by the age of 6 or 7 years old. However, some children do not automatically develop that swallowing pattern, leaving them with a reverse swallow or tongue thrust. Often these children’s swallowing patterns are overlooked, and they grow into adulthood with their tongue pushing against their front teeth every time they swallow.
Tongue thrust can be corrected at any age. However, identifying the tongue thrust early can prevent potential health issues later.
What causes tongue thrust?
There are several possible causes of tongue thrust, including but not limited to:
Blocked airways (caused by enlarged tonsils, enlarged adenoids, deviated septum, or chronic allergies)
Poor muscle control
“Tongue thrust can also be associated with an open mouth posture, where the lips remain apart at rest,” says Laura Thorburn, MS, CCC-SLP, a speech-language pathologist with Expressable. “This posture often encourages the tongue to sit low and forward, contributing to a tongue thrust pattern over time.”
Tongue thrust can be linked to stress and anxiety. Stress doesn't cause tongue thrust. However, if you grind your teeth or clench your jaw when you're feeling anxious, you may also push your tongue forward.
Signs of tongue thrust in adults
Some signs of tongue thrusting that you may notice include:
Mouth breathing or an open mouth at rest, when you aren’t speaking or eating
Trouble speaking clearly (speech articulation difficulties)
Dental issues such as an open bite or a worsened underbite
A “full” bottom lip or tongue fully out while drinking from an open cup
You anchor the straw with your tongue when straw drinking
Pursed lips while swallowing
Jaw movement when swallowing
Tension in your neck or jaw
Why is it important to correct a tongue thrust?
When should you worry about a tongue thrust? Tongue thrust can affect a person’s health in many ways.
Persistent pressure on the teeth from the tongue can affect the development and alignment of the teeth. When the tongue pushes against the teeth during swallowing, speech, or at rest, this can lead to dental misalignments or malocclusions such as an overbite, underbite, open bite, or crossbite. Tongue thrusting that persists into the teen and adult years can even affect jaw alignment.
“This pressure against the teeth can also cause speech articulation difficulties, or problems pronouncing words clearly,” Thorburn says. “A lisp is a common result of tongue thrust.”
Other potential health issues related to long-term tongue thrust include:
Snoring
Sleep apnea
Jaw or neck pain from temporomandibular joint syndrome (TMJ)
Mouth breathing
Malnutrition (due to inefficient chewing and breakdown of food)
Social isolation and self-consciousness because of speech articulation difficulties, such as a lisp
Tongue thrust treatment for adults
You might wonder if you can fix a tongue thrust on your own. However, the most effective way to fix a tongue thrust is through speech therapy.
Your speech therapist will use an evidence-based treatment called myofunctional therapy. This treatment for tongue thrust targets the muscles of the face, jaw, tongue, neck, and mouth. The goals of myofunctional therapy are to improve your tongue’s oral resting posture and correct your tongue positioning in speech, chewing, and swallowing.
After a full evaluation, your speech therapist will teach you exercises for tongue thrust that are tailored to your needs. You may focus on:
Breathing through your nose with lips closed at rest
Improving jaw and lip stability
Optimizing tongue placement and coordination
Retraining your chewing and swallowing patterns
Consistent practice between therapy sessions is important. “Tongue thrust treatment is all about retraining your muscle movements and building new habits. Research supports short, frequent practice to remind your brain to tell your muscles what to do,” Thorburn explains. When you commit to an evidence-based treatment program, and regularly practice at home under the guidance of your speech therapist, you will see lasting change!
Treatment for tongue thrust can help prevent long-term health issues, no matter what age you are. Get matched with a speech therapist who can answer your questions and create a treatment plan just for you.
Frequently asked questions (FAQs)
What does tongue thrust look like in adults?
Common signs of tongue thrust include tongue pushing forward during swallowing, speech articulation difficulties such as a lisp, and dental changes like an open bite or forward front teeth.
What causes tongue thrust in adults?
There are several possible causes of tongue thrust, including thumb sucking as a child, blocked airways, poor muscle control, or a tongue tie.
When should I worry about tongue thrust?
A tongue thrust can contribute to health problems, such as dental misalignment, speech difficulties, jaw and neck pain, and sleep apnea. Issues like these can also affect your confidence and social participation.
What are some tongue thrust exercises for adults?
A speech therapist can teach you exercises for tongue thrust that are tailored to your needs. Exercises may focus on closed mouth breathing, jaw stability, lip closure, or tongue strength and range of motion. You may also practice techniques for chewing and swallowing.
Does insurance cover tongue thrust treatment in adults?
Many health insurance plans do not consider myofunctional therapy medically necessary for adults and therefore may not cover it. Each insurance plan has their own qualifications for medical necessity, so it's important to understand your plan's coverage if you'd like to use it for speech therapy.
Key takeaways
In a tongue thrust, the tongue pushes forward against the front teeth during a swallow.
Signs of tongue thrust can include (but aren’t limited to) mouth breathing, misaligned teeth, and speech issues such as a lisp.
Treatment is important because tongue thrusting can lead to dental problems, speech difficulties, jaw and neck pain, and sleep apnea.
The best way to fix a tongue thrust is through evidence-based treatment called myofunctional therapy, delivered by a speech therapist.
How Expressable Can Help
Concerned your child isn't reaching age-expected milestones? Looking for communication support from a professional? Expressable is a national online speech therapy practice serving children and adults. We treat all major areas of communication and feeding, offer flexible hours including evenings and weekends, and accept most major health insurance plans. We’re proud to have earned more than 3,000 5-star reviews from our clients (4.9/5 average).
Our therapy model is centered on parent and caregiver involvement. Research proves that empowering caregivers to participate in their loved one’s therapy leads to better outcomes. That’s why we combine live, 1-on-1 speech therapy with personalized education and home practice activities for faster progress.
Communication is more than words. It’s how we share how we feel and show who we are. We’re here to help you or your child do just that.
