Treatment for an Orofacial Myofunctional Disorder (OMD) is designed to optimize the individual’s ability to swallow, thereby improving their quality of life.  Treatment is developed and implemented to address the presenting concerns of swallowing or a related issue.  The goal of swallow treatment is to establish a new ability to swallow or to remediate or restore an impaired ability.  Usually, many questions are asked.

Often, I hear the term “tongue thrust”.  Others use medical terminology.  What is tongue thrust?
Tongue thrust is a common term used to describe a type of swallow in which the individual pushes his tongue against or between his teeth.  The key characteristic of tongue thrust is the protrusion of the tongue during swallowing and at rest.

What causes tongue thrust?
On the basis of evidence available at the present time, we believe tongue thrust is a normal behavior in infants.  We expect that by 5 or 6 years, more children appear to swallow without a tongue thrust than with one.  Some of the factors which seem to influence tongue thrust include improper infant feeding, enlarged tonsils and adenoids, mouth breathing, finger sucking, genetic factors, mixed dentition, and macroglossia (an abnormally large tongue).

What can be done?
A comprehensive tongue thrust program teaches a correct habitual resting posture of the tongue, lips, and mandible.  Treatment should involve strengthening all the muscles involved in chewing and swallowing.  Swallow training involves teaching the correct swallow and gradually increasing the use of the new behavior.  Finally, the goal becomes making the new swallow pattern automatic, at the subconscious level.

When should treatment begin?
It is difficult to make generalizations.  Each patient should be evaluated in terms of maturity, the presence of malocclusion, and the associated oral behaviors.  Having tongue thrust therapy before orthodontic treatment  should decrease the amount of time appliances are worn as well as having an influence on the teeth staying where they belong, once braces are removed.  Depending on the type of malocclusion, tongue thrust therapy can be done before, during, or after orthodontic treatment.