Tongue Thrusting - help!

Message

#1 Post by **Skylark** » Fri May 08, 2009 10:58 am

Hi,

I've been through braces twice - one full treatment when 16, and one compromise treatment a couple of years ago. My problem was that my bite had opened up on my left side and that my left canine had been pushed upwards.

I had upper fixed braces three years ago to bring the canine down and close the bite somewhat. This was not supposed to get the perfect bite, just to improve it. I had never experienced any bite problems previously and was fine with that.

Anyway, my bite is now opening up for the second time on the left and is virtually as bad as it started. My canine is held by a bonded retainer but it is rising up a little. Am back in a removable appliance to close bite.

Ortho was baffled about why my teeth moved after first braces and has been unable to explain this second movement. Now has finally realised that this is all down to tongue thrusting to the side and clenching (we've been aware of clenching for a year or so).

I have a lot of faith in my ortho but I'm disappointed that this is happening again and that no one has picked up on this tongue thrusting habit in 3 years. Is it unreasonable to expect that a destructive habit should have been noticed by experts, or is it hard to diagnose?

I'm worried that my canine will continue to move even with bonded retainer as the active spring does not protect my front teeth. Ortho keen to push on and improve bite which I know will help me health-wise. Will the bonded retainer be enough?

I just feel like I'm watching all this hard work go to waste - and I seriously couldn't face braces for a third time.

Any suggestions for curing tongue thrusting myself? Ortho said I could eventually get a retainer to help but am worried it will be too late!

Any advice welcome.

#2 Post by **Brandon1978** » Fri May 08, 2009 12:08 pm

I have the same issue, though I am still going through round 2.

I will have fixed retainers when through, so I wonder if I am going to experience the same issue.

#3 Post by **Skylark** » Fri May 08, 2009 1:42 pm

Oh no, I didn't realise it was a common prob! I had no idea that it was my prob until yesterday - despite 6 years altogether of orthodontic work!

Has your ortho suggested any ways of retraining your tongue?

My bonded retainers are certainly helping and it's likely yours will do the trick. It's very comforting to know they're there.

#4 Post by **lav1** » Fri May 08, 2009 1:49 pm

Great post! Now when you say that you have a bonded upper, is it bonded on all 6 of the front teeth (behind) of just glued on the canines? Is that the typical way? Do you have a second retainer too?

From what I understand is that our open bite have alot of problems with relapse! Most of the time with tongue thrusting. In the past I was resting my tongue on my teeth in the resting position and swallowing forward, now I am working on correcting that. You can consider going to a speech therpist to work on swallowing or wear a tongue thrust appliance.

I am thinking about asking if I can have a essex retainer in addition to bonded upper and lower. Although I think that a hawley would be better, since I'll already be bonded I was thinking that the essex could help prevent grinding at night.

Good luck!

#5 Post by **lav1** » Fri May 08, 2009 1:51 pm

Also is your upper bonded a twisted wire or those little grey pads with a thin wire (they like to put those on the bottom)?

#6 Post by **dentalguy** » Fri May 08, 2009 1:51 pm

Hi, Skylark. I just feel your frustration coming through.

I was diagnosed with a similar problem of clenching my teeth and then thrusting my tongue into them. However, I wasn't that convinced as I didn't seem to have any of the typical clenching symptoms like damaged teeth or jaw pain. Indeed, the consultant giving the information seemed somewhat weary too, as if it was his best guess.

I've since done some research and come to the opinion that I've a bit of a deviant swallow. When you swallow correctly you're supposed to draw your tongue back and up into the pocket in your palate behind the alveolar ridge. Those of us with deviant/reverse - I think the clinical description is dysthargia - thrust our tongues forward instead. If you're doing this you could be pushing your tongue into or through you teeth every time you swallow. And when you think about the number of times we eat that's a lot of pressure on your teeth.

This might be a long shot as maybe your swallow's fine and the thrusting arrises just from the clenching. I came across some clips on youtube on exercises to cure this problem - they were just an introduction though. But here's one: http://www.youtube.com/watch?v=NC9-8JSem4Q

#7 Post by **Skylark** » Fri May 08, 2009 1:55 pm

It's bonded on all 6 of the front teeth. It must be holding pretty well because my molars have moved far more than my front teeth.

I had a splint style retainer that caused clenching probs (do you know if most thrusters clench too?) and I now have an active retainer to slightly improve my bite. But I really want an essix style one too! And I'm worried that my front teeth will continue to worsen while they fiddle about with my molars.

Is it unusual to have had so much treatment without this prob being noticed?

How are you working on correcting yours? Just consciously swallowing with your tongue in the roof of your mouth? I'd really like to know if it's possible to retrain your tongue on your own...

#8 Post by **Skylark** » Fri May 08, 2009 2:13 pm

Lav - it's a twisted wire. Apparently they have a tiny bit of give at the beginning which might be why my canine has moved a little.

Dental Guy - yes it's very frustrating! And it sounds like clenching and thrusting are connected. I think mine is more a combination of the two than a swallowing thing.

The YouTube clip is great - you really can find anything on there! It does seem that this might be more common than I thought. I'll have a look at those exercises esp as the girl in the clip pushes to the side like me.

Any other advice about curing this habit?

#9 Post by **sauerkraut** » Fri May 08, 2009 2:35 pm

Skylark wrote: I'd really like to know if it's possible to retrain your tongue on your own...

My daughter had severe tongue thrust issues and the ortho referred her to a speech therapist. For various reasons we couldn't get an appointment right away (had to wait a couple of months I think), so in the meantime my daughter was told to start training her tongue herself. At every opportunity (eg while sitting in class at school) she was supposed to hold the tip of her tongue against the roof of her mouth - for minutes at a time if possible - and to practise swallowing (mouth closed) with her tongue held there as well.

She did it so faithfully that it became a habit, and the speech therapist, when we finally got our appointment with her, said there was no need for further treatment.

So I think it can be done, but you really need someone to show you how to do the exercises properly and which ones are needed for your kind of tongue thrust, so at least one visit to a speech therapist would probably be a good idea.

Incidentally, our ortho did also say that if the exercises didn't work we might have to think about having my daughter's tongue made smaller

I was convinced he was joking at the time, but I have since discovered there is indeed such a thing as tongue reduction surgery. Thankfully we didn't need it, so I don't know anything more about it I'm afraid.

#10 Post by **newsboysgrl777** » Sun May 10, 2009 2:46 am

Hi there..I don't have a ton to add, but I've read of someone else's experience where she had something put on her brackets (or something?) that had a wire spanning the roof of the mouth....and on that wire, there was some little thing there that dangled slightly. What this did was give your tongue something to 'play with' in the correct position in the mouth, so that as you were 'playing' with that little thing (consciously or subconsciously), you were re-training your tongue. I'll see if I can find the post about it (whether from this message board or another one) and give you the info.

So sorry to hear about this late diagnosis, but I can't imagine it's easy to figure out. :-\

#11 Post by **newsboysgrl777** » Sun May 10, 2009 2:49 am

This was from another message board I belong to and is the post I was thinking of.

Hope it can help you!

Sunny wrote:I have had a very similar experience. I had a class III bite and my lower teeth have been moved back in the arch and my tongue was already not going to the roof of my mouth as it should be, but was pressing against my teeth and causing an open bite. As my lower teeth moved back, my tongue appeared not to have enough room and I was really uncomfortable with this. My ortho realised I was developing a tongue thrust and used an appliance, with had a bead on a wire across the top of my mouth. The wire was attached to buttons on my first molars. I then worked at training my tongue to 'play' with the bead ... it worked well.

My ortho also felt the 'less space' was so minimal, that it must be a subconscious thing, but ghee my tongue didn't like the cramped feeling at the time.

Please talk to your ortho about the possibility of tongue thrust, as the tongue is a very strong muscle and it will undo all orthodontic work, if it's continues to push against your teeth every time you swallow. You tongue must come to rest against the roof of your mouth.

Good luck!
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#12 Post by **Skylark** » Sun May 10, 2009 8:04 am

Hi,

Thank you all so much for your quick and helpful replies!

This is clearly a common problem and there are things that can be done.

I know my ortho suggested some type of spike thing on my final retainer but I'm hoping that I don't ruin my front teeth while they play about with the molars. Fingers crossed the bonded retainer will keep them there.

Am trying to retrain my tongue in the meantime so it doesn't push mainly on the left molars and canine. Should your whole tongue sit on the roof of your mouth when resting and swallowing or just the tip? Should your tongue touch your teeth when talking? So many questions but I've never given my tongue any thought before!

Thanks again for all your replies, and it's encouraging to know that you can retrain it if aware of the prob.

This board is so helpful. None of my friends or family has a clue how tricky orthodontic issues can be so it's nice to know there are lots of people out there who do!

Skylark

#13 Post by **dentalguy** » Sun May 10, 2009 10:58 am

I don't know if your tongue naturally sits up against the roof of the mouth for its length in the mouth - if that makes any sense! I think alot of people tuck the tip in behind the lower teeth. I have read that if you can train yourself not to do this - keep the tip up on the roof as well - that it will have benefits for tongue function and swallow.

Your tongue does have to touch - or come very close to - your upper incisors to articulate certain speech sounds like 't' and 'th'.

#14 Post by **newsboysgrl777** » Sun May 10, 2009 7:50 pm

Skylark wrote:Should your whole tongue sit on the roof of your mouth when resting and swallowing or just the tip?
Skylark

Sky, not sure what an ortho would tell youm but the way my tongue 'naturally' sits in my mouth is with almost the whole tongue touching the roof of my mouth...it feels like there is a natural 'curve' in the roof of my mouth that my tongue fits into. As for how far forward my tongue rests...i'd say its a little more than an inch behind the front teeth. there seems to be a ridge there that my tongue rests just on top of. (like there's the ridge, then my tongue goes slightly past it and sits where (i assume) my tongue's length stops.) don't know if that helps

#15 Post by **Zeppguy73** » Sun May 10, 2009 10:43 pm

I've actually met the therapist from the youtube video. She operates in my area and gave me a free consultation. She checked me out and made sure I didn't have tongue thrust, thus ensuring that my jaw issue was a minor skeletal issue. Since I had straight teeth, no speech impediment, and could swallow liquids open mouthed without any spilling out, it was pretty obvious to everyone I had no tongue thrust. My issue had to do with the fact that as I had grown, my upper jaw had tilted back slightly, creating an awkward bite angle and a slight open bite. However, the actual jaw itself was not deformed, and the teeth were still in perfect alignment.