There were great things that came about in the 1970s. They are now affectionately referred to as “the classics”. (I’m not sure how I feel about being classic, but anyway…). However, classic treatment approaches should be done away with when better, more effective, more efficient clinical techniques replace them.
I am continually amazed that in 2018 we still have these perpetuated myths about tongue thrust, whether it exists, what to do about it and whether it matters. I guess I’m amazed, because I’ve been effectively treating and eliminating tongue thrust for almost 20 years; so when I hear these reports from clients, friends, or family I just shake my head in disbelief! Am I time warping back 40 years to 1978?
Situation #1
Completing an evaluation with a 15-year-old young lady who has had speech therapy not once but twice in the past 10 years because of concerns with tongue thrust by the PARENTS because of mouth breathing and jumbled dentition.
She, of course, sees an orthodontist who uses appliances not only to spread her palate but also hinge her jaw to aid with dental alignment. The orthodontist agrees there is an issue with tongue thrust and refers to a speech therapist that is close by his office.
Unfortunately, this therapist is not trained in the elimination of tongue thrust so she does an articulation approach (understand that this child had no articulation errors) and no one sees any results or understands what is even to be expected.
Fast forward 5 years or so and the speech therapy is long gone, the braces are off, and low and behold the teeth are going right back where they started! Maddening! Kudos to the PARENTS who know this isn’t OK.
Their child has had sinus surgeries and massive orthodontia and 10 years later is still breathing through her mouth and thrusting. She is now old enough that she doesn’t want her teeth to go back to an open bite (which it already has) and her parents are concerned that the open mouth posture is indicative of something else.
YES! She has tongue thrust…
She has tongue thrust and if you understand why her palate needed to be spread and her jaw needed hydraulics, you understand that it all has to do with the oral muscles we use to swallow. If you have a reverse swallow, the front of the tongue is doing all of the work and not distributing the tongue where it should be as you mature from an infant to a toddler to a child to an adolescent and finally an adult.
Yes, these mouths are changing for many years and if the muscles are not working properly you have all sorts of maladies like jumbled dentition, misalignment of the jaw, TMJ pain, articulation disorders, and now research is pointing to progressive swallowing problems as we age.
It’s just like the toddlers who walk on their tip toes and as they get older they receive physical therapy to release the tight tendons and retrain their gait so that it doesn’t throw off their muscles, spine and posture as they grow.
Unfortunately, most people don’t “see” the effects of the reverse swallow and certainly don’t equate it to a tongue thrust so nothing gets done until the structures are set and even then, they treat the symptoms with appliances and surgeries rather than fixing the underlying muscle and swallowing issues that are causing it.
Situation #2
Another mind-blowing experience I had the other day.
The situation takes place in a well-respected and highly knowledgeable dental office where the dentists, assistants, and hygienists have all received education about tongue thrust. A 10-year-old child sitting in the dentist chair is accompanied by his mother and the dentist mentions that the boy has “tongue thrust”.
The mother says “What is that?”
The dentist briefly explains to the mother that it is the forward pushing of the tongue against the child’s teeth and it is contributing to his dental problems.
The mother says “What do we do about it?”
The dentist says “Nothing really”.
No one else (assistant or hygienist) chimed in and mentioned tongue thrust therapy and that it can eliminate the tongue thrust resting posture and active thrusting.
The mother left overwhelmed with a “problem” and no solution. The dentist will likely wait until the boy has all of his adult teeth mostly in and then refer to the orthodontist to have the palate spread, tongue basket or spikes, and braces followed by a permanent retainer. After a year or so, the boy will be back at the orthodontist for a second set of braces because the teeth have moved again.
When this conversation was shared with me, I was so sad and frustrated. I don’t know why the dentist didn’t refer for tongue thrust therapy to eliminate the tongue thrust as an option. Was it because he has referred in the past and it wasn’t eliminated? Was it because it was too time consuming and the patient won’t stick with it? Was it because he didn’t know?
Situation #3
This is taken from a conversation I had with an SLP colleague who stated “I hate tongue thrust. I really don’t know what to do with it so I just avoid those referrals.”
Well, I have to respect her honesty and candor but ethically I’m not ok with avoiding referrals. I am OK with referring to another professional who IS specially trained in tongue thrust.
Tongue thrust both as a condition as well as the treatment to eliminate it, is wildly misunderstood and ignored. Unfortunately, it gets more compounded with age as the misuse of the muscles leads to structural changes and eventually deterioration.
Fortunately, it’s not 1978 and we now know and understand the oral motor musculature and function and how to eliminate tongue thrust completely in a very short period of time.
Unlike almost every other aspect of speech language pathology, tongue thrust elimination, done properly, is very tangible and predictable. In other words, you can see it changing and you know exactly what to do next. Like many things in life, just because it’s simple doesn’t mean it’s easy…
Welcome to 2018!
These situations should bring both professionals and consumers into the reality that tongue thrust most definitely does exist, tongue thrust elimination should be provided by a professional specially trained in the elimination of tongue thrust as a swallowing disorder not just a tongue placement issue.
I have eliminated tongue thrust for over 15 years and trained many other professionals with the Stone Tongue Thrust Protocol to identify, diagnose and eliminate tongue thrust. Because of this I feel confident that the word is spreading and people are getting it… Then I have experiences like these! Oh boy! We still have a lot of work to do!
One of the biggest differences between 1978 and 2018 is the access to knowledge at our fingertips. There is no excuse for professionals to not be able to recognize tongue thrust. There is no excuse to not refer to a competent specially trained professional who has proven to eliminate tongue thrust.
The STTP Training Center provides education to both the public and the professional who are seeking information about the identification, diagnosis, and elimination of tongue thrust. We also have a provider registry listing those providers who have completed the extensive specialized training to eliminate tongue thrust as Certified STTP Practitioners. Visit StoneTongueThrustProtocol.com to learn more and welcome to the future!
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