Other Treatment Techniques for Tongue Thrust
It is important to note that if a patient has any unwanted oral habits, such as thumb/finger sucking or lip biting, treatment must first focus on eliminating those behaviors.
Orthodontia
Orthodontists can create more space for the tongue by expanding the maxillary arch. He can reposition the teeth to form more normal arch configurations and occlusions which, in turn, facilitate non-thrusting resting positions and swallowing patterns. In cases of extreme over-jet, the orthodontist will push back the maxillary incisors posteriorly to foster better lips and tongue postures.
(Hanson, 1976)
Orthodontia
Orthodontists can create more space for the tongue by expanding the maxillary arch. He can reposition the teeth to form more normal arch configurations and occlusions which, in turn, facilitate non-thrusting resting positions and swallowing patterns. In cases of extreme over-jet, the orthodontist will push back the maxillary incisors posteriorly to foster better lips and tongue postures.
(Hanson, 1976)
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![Picture](/uploads/1/9/6/5/19656439/7668595.jpg?163)
http://www.tripleodentallabs.com/
The Alternative Lightwire Functional Appliance (ALF) device follows the Arndt-Schulz Law by applying a light, continuous force to the teeth and skull bones.
(A.L.F. advanced lightwire functional )
It may be necessary for a dentist or orthodontist to place an appliance in the patient's mouth to prevent the tongue from thrusting against the front teeth. These appliances aren't always very successful; they simply act as a punishment for the tongue.
(Braces san diego, 2011)
(Braces san diego, 2011)
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![Picture](/uploads/1/9/6/5/19656439/4690161.jpg?148)
www.completespeech.com
A Palatometer provides visual feedback to the client and/or clinician of real-time tongue-to-roof-of-mouth contacts
This video portrays the effectiveness of using a palatometer
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![Picture](/uploads/1/9/6/5/19656439/2390220.jpg?153)
www.drhomon.com
The Bio-Block/Tongue Crib blocks the tongue from pushing against the teeth during swallowing, speech, and at rest. Watch this video for a demo of how the tongue crib functions.
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![Picture](/uploads/1/9/6/5/19656439/7127409.jpg?134)
www.drhomon.com
After the tongue crib is removed, a retainer is worn to 'remind' the tongue of the correct tongue position.
Surgical Treatment
Surgical treatment may be necessary to modify the oral environment. Partial glossectomies, tonsillectomies, or labial and lingual frenectomies may be done to produce a more favorable spatial relationship or to improve the mobility of these structures.
(Hanson, 1976)
Surgical treatment may be necessary to modify the oral environment. Partial glossectomies, tonsillectomies, or labial and lingual frenectomies may be done to produce a more favorable spatial relationship or to improve the mobility of these structures.
(Hanson, 1976)
Other Techniques
- Heighten the patient's awareness of the thrust pattern and remind them to intentionally position their tongue on the alveolar ridge and begin the swallow with an upward-backward movement.
- During feeding, apply downward pressure to the middle portion of the tongue
- Teach the patient to position food posteriorly on the tongue
- Tilt the patient's head backwards.
- Train the client to use the correct oral resting posture. This ensures that the tongue will be in the correct position for a mature swallow. Steps for obtaining the correct tongue position:
b) The tongue tip should not touch the teeth
c) While the tongue is kept in that position, close lips without clenching the teeth
- Practice keeping the tongue on the "spot" aka alveolar ridge. Click on the links below to view videos that depict various exercises for this technique. - Elevator Disks: http://orofacialmyology.com/blog/wp-content/uploads/Disk-Elevator-Exercises.wmv
- - Neon Exercise Elastics: http://orofacialmyology.com/blog/wp-content/uploads/Neon-Exercise-Elastics.wmv
- Mouth Props: http://orofacialmyology.com/blog/wp-content/uploads/3Way-mouth-props.wmv
- (orofacial myology, 2013)
- If the tongue thrust is due to the patient's overall low tone or trunk instability then gently rock the patient through the entire spine while s/he is in a supine or prone position. Another approach for this patient is to have him/her bounce on a ball while the spine is supported in an upright position
- Place your hand on the patient's jaw and your finger directly under the chin while applying firm pressure. This helps the patient achieve and maintain the tongue in the mouth.
- Change the consistency of the food so that the tongue protrusion isn't necessary to move it back
- Use vibrating teethers or a z-vibe to increase awareness of the mouth and tongue
- Use your finger to push up under the chin to close the mouth and then press around the mouth to awaken those muscles