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TONGUE THURSTING HABIT

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Definition

Tulley (1969) forward movement of tonguetip between the teeth to meet the lower lipduring deglutition and in sounds of speech sothat the tongue lies interdentally.

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Classification

1. Physiologic- comprises of the normal thurstswallow of infancy

2. Habitual- this swallow pattern is presenteven after the correction of malocclusion

3. Functional- it remains as an adaptive

behavior to achieve oral seal.

4. Anatomic- due to enlarged tongue

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Brauer& Holt

classification Type I- Non deforming tongue thurst

Type II- Deforming anterior tongue thurst

Subgroup 1- Ant. Open bite

Subgroup 2- Associated procumbency of ant.

Teeth

Subgroup 3- Associated posterior cross bite

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Type III- Deforming Lateral Tongue Thurst

Subgroup 1- Posterior open bite

Subgroup 2- PosteriorCross bite

Subgroup 3- Deep over bite

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Type IV- Deforming anterior & lateral tonguethurst

Subgroup 1- Anterior & Posterior open bite

Subgroup 2- Associated procumbency of ant.Teeth

Subgroup 3- Associated PosteriorCross bite

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Etiology

1. Genetic influence

2. thumb sucking habit

3. Mixed dentition stage

4. Gap filling tendency

5. allergies of upper respiratory tract

6. macroglossia

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Swallowing patterns

Normal infantile swallow

-the tongue lies between the gum pads

-mandible is stabilized by contraction of facialmuscles

-it disappears on eruption of buccal teeth

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Normal mature swallow

-carried out mainly by contraction of mandibular

elevators

- There is very little lip & cheek activity

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Complex tongue thurst

Teeth apart swallow

-marked contraction of lip, facial &mentalismuscle, but absence of temporal musclecontraction during swallow.

- Anterior open bite is also present

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Diagnosis of habit

1. examination of tongue

Check for size , shape and movement

2. Functional examination

- Observe the tongue position when mandible is in restposition

- Observe the tongue during various swallows

- Ex- conscious swallow, command swallow of saliva &water and during mastication

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3. place water between tongue tip & ask toswallow

- normally, mandible rises and teeth are broughttogather but no contraction of lips or facialmuscles

- In tongue thurst, marked contraction of lipsand facial muscles

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4. place hand over temporalis muscle andaskto swallow

Normally, temporalis contracts and mandible iselevated

Tongue thurst, no temporalis contraction

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Clinical features

Simple tongue thursting

-anterior open bite

Normal tooth contact in posterior region

Contraction of lips, mentalis muscle, and

mandibular elevators

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Complex tongue thursting

-generalized open bite

Absence of contraction of lip & oral muscles

Proclination of anterior teeth

Midline diastema

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Treatment options