Wednesday, May 15, 2013

Tongue Thrust Suggestions from an Orthodontist



For several years I have wanted to work with an orthodontist to correct some of my misaligned teeth. I started my journey about 4-6 weeks ago. Today I received a phone that my Invisalign trays were ready! As I was at the orthodontists office he noticed my name badge and asked "What does OP Neuro mean?" I explained to him that it meant Outpatient Neuro Rehabilitation and that I was a Speech-Language Pathologist! He then asked about my experience with tongue thrust. I was honest and said that I didn't have a lot of experience with tongue thrust. Still my orthodontist was generous and curious about this issue. He handed me a card and explained "a PhD in your field made these exercises to correct tongue thrust so we give them to all of the patients that need it...read it over and tell me what you think!" After further discussion on tongue thrust, age of child, and understanding of tasks my orthodontist asked if I would take some time and get back with him on any other activities that I may think would be beneficial.

So I wanted to pose this question to the blog world! What have you found most beneficial to help your students with tongue thrust? Below I will have the 2 exercises provided by my orthodontist. I would love everyone's thoughts and insights! Please remember the perspective of this orthodontist - wanting to prevent the tongue from causing poor dental alignment. He is not necessarily thinking of articulation here. Lets also pretend that there is no other dysphagia symptoms occurring.

"For the Correction of Abnormal Swallowing No. 1
Follow these directions for swallowing correctly:
1. Close the teeth firmly in contact with one another.
2. Place the tip of the tongue against the palate or gum ridges.
3. Suck tongue up flat against the roof of the mouth, slide the tongue back with sucking action.
4. SWALLOW
5. Again, close teeth firmly, close lips easily, tongue flat against roof of mouth such hard and swallow.

Remember
*Use mirror to watch for facial movements when practicign. Muscles around mouth are completely relaxed when swallowing.
*Never curl tongue.
*Practice on small pieces of food or small swallows of liquid. Do not blow but suck when swallowing. Keeps lips closed lightly, use card or wax paper between lips as a reminder to keep lips closed.
*Repeat the above many times a day and the following exercises to learn to swallow correctly.

1. Lick the palate or gum ridges as many times each day.
2. Place the tip of the tongue on the palate or gum ridges and keep it there while studying, playing, watching television or in school.

Night Time Suggestions
3. Place the tip of the tongue on palate when you go to bed and try to keep it there.
4. When you awaken in the morning again place tip of tongue on palate.

Follow the above basic steps of swallowing when you eat breakfast, lunch, snacks and dinner. Always think of the four basic steps used in correct swallowing whenever you eat or drink."

"For the Correction of Abnormal Swallowing No. 2
You should practice the following words and sounds; and they should help you place your tongue in position for correct swallowing. If practiced properly a specified number of times daily it will help you to remember the proper tongue positions.

The following words and sounds will help you place the tip of your tongue on the palate or gum ridges where it should be for the beginning of correct swallowing. Say them aloud and slowly and feel the tip of the tongue on the palate ridges. After each line of words swallow.

  *Tact, Tight, Tot, Taunt, Treat - Swallow
  *Light, Lit, Lent - Swallow
  *Straight, Strict, Strut, Start - Swallow
  *Dee, Doe, Dart, Day, Dan, Dot, Dote - Swallow
  *Net, Nee, Nay, Newt, Note - Swallow
  *Num, Bun, Sun, Run, Fun - Swallow
  *Say: "My Country 'Tis of Thee, Sweet Land of Liberty, of Thee I sing."

Close the back teeth firmly and say:
  *Choo, Choo, Choo, Choo, Choo - Swallow
  *Cha, Cha, Cha, Cha, - Swallow

Practice each sentence of words slowly and as many times as you can.
Practice clicking as per instructions and swallow.

The following sounds will place the middle and back of the tongue high against the roof and back of your mouth. Say them slowly and feel the back of the tongue against the roof of the mouth and swallow.

Practice K's
  *Kah, Kay, Key, Kye, Ko, Ku - Repeat rapidly K as in K-K-K-K-Katie - Swallow
  *Nick, Kick, Nick, Kick, Nick, Kick, Kick, Kick - Swallow
  *Ache, Ick, Ike, Oak - Swallow

Then Practice the G's
  *Ahg, Egg, Igg, Ogg, Ugh - Swallow
  *Hag, Heg, Hig, HOg, Hug - Swallow

Practice making the Ng sounds through your nose for a long time.
  *Ahng, Ing, Ung, Ong, Sung, Sing, Hung, King, Ring, Sung - Swallow

Practice yawning.
  *Yawn, Yawn Yawn many times a day.

Gargle before you brush your teeth. Practice gargling. These exercises will strengthen the muscles of the back of your throat and mouth and place your tongue in back of the throat in proper position for correct swallowing." 

I found it interesting to have articulation "exercises" available for a goal of swallowing. I will have to find the study that shows that muscles used in swallowing and articulation are innervated by different neurons. Thoughts?

I think that my orthodontists inquiry opens the door for some fabulous education and discussion!

6 comments:

  1. Very insightful. My son thrusts his tongue. I never equated it to swallowing issues. I am going to try some of these with him. He is 10 and a bit strong-willed, but I also know he doesn't like the way his teeth are pushing out.

    I am going to bookmark your blog as I have other children with speech delays/articulation issues. Two of them were born with cleft lip and palate, and one of those children is deaf in one ear (but he now has a BAHA and has near normal range with it on). Then my oldest son has some resonance issues, and I hope to get him to work with our private SLP when our DD graduates from speech.

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  2. Wife of the Prez,
    I thought you may enjoy this site from ASHA. It gives some nice insight into Orofacial Myofunctional Disorders! http://www.asha.org/public/speech/disorders/OMD.htm. Let me know if there are any techniques or general topics you would like me to post about!
    Thank you!
    Mallory Mahon M.S. CCC-SLP
    spiritedspeechpathology@gmail.com

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  3. I have heard orthodontics gilbert az have been great with this situation. They have helped me out a lot when they were working with my daughter. They were super sweet and warm welcoming.

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  4. Nice post! Today, orthodontic treatment is simple, convenient, and affordable for patients of all ages. And an attractive smile is just one of the benefits. Orthodontic treatment results in correctly-aligned teeth that provide ideal jaw function and a great smile! Additionally, your teeth are easier to clean and more resistant to gum disease. Perhaps most importantly, orthodontic treatment almost always provides improved self confidence.

    Colorado Springs Braces

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  5. Hello!
    Can you write also the author of these exercises and the title of her PhD? I looked up the web and couldn't find any reference.
    Thank you very much!!

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  6. I have found the best step by step program to be The Tongue Thrust Book by Marcelle Richardson. I have used it a lot and it really is great! Comes with exercises and step by step lessons.

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