Tongue thrusting is when the tongue pushes forward against the teeth or between them during swallowing, speaking, or at rest. In adults, it most often traces back to one of three things: a swallowing pattern that never fully matured in childhood, a structural issue like an open bite or enlarged tonsils, or a neurological condition that affects tongue control. It is not a habit you can simply decide to stop. The tongue is a muscle, and the pattern is usually wired into how it moves.
What Causes Tongue Thrusting In Adults?
There is no single cause. Most adults who have this pattern fall into a few broad categories, and some have more than one factor at play.
The most common is what clinicians call a retained infantile swallow. Babies swallow by pushing the tongue forward to help move milk. As children grow, that pattern typically shifts to a more mature swallow where the tongue presses against the roof of the mouth. In some people, that shift never fully happens. The childhood pattern stays. This does not always cause problems, but it can contribute to dental changes over time.
Structural factors matter too. An open bite — where the upper and lower front teeth do not meet when the jaw is closed — can both result from and reinforce tongue thrusting. Enlarged tonsils or adenoids can push the tongue forward because there is less room in the airway. A tongue that is physically too large for the mouth, a condition called macroglossia, can also contribute, though this is less common.
Neurological conditions are a separate category. Stroke, Parkinson’s disease, cerebral palsy, and other disorders that affect muscle control can change how the tongue moves. In these cases, tongue thrusting is a symptom of the underlying condition, not a standalone habit.
Finally, there is the question of what came first. Did the tongue thrust cause the dental problem, or did the dental problem cause the tongue thrust? In many adults, it is impossible to say with certainty. Both can be true at once, and each can make the other worse.
Is Tongue Thrusting a Habit or a Reflex?
It is closer to a reflex than a habit. That distinction matters for anyone trying to change it.
A habit is something you do consciously and can stop with awareness. A reflex is an automatic motor pattern. When you swallow, your tongue moves in a specific way without you thinking about it. For most adults, swallowing happens hundreds of times a day, and almost all of it is outside conscious control.
This is why simply “remembering to keep your tongue back” rarely works long term. The pattern is stored in the motor system. Changing it usually requires retraining that motor pattern, not just trying harder to remember.
Some adults can become more aware of their tongue position at rest. That awareness is a starting point. But awareness alone does not rewire a swallow pattern that has been in place for decades.
How Do You Know If You Have Tongue Thrusting?
Most adults do not know they have it until a dentist or orthodontist points it out. The signs are often dental or speech-related rather than something you feel directly.
Common signs include:
- An open bite, where the front teeth do not touch when the back teeth are closed
- Teeth that have shifted or moved after orthodontic treatment
- A lisp or difficulty making certain sounds, especially “s” and “z”
- Mouth breathing, especially during sleep
- Jaw pain or TMJ discomfort
- A tongue that visibly pushes forward when you swallow
A speech-language pathologist or dentist can usually identify it during an exam. They may ask you to swallow while they watch your tongue position. In some cases, imaging helps rule out structural causes.
It is worth noting that not everyone with a forward tongue pattern has problems from it. Some adults have this pattern and no dental or speech issues at all. The pattern itself is not automatically a disorder.
What Is the Connection Between Tongue Thrusting and Dental Problems?
The relationship is real but not simple. Tongue thrusting can contribute to dental changes, and dental changes can make tongue thrusting more likely.
When the tongue pushes against the front teeth repeatedly, it can contribute to an open bite or cause teeth to shift forward. This is especially relevant for adults who have had braces. If the tongue pattern was never addressed, it can push teeth out of alignment again after treatment ends.
This is one reason orthodontists sometimes recommend myofunctional therapy alongside or after braces. The goal is to address the tongue pattern so the teeth stay where they were moved.
That said, the evidence on how much tongue thrusting alone causes dental relapse is mixed. Some studies suggest it plays a role. Others find that other factors, like jaw growth patterns and genetics, matter more. The honest position is that tongue thrusting is one contributing factor among several, not the sole cause of dental problems.
Can Underlying Health Conditions Cause Tongue Thrusting?
Yes. When tongue thrusting appears or worsens in adulthood, it is worth considering whether an underlying condition is involved.
Neurological conditions that affect muscle control can change tongue movement. Stroke is one example. So are Parkinson’s disease, multiple sclerosis, and cerebral palsy. In these cases, the tongue thrusting is part of a broader pattern of motor changes.
Airway issues are another factor. Chronic mouth breathing, often related to enlarged tonsils, adenoids, or nasal obstruction, can change tongue posture. When you breathe through your mouth, your tongue tends to sit lower and forward in the mouth. Over time, that posture can reinforce a forward tongue pattern.
Sleep-disordered breathing and obstructive sleep apnea have been studied in relation to oral posture, though the exact relationship is still being worked out. Some research suggests that tongue position during sleep differs in people with sleep apnea. Whether tongue thrusting causes or results from these breathing issues is not fully settled.
If tongue thrusting appears suddenly in an adult who never had it before, that is a reason to see a doctor. New onset of any motor change warrants a medical evaluation.
What Actually Helps With Tongue Thrusting in Adults?
The most common approach is myofunctional therapy. This is a type of training done with a speech-language pathologist or a trained myofunctional therapist. It focuses on retraining tongue posture, swallowing, and breathing patterns.
Myofunctional therapy typically involves exercises to strengthen and reposition the tongue. The goal is to teach the tongue to rest against the roof of the mouth and to swallow without pushing forward. It is often used alongside orthodontic treatment, not instead of it.
The evidence for myofunctional therapy in adults is limited but growing. Some studies show improvement in tongue posture and swallow patterns. Fewer studies look at long-term outcomes like whether teeth stay in place years later. The research is stronger in children than in adults.
For adults with an underlying neurological condition, treatment focuses on the condition itself. Speech therapy may help with swallowing and speech, but the tongue pattern may not fully change if the underlying motor control is affected.
If airway issues are involved, addressing those — whether through allergy treatment, nasal surgery, or other interventions — may change tongue posture over time. This is an area where the evidence is still developing.
What does not have strong evidence: devices marketed to “fix” tongue thrust on their own, or apps that claim to retrain your swallow. Some clinicians use intraoral devices as part of therapy, but there is no good evidence that a device alone changes the pattern long term.
Does Tongue Thrusting Need to Be Treated?
Not always. If there are no dental, speech, or breathing problems, treatment may not be necessary. The pattern itself is not dangerous.
Treatment makes the most sense when tongue thrusting is contributing to a problem you want to solve. That could be teeth shifting after braces. It could be a lisp that bothers you. It could be jaw pain or mouth breathing that affects your sleep.
The decision is usually made with a dentist, orthodontist, or speech-language pathologist who can assess the full picture. There is no one-size-fits-all answer.
What is clear: if you are an adult with this pattern and you are considering orthodontic treatment, it is worth asking whether the tongue pattern should be addressed too. Otherwise, the teeth may move back.
Frequently Asked Questions
Can tongue thrusting be fixed in adults?
It can often be improved with myofunctional therapy, though the evidence in adults is more limited than in children. The pattern may not fully change, especially if an underlying neurological condition is involved.
Is tongue thrusting a sign of a serious condition?
Usually not. Most cases are related to a retained childhood swallow pattern or dental structure. But new onset in adulthood should be evaluated by a doctor to rule out neurological causes.
Does tongue thrusting cause teeth to shift after braces?
It can contribute to relapse, but it is one factor among several. Jaw growth, genetics, and retainer use also play significant roles.
Can I stop tongue thrusting on my own?
Probably not through willpower alone, because it is an automatic motor pattern rather than a conscious habit. Working with a speech-language pathologist or myofunctional therapist is the more reliable approach.
