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Saturday, October 1, 2022
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The Mighty Tongue


Your tongue is a very mighty organ!  It controls you.  It dictates the shape of your face, the way you talk, your posture, your sleep, even your jaw joints, and total body health!  Got pain in your temporomandibular joint (TMJ)?  It could be caused by your tongue. Take control back and learn to be healthy by taking charge of your tongue!  Whenever I look at the list of problems the tongue can create, I think of that children’s song: the knee bone’s connected to the shin bone…

You might think this is an irrelevant factoid but it could well change your life and/or the life of your child.  (No, I’m not being overdramatic!)  I have a lot of information to share so hang on!

Your Tongue’s Proper “Home”

I just returned from a fabulous conference in the beautiful city of Los Angeles at the iconic Biltmore Hotel- although I hardly ventured outside because there was much to learn inside.  I attended the Academy of Applied Myofunctional Sciences 1st Annual Congress (AAMS) and am excited to share new information with you over the course of these posts.  Many of the lectures I attended discussed the importance of the tongue and when it “misbehaves” in resting or swallowing.

It all starts with what professionals call “Tongue Rest Posture”.  Right now- notice where your tongue is in your mouth.  Is it resting on the floor of your mouth, puddling behind your bottom teeth?  Is it between your front teeth, touching your front teeth or is it resting on the roof of your mouth, not touching any teeth???  Is it even in your mouth (think Michael Jordan)?  Where’s your tongue? Are you mouth breathing?  I had three patients just this week whom I showed correct “tongue posture” and they all said, and I quote, “that feels weird.”  Not one of them was swallowing correctly, nor were they placing it anywhere near the roof of their mouth!  And it shows in their face.  The airway is affected and facial development is unbalanced.  It is vitally important to have the tongue in the “proper” place.  If not, these problems may arise:

TMJ pain
Headaches
Facial pain/muscle strain
Head and neck pain
Migraines
Herniated discs
Arthritis
Clenching and grinding
Gas/gastric distress
Belching
Colic
Flaccid lower lip, rolled out upper lip
Failure to thrive
Crusty lips
Facial Asymmetry
Gummy Smile
Head forward posture
Shoulder and neck tension
Jaw development- narrow arch
Crowded teeth
Open bite
Orthodontic relapse
Orthognathic surgery relapse
Mouth breathing
Sleeping- snoring and sleep apnea- even in babies and children!
Face shape – long face syndrome
Teeth alignment- crowded front teeth
Gum disease 
Tooth decay 
Dry mouth/Xerostomia
Nose-lip angle greater than 110 degrees
Flattened cheeks
One or both jaws recessed from ideal position
Lips straining with flattening
Chin wrinkling when swallowing
Chewing – teeth don’t “fit” so gulp food or partially chew food
Swallowing- tongue thrust, swallow partially chewed food
Breastfeeding difficulties
Speech difficulties

Yikes! That’s quite a list- and it can all be caused by improper tongue placement and thus mouth breathing.  Did you even know there’s a proper “best practice” place for your tongue and that it really matters?  So first, where should your tongue go when you are not eating, chewing, or talking?  The tip of the tongue should be resting on what we professionals call: “The Spot.” (So fancy.)

That Spot is behind your front teeth and further behind the bumps we call rugae.  The entire rest of your tongue should then be PLASTERED to the roof of your mouth- covering what’s called the hard palate and extending to what is called the soft palate.  It should never touch your front teeth, and instead, it should rest about a half-inch behind them.  I highly recommend you watch this video by Dr. Mike Mew to see a side view and explanation of correct tongue position. Your lips should be gently together and your teeth apart about two to three millimeters or, like Dr. Mew says, lightly touching- like a butterfly.
So, recap: tongue on the palate, lips together, teeth apart or lightly touching, and then breathe through your nose.  That’s proper tongue rest posture.  Your palate is like a garage for your tongue.  And, it acts just like a dental orthodontic appliance.  You swallow 600 to 1,000 times a day and this pressure from your tongue on your palate causes the bones in your upper jaw to spread out nice and flat.  That’s a lot of gentle pressure! Similar to a nice, gentle dental palatal expander appliance. (And it won’t cost you $$$$)  Your lips then act like a dental retainer and maintain this nice straight, healthy smiling arch!  Then no relapse after orthodontics!  Again, another video by Dr. Mew on how to achieve that beautiful jawline with the proper tongue rest posture.

The Sweet Spot- Why it Matters

The “Spot” is special- it is the place on the roof of the mouth when the trigeminal nerve ends.   When the spot it touched, it turns on other parts of your brain!

 

According to the lecture given by Antonio Ferrante MD, DDS, a lecturer at the AAMT Congress,  stimulating the spot turns on the neuroreceptors in the brain and improves brain function!  This promotes overall correct body posture, muscle movement, and neurotransmitter production such as dopamine, serotonin, acetylcholine, and norepinephrine.  This posture shows evidence in research for controlling pain!  Touching this spot has been shown to have a protective effect against breast cancer, and also stimulates melatonin and prolactin development.  Melatonin controls all the circadian rhythms- it’s a timekeeper for the body structures and immune endocrine systems.  It improves sleep and cognitive function.  All from placing the tongue in its proper spot!  

 

Dr. Ferrante discussed encouraging a nonverbal autistic child to speak by placing Nutella on “the spot” 12 times per day- the child rubbed it off with his tongue, and eventually started speaking.  I have searched for this paper but since my Italian ability is nonexistent, I was not able to cite his paper here. (Editor’s update: You can read Dr. Ferrante’s published research here, though his Nutella story is not included, sadly.)  He did show a video of a gentleman with Parkinson’s disease walking on a ramp both without his tongue on the spot and then again with the tongue in the proper place on his spot.  The transition was nothing short of a miracle!  I was not able to find that video but did find this article from the Parkinson’s Resource Organization.  They too had success with jaw alignment and tongue-to-the-spot therapies in patients with Parkinson’s disease. Here’s a link to a study reviewing postural control and tongue posture.   As soon as I can find a source for Dr. Ferrante’s research I will connect it to this paragraph.  For now, I can tell you what he said at the conference.  So, rub on the spot and stimulate your brain!

 

I wonder if children who suck their thumb or other fingers are trying to stimulate the spot!?!  And, has anybody checked to see if the thumb-sucking child is tongue tied, so their tongue can’t even reach the spot, let alone the palate??  Hmmm, food for thought…

 

Failure to Thrive – If your child’s tongue and/or lip is tied (see below) they may find it difficult to eat. This may cause them to stop growing.  When the tongue is not going to the roof of the mouth the sphenoid bone is not rotated properly and then growth hormones are not released from the pituitary gland according to Dr. Karl Nishimura.  The whole pumping action of the tongue to the roof of the mouth may help expand the nasal cavity and stimulate the pituitary gland to rotate and secrete hormones. 

 

When the mouth is open the sense of smell is diminished and something called Hyposmia sets in.  Hyposmia means  a partial loss of sense of smell.  Food tastes bland. That results in loss of appetite. Might be why children like sweet things, it has a more powerful taste.   More food for thought…

 

Airway – When your tongue is resting on the spot, it opens your airway by lifting the tongue.  Breathing is not optional so maintaining a good, open airway both during the day and while sleeping is vital to a healthy mouth and a healthy body.  The left side image (above) would be similar to breathing through a straw- all night.  That might be a rough night! Getting your tongue up to the spot and keeping it there will start to firm up and strengthen your mouth muscles.  More on muscles strengthening and airways in a moment.

Posture – Good posture starts when the tongue is on the spot. The tongue lifts the head, pulls it back up and over the ears. When the tongue is nestled on the roof of the mouth this supports the head,  and spine which is vital to good posture. Proper posture is when the body is standing straight up.  Ears over shoulders over torso over hips over knees over the feet.  Be centered over those hips.  Don’t look like a wet spaghetti noodle.  Here’s why it matters- #1: when you have good posture you breathe better and use you diaphragm correctly.   #2. People with good posture get better jobs and have a more confident attitude.  Posture counts!  Health matters long term- so take every advantage of simple things like oxygen and better breathing because it all adds up. 

 

Causes 

Tongue tie (TT) – also called Ankyloglossia, is something a person is born with, and is often inherited!  It reduces the mobility of the tongue. You can’t get your tongue to reach the spot! UH oh!!  Read more about tongue ties on my post Cat Got Your Tongue.  

TT is a cause of early weaning.  The baby is not able to latch efficiently onto the nipple and create suction to bring the milk down.  If baby can’t nurse, he’s often then given a bottle.  A dysfunctional swallow occurs with the tongue thrusting forward, not on the roof of the mouth and the jaw develops improperly.  If you can’t chew in a good way, you can’t swallow in a good way either.  Poor swallowing can result in poor digestion, constipation, and other digestive issues such as colic and reflux.  Small, narrow constricted palates result and thus, baby can’t get enough air through his nose so he starts mouth breathing.  The roof of the mouth is the floor of the sinus.  The muscles of the face pull in and make the face/upper jaw even narrower and longer.  Read my post on Long Face Syndrome.  Tongue tie is a marker for Obstructive Sleep Apnea.  This attached and tethered tissue causes the above cascade of events that last a lifetime.

Is baby snoring?  How about nighttime reflux?  Nighttime congestion?  How about morning congestion?   Think possible tongue tie!  Even ADHD symptoms are connected to tongue tie!   If you suspect your child of having a tongue tie- check out this website- Kiddsteeth.com.  There is so much great information at Dr. Kotlow’s site.

Mouth breathing– feels like we’re making a big circle here: the more you mouth breathe, the more congested your sinuses become, and the more you mouth breathe.  Then your head shifts forward to open the airway.  Tonsils and adenoids swell and get inflamed from all the pollen you inhale- they are doing their job- but then it’s hard to breathe through your nose and more mouth breathing occurs.  Swollen tonsils and adenoids block the airway, making breathing hard, causing the tongue to go forward in a tongue thrust (see below).  Mouth breathing causes the tongue to rest on the floor of the mouth.  Next time you’re in a crowd of people- just look around at all the mouth breathing, head-forward postures.  Check out my blog post on breathing.  It fits along with all this.

Poor oral habits (also called chronic non-nutritive sucking)

Facial remodeling

Digit sucking- thumbs and other fingers can cause these problems as well.  Fingers, pacifiers, bottles, and sippy cups (!) all train the tongue to sit down on the floor of the mouth.  Can’t you just picture that tongue puddlin’ down there…  

Any time the tongue is down, the mouth is open.  Other oral habits like hair chewing, fingernail biting, and blanket sucking are other sources that also train the tongue to be in the wrong place for a long time, even pushing on the teeth.  With the absence of the tongue on the palate, the jaw then develops high and narrow, as well as other malocclusion problems!  Want to save your child the pain of orthodontics (and your wallet the $$)?  Help them stop these habits now!  Narrow jaws and “cross bite” = long complicated orthodontics to correct this!

Tongue Thrust

All infants start out with a tongue thrust reflex but at about four months old it should disappear.  When it doesn’t go away, we call this swallowing a tongue thrust and it is dysfunctional.  The tongue pushes out against the teeth.  When the habits mentioned above occur and continue for any length of time they encourage incorrect swallowing.  The tongue can either come forward or out the side(s).  It uses that gentle pressure to move both teeth and bone.  

The Tongue is indeed quite mighty!  It can quite quickly undo all that nice orthodontia you just finished paying for- oops!  Did the orthodontist ever look at your swallow and teach you to swallow correctly? Unfortunately, neither did my daughters’ orthodontists.  The girls both had lateral tongue thrusts and had no bite on their back teeth  (see the photo below) – their tongues slid nicely between the back teeth when they swallow.  I’m giving myself a dope slap for not realizing this, and I’m giving the orthodontists failing grades for not seeing it either!  They just kept putting more rubber bands on each girl’s teeth, trying to close that space.  As soon as the bands came off, the space opened up, again.  No surprise. Muscle is mightier than bone and the tongue is strong enough to move teeth any where it wants them to go.  The orthodontists should have looked at the bite and then the swallow, and referred us to  an orofacial myofunctional therapist! I wish I had known then what I know now. BUT, you don’t know what you don’t know. 

The Big Fix

Orofacial Myofunctional Therapy– Bet you’ve never heard of this!?  I hadn’t either until just a few years ago, and I’ve been a dental hygienist for a long time!  It was never mentioned in my professional journals.  But, after my girls’ swallowing/ortho issues, as well as one daughter’s super burps I went looking for information and stumbled on a whole other side to dentistry – swallowing, muscles and breathing.  

Without this hidden side being in harmony, all the drilling, filling, scraping and polishing is for naught!  Think about it- mouth breathing causes dry mouth which causes tooth decay, gum disease, and sleep apnea. Incorrect swallowing causes ortho relapse- ouch!  Doesn’t the orthodontist remind you to wear your retainer- forever! Then you left it behind when you went to college and … your teeth moved!  Unless you address the root of the problem (pun intended), the problem is not truly solved, you are just treating the symptom.

I’ve been studying it extensively and want to spread the word about this gem of a profession.  Most everyone would benefit in some way from doing myofunctional therapy! What exactly is myofunctional therapy?  It is the re-education of the orofacial muscles.  Just as you go to the gym to strengthen your muscles, “myo” evaluates and strengthens the muscles in your mouth and throat.  A myofunctional therapist teaches you correct swallowing posture and helps put your oral cavity (your mouth) in harmony.   (See the above list if you don’t think that’s important!)

 

Myofunctional therapists can help with sleep apnea.  Training the muscles can decrease the apnea-hypopnea index in adults by 50% and in children by 62%!  That should catch your attention, especially if you are hooked up to a CPAP machine every night!  I’m not saying do this instead of the CPAP but do this in addition and work with your team of professionals to treat the problem.

Myofunctional therapy can retrain your tongue to swallow correctly.
Myo can help tighten facial muscles.  In Brazil, myofunctional therapists work with plastic surgeons to help keep saggy lines and wrinkles at bay.  A natural facelift? I’m doing the exercises myself so if I happen to look younger next time you see me… 😉
Myo may help relieve TMJ pain and headaches.  When there’s lack of harmony in your muscles, muscles react negatively.  My favorite book on healing your TMJ is by Cynthia Peterson-The TMJ Healing Plan.  If you have TMJ pain- read this book, and find a myofunctional therapist to be part of your healing team!
Myo teaches you how to breathe through your nose and how to grow your facial bones properly.
Myo exercises retrain your muscles- so just like going to the gym regularly, you need to do these long term. So, no quick fixes.  And finding some on YouTube really won’t really work either.  Just like the gym, a “personal trainer” i.e. a myofunctional therapist will get you the best results.

I’m excited to add Myofunctional Therapist  to my job titles. It’s exciting to be on the ground floor of this actually very old, newly re-emerging field.  It’s about as “green” as it gets- healing yourself through proper positioning and exercise.  To find a therapist near you- click here

To review: tongue on the palate and the “spot”, lips together, teeth apart, breathe through your nose.  Be well my friends!

Keep Smiling (with your tongue on the spot)
Barbara 

Specialist in Orofacial Myofunctional Therapy

 

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