Etiology of Tongue thrust
Fletcher has proposed the following factors as being the cause for tongue thrusting.
Genetic factors : They are specific anatomic or neuromuscular variations in the oro-facial region that can precipitate tongue thrust. e.g. Hypertonic orbicularies oris activity.
Learned behaviour (habit) : Tongue thrust can be acquired as a habit.
The following are some of the predisposing factors that can lead to tongue thrusting:
a. Improper bottle feeding
b. Prolonged thumb sucking
c. Prolonged tonsillar and upper respiratory tract infections
d. Prolonged duration of tenderness of gum or teeth can result in a change in swallowing pattern to avoid pressure on the tender zone.
Maturational : Tongue thrust can present as part of a normal childhood behaviour that is gradually modified as the age advances. The infantile swallow changes to a mature swallow once the posterior deciduous teeth start erupting.
Sometimes the maturation is delayed and thus infantile swallow persists for a longer duration of time.
Mechanical restrictions : The presence of certain conditions such as macroglossia, constricted dental arches and enlarged adenoids predispose to tongue thrust habit.
Neurological disturbance: Neurological disturbances affecting the oro-facial region such as hyposensitive palate and moderate motor disability can cause tongue thrust habit.
Psychogenic factors : Tongue thrust can sometimes occur as a result of forced discontinuation of other habits like thumb sucking. It is often seen that children who are forced to leave thumb sucking habit often take up tongue thrusting.