Swallowing may seem like an automatic process that requires no thought, but in reality, the way we swallow has a significant impact on oral health, facial development, and the balance of head and neck muscles. Improper swallowing (also called abnormal swallowing or tongue thrust swallowing) is a common pattern that can negatively affect jaw growth, tooth alignment, breathing, and even speech.
What Is Improper Swallowing?
Improper swallowing is a dysfunctional swallowing pattern in which a person pushes the tongue forward or between the teeth during swallowing instead of directing it upward and backward toward the palate, as in proper swallowing.
Common patterns include:
- Tongue thrust (pushing the tongue forward)
- Using lip and facial muscles to assist with swallowing
- Keeping the mouth open during swallowing or breathing
Why Does Improper Swallowing Occur?
Possible causes include:
- Prolonged thumb or pacifier sucking beyond age two
- Chronic mouth breathing due to enlarged tonsils or adenoids
- Muscular or neurological issues affecting coordination of tongue and mouth muscles
- Lack of breastfeeding or early weaning
- Malocclusion or poor tooth positioning
How Does Improper Swallowing Affect the Face and Mouth?
Swallowing is not just an internal motion—it is a muscular act that happens 800 to 2000 times daily! This repetition means that any dysfunction in swallowing creates constant pressure on the bones and muscles of the face and jaws.
1. Malocclusion
In proper swallowing, the tongue pushes upward and food moves backward. In improper swallowing, the tongue pushes forward or between the teeth, causing:
- Anterior open bite: Front teeth do not touch when biting down, making chewing difficult.
- Protruded upper teeth: Constant pressure from the tongue pushes the upper incisors outward.
- Crowded or spaced teeth: Tongue movement alters consistent alignment over time.
Imagine the tongue as a strong muscle pressing incorrectly against the teeth hundreds of times daily—this gradually but surely shifts their positions.
Source: Association Between Tongue Thrusting Habit And Malocclusion: A Retrospective Study
2. Narrow Palate or Stunted Maxillary Growth
During rest and swallowing, a healthy tongue acts as a natural mold for expanding the palate. When the tongue presses against the roof of the mouth (palate), it stimulates the upper jaw to grow laterally (width-wise).
In tongue thrust swallowing:
- The tongue is too low or too far forward
- The palate lacks natural pressure
- The result is a high, narrow palate
- Leads to crowding of teeth, restricted breathing, and often a need for orthodontic expansion
The palate grows in part due to the tongue’s presence—if the tongue is absent from its ideal location, growth is halted or misdirected.
3. Altered Facial Appearance (Long Face Syndrome)
In chronic mouth breathing or tongue thrusting, the mouth often stays open. This causes:
- Weakness in lip and mouth muscles
- Vertical facial elongation due to downward instead of forward growth
- Head posture tilting forward to improve airflow
- Expressionless or narrow face shape
Facial structure is not only genetic—it is shaped by muscle function and pressure distribution. An open-mouth posture disrupts this balance.
4. Speech Difficulties
Proper speech requires accurate tongue positioning, especially for sounds like /s/, /t/, /z/. With tongue thrust:
- The tongue moves too far forward during speech
- Sounds may become slushy or distorted
- Some sounds are confused or delayed in development
It’s like using a tool incorrectly—the tongue should push sound upward and backward, not forward and out.
5. TMJ (Temporomandibular Joint) Disorders
Improper swallowing leads to abnormal use of facial muscles:
- Tightening the lips or facial muscles to aid the tongue
- Unbalanced lower jaw movements during swallowing
Over time, this stresses the TMJ—the joint that connects the jaw to the skull—causing:
- Pain
- Headaches
- Clicking sounds
- Difficulty chewing
A small error in movement, when repeated thousands of times, leads to fatigue in the delicate joints of the face.
Source: PubMed / Cleveland Clinic
Summary
Improper swallowing is not just a bad oral habit—it’s a repetitive muscular pattern that can:
- Alter jaw structure
- Hinder breathing
- Affect speech clarity
- Disrupt tooth alignment
- Permanently impact facial features
Early correction is essential, especially in children, to prevent later need for surgery or complex orthodontic interventions.
Source: https://my.clevelandclinic.org/health/diseases/tongue-thrust
Teaching Proper Swallowing
Basic Myofunctional Therapy Steps:
Tongue Rest Position:
- Ensure the tongue rests on the roof of the mouth, behind the upper front teeth but without touching them.
- Mouth should be closed, and breathing should occur through the nose.
Proper Swallowing:
- Have the patient place the tongue tip on the palate behind the front teeth.
- Swallow saliva without moving lips or facial muscles.
- Use a small piece of edible paper on the tongue tip as training feedback.
Supportive Exercises:
- Tongue lifting to the upper ridge
- Lip strengthening exercises
- Spoon or straw training with proper guidance
Correcting Associated Habits:
- Stop thumb sucking or chronic mouth breathing
- Refer to ENT specialists or orthodontists as needed
Tips for Therapists and Doctors:
- Explain it simply: Proper swallowing is like gently closing a door; improper swallowing pushes it open.
- Use mirrors, images, or video for guidance
- Schedule follow-ups to track improvement
- Make it fun for kids through games and visuals
Source: Impact of Oral Myofunctional Therapy on Orofacial Growth
Conclusion
Proper swallowing is more than an oral skill—it’s a key to holistic facial and oral health. Teaching this preventive behavior can reshape jaw development, reduce orthodontic needs, and improve speech and breathing. At the European Dental Center, Dr. Mohannad Al-Kiswani always emphasizes correcting tongue thrust patterns early to avoid major treatments later—knowing that proper swallowing supports long-term oral function and facial harmony.
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- European Dental Center
