Tongue Sucking: When Parents Should Be Worried

Tongue sucking is a habit that can begin in infancy when feeding habits are established. Even though it seems natural, infants must learn to breathe, suck and swallow while feeding. Some infants struggle to learn this process, and poor habits develop.

Known as a non-nutritive sucking habit, the tongue is not placed correctly and gets in the way during feedings. This can negatively affect the infant’s suck and swallow. It can also be found in children and adults.

What causes non-nutritive tongue sucking?

Non-nutritive sucking is sucking that is not associated with feeding, like with the thumb, fingers, a pacifier, or anything other than the breast or bottle. Non-nutritive tongue sucking may develop as normal behavior in infants. Most infants use sucking behaviors as self-soothing methods early in life.

This is completely normal. Many infants will suck their fingers or thumbs, and others will be given pacifiers. Generally, this stops with age and the child’s ability to cope in other ways.

Tongue sucking may also be a behavior that develops related to health conditions that are more common later in life, too. It may be coping skill children use, related to health problems or anxiety. Medical issues like Tardive dyskinesia, Parkinson's disease, and Tourette syndrome are also possible causes.

Problems caused by tongue sucking

Tongue sucking can lead to problems in later years. Infants and toddlers under age three are less likely to see any negative impact from this non-nutritive sucking habit. Again, it is normal and typically resolves around age three.

However, if the habit continues, or develops in older children or adults, other problems can develop. This habit causes impairment to the hard and soft tissues of the mouth. Injuries include:

• Oral lesions or sores.
• Narrowing of the upper jaw.
• High palate.
• Receding lower jaw.
• Tongue thrust.
• Altered speech.
• Malocclusions or dental abnormalities like the improper alignment of teeth.
• Overbite, open bite, or crossbite.
• Mouth breathing.

Diagnosing tongue sucking

Children and adults may not notice tongue-sucking. It is a habit they have had for a long time. You may notice your child showing signs of tongue-sucking. The diagnosis can be made by your dentist.

Treating the effects of tongue sucking

A team approach is likely best for your child. Your dentist will complete an evaluation and refer you to an orthodontist if your child has dental or oral abnormalities that need to be addressed.

It will also be important to include speech-language pathologists to work with your child to improve any speech issues. A speech-language pathologist will develop a treatment plan that will include the following:

• Working through oral motor exercises to relax the tongue.
• Improve tongue position.
• Assess swallowing.
• Stop tongue thrusting and pressure.
• Stop sucking habits.

Treatment should begin as soon as possible. Most children receive a diagnosis and begin treatment between 8-12 years old. Some children may begin treatment at younger ages depending on how severe the condition is or how early it is diagnosed. Early treatment also depends on there being no other medical or oral conditions present.

Can tongue-sucking be prevented?

Initially, non-nutritive tongue sucking is normal in infants. However, it should resolve as the infant becomes more proficient at nursing or bottle feeding. This habit should not interfere with feedings.

Prevention methods are not necessary for infants in normal situations. As children age, if you notice signs that tongue sucking might be happening, contact your healthcare provider or dentist.

Signs of tongue sucking

The problems listed above can be considered signs, possibly even late signs, of tongue sucking. However, these signs may appear earlier, but are not only found in tongue sucking:

• Mouth breathing or difficulty breathing through the nose.
• Drooling after age 2.
• Difficulty closing the lips.
• Tongue thrusting.
• Limited tongue movement.
• Difficulty eating.
• Speech difficulties.

If these problems are present, contact your healthcare provider or dentist for an evaluation.

Non-nutritive tongue sucking begins when feeding skills develop in infants. This can be a normal habit that often stops in infancy or during the toddler years. If this habit continues into childhood or beyond, oral problems can develop. Tongue sucking may be related to anxiety or other health conditions but should be treated as soon as possible. It can impact breathing, eating, and speech, as well as facial development as children, grow.