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Core symptoms of dysfunction

Low Tongue Posture
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Incorrect tongue posture is related to the tongue resting on the teeth, between the teeth or on the floor of the mouth. A low resting tongue posture is often the result of a tongue tie, an oral habit (thumb/finger sucking) or mouth breathing. Ideally, the tongue should be lightly suctioned to the entire roof of the mouth with the tip of the tongue on the "spot". The "spot" is located just behind the upper front teeth and the tongue should not be resting or pushing on the teeth. A low resting tongue posture can lead to health issues throughout the body. An incorrect tongue posture, mouth breathing, or a dysfunctional swallowing pattern can all contribute to the vagus nerve not being correctly stimulated. The vagus nerve is the longest parasympathetic (rest and digest) cranial nerve in the body. It is involved in the regulation of all major bodily functions, including breathing, digestion, and relaxation. With a low resting tongue posture, the vagus nerve is not stimulated and leads to a permanent state of stress.

Tongue Thrust
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Tongue Thrust

Anterior Open Bite

Tongue thrust is a dysfunctional swallowing pattern that occurs when the tongue pushes against the front or back teeth during a swallow. It is often associated with an open bite and it can lead to orthodontic treatment concerns and orthodontic relapse. Tongue thrust is always a symptom of another problem and it is one of the first symptoms seen with low resting tongue posture. The underlying cause always needs to be addressed to eliminate the tongue thrust. However, addressing the underlying cause will not fully solve the problem as the orofacial muscle dysfunction will still need to be addressed. Problems that often go hand-in-hand with tongue thrust include: mouth breathing, tongue tie, sucking habits, prolonged bottle use, and open mouth posture.

Mouth Breathing

Our bodies were designed for nasal breathing. Mouth breathing activates the "fight or flight" response (sympathetic nervous system), while nasal breathing activates the "rest and digest" response (parasympathetic nervous system). Mouth breathing activates the upper chest, with shallow breathing and larger breaths, which leads to over breathing. Conversely, nasal breathing activates the diaphragm, which allows for deeper breathing and better uptake of oxygen. The benefits of nasal breathing include:

  • Filters out foreign particles like dust, allergens, viruses and bacteria

  • Optimal jaw and facial development

  • Increases oxygen uptake and circulation

  • Adequate saliva/fresh breath
  • Prevents snoring and sleep apnea
  • Slows down breathing, which increases nitric oxide concentrations
  • ​Warms and moistens inhaled air to body temperature, making it easier for the lungs to use

  • Increases stamina and endurance

  • Brain development in children

  • Produces nitric oxide (vasodilator), which reduces blood pressure and improves oxygen circulation throughout the body


Causes of chronic mouth breathing include:

  • Nasal obstruction

  • Enlarged adenoids or tonsils

  • Chronic nasal congestion

  • Allergies

  • Deviated septum

  • Nasal polyps

  • Enlarged nasal turbinates

  • Tongue tie 


Mouth breathing can contribute to the following signs and symptoms: 

  • Dry mouth (increases risk of cavities)

  • Bad breath

  • Enlarged tonsils

  • Snoring and obstructive sleep apnea

  • Long face syndrome

  • Gingival inflammation

  • Periodontal disease​

  • Chronic fatigue

  • Poor health

  • Open mouth chewing/messy eating/noisy eating

  • Dry lips/continous need to lick lips 

  • Need to drink water while eating 

Tongue Tie
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A tongue tie is a physical limitation that affects tongue mobility, function, and rest posture. It is present at birth and it is characterized by an abnormally tight or short lingual frenum (the string of tissue under the tongue). This may restrict the mobility of the front, middle and/or back of the tongue and forces the tongue to sit on the floor of the mouth. A tongue tie is often the root cause of a low postured tongue. The muscles of the tongue are connected to many other muscles of the jaw, face, and neck. These accessory muscles may compensate during speech, swallowing, chewing, and breathing. Grinding, clenching, jaw pain, headaches, and neck and shoulder pain are common tongue tie symptoms that result from these accessory muscles activating/compensating for the lack of tongue movement. Mouth breathing, open mouth posture, and tongue thrust are often associated with a tongue tie. 

Tethered Oral Tissue (TOTs)

Tethered oral tissues refers to all ties, including lip, cheek, and tongue ties. Lips and cheeks can also have abnormally tight or short frenums, which can restrict movement and affect speech, swallowing, chewing, and breathing.  

Treatment for Tethered Oral Tissues

The treatment for tethered oral tissues is a surgical procedure called a frenectomy. All clients are screened for tethered oral tissues during the initial evaluation and this will help us determine if a frenectomy may be required. If a frenectomy may be necessary, you will be referred to a frenectomy provider for an evaluation and to perform the procedure. A frenectomy may be done with a laser or with scissors and it involves removing or altering the frenum and possibly the surrounding tissues. Myofunctional therapy is required 6-8 weeks before and a minimum of 6-8 weeks after the frenectomy for the best results. Myofunctional therapy is important for the following reasons:

  • Prepares the muscles for the procedure

  • Easier for the provider to perform the release

  • Less pain, bleeding, and swelling

  • Prevents the tongue from reattaching

  • Teaches proper function after the procedure

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