Tuesday, September 22, 2015

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 over-dramatic!)  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
Facial pain/muscle strain
Head and neck pain
Herniated discs
Clenching and grinding
Gas/gastric distress
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
Accentuated cupid's bow upper lip
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
The "Spot" is behind the bumps

 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."  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.  View this video by Dr. Mike Mew to see a side view of correct tongue position. Your lips should be gently together and your teeth apart about two to three millimeters (there's some controversy about that- some docs, like Dr Mew say lightly touching- like a butterfly. For now I'll recommend keeping them slightly apart.  The researcher I'm reading says apart).  So recap- tongue on the palate, lips together, teeth apart, 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.

Left image  pink area of collapsed airway/ right image open airway

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 control 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 getting an autistic child to speak by placing Nutella on "the spot" 12 times per day- the child rubbed it off with his tongue and started speaking.  I have searched for this paper but since my Italian ability is nonexistent, I was not able to cite his paper here.  As soon as the AAMS Congress publishes their papers from the conference I will cite the source of his lecture research.  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??  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.   More food for thought... 

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 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.  


Tongue tie (TT) - also called Ankyloglossia, is indeed a birth defect 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 onto the nipple and create a suction to bring the milk down.  If baby can't eat, 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. Also click here**  This attached and tethered tissue causes the above cascade of events that last a lifetime.
 Is baby snoring?  How about nighttime reflux?  Night time congestion?  How about morning congestion?   Think possible tongue tie!  Even ADHD is 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 breather 
Mouth breathing- feels like we've 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 goes 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 posture.  Check out my blog post on breathing.  It fits along with all this.

Poor oral habits (also called chronic non-nutritive sucking)
Facial remodelling
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?  Help them stop these habits now!  Narrow jaws and "cross bite" = long entailed orthodontics to correct this!

Tongue thrust
See the mighty tongue in action- hear him roar?!
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 undo quite quickly 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- 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.  The orthodontists should have looked at the bite and then the swallow, and referred us to an orofacial myofunctional therapist!

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 to 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 you attention, especially if you are hooked up to a C-pap 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 work either.  Just like the gym, a "personal trainer" i.e. a myofunctional therapist will get you the best results.

I'm in the middle of learning to become a Myofunctional Therapist and it's exciting to be on the ground floor of this new 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.  Stay tuned as I learn more and get my name on this list as well!

To review- tongue on the "spot", lips together, teeth apart, breathe through your nose.  Be well my friends!

Keep Smiling!


  1. I get it that I'm doing it wrong- but I still don't get exactly where the proper resting position/ the spot is. Is there a sketch or something I could see please?
    is my entire tongue suppose to be along rod of mouth? thanks

    1. Yes!!! so glad you "get it"! Look up on the first diagram above- I put an X on the spot. The "spot" is about a half inch behind the front teeth - just where the roof of your mouth starts elevating. and yes! your entire tongue should be suctioned up to the roof of your mouth. Let me know if that's helpful.

    2. Hi there, great article, but I am curious where exactly the tip of the tongue should rest on the roof of the mouth. For the past 10 months I've been working on correcting my oral posture and as a result I have been placing my tongue tip on the incisive papilla, but I am now reading different articles, including yours, that say that the tongue tip should be further back than that.

      My question is, does the tongue tip rest on the aveolar ridge, or further up behind it on the actual hard pallate. I'm not certain from your picture, as it does not have any indication of the 'Spot' in relation to the aveolar ridge, just that it is behind the incisive papilla.

  2. I was taught how to correctly postion my tongue and swallow in 1969. I was 9 years old living in Brooklyn NY. My teeth were beautiful and came straight. I was given a series of tongue and lip exercises to perform daily with my grandmother. This information on correct tongue placement is not new but was probably suppressed all these years. My teeth slipped back to improper positioning during my teen years.
    Start exercising the tongue by saying little words that start with t,l,d, such as tip,tap,lip,dip,lay,toe. I only remember some of the exercises now. Strengthen the lips, put a marshmallow on a baggie, attach thread to it , dangle it from your mouth then pull it up with your lips. As a reward eat the marshmallow- I loved this part as a kid. Enjoy

    1. Thanks for stopping by and taking the time to comment! Orofacial Myofunctional Therapy is actually far from "new". The term was first coined in the early 1900's by a dentist and orthodontist that recognized that crooked teeth were the result of mouth breathing and improper tongue placement. Imagine where we'd be today had real prevention been incorporated into ortho!?!?! So glad you did your exercises, I kinda like the marshmallow idea, I use little wooden discs on a string instead. I am working on an ortho/myo history post so come back another time!

  3. The position mentioned in this article is WRONG! A HALF INCH behind your teeth??! The tongue is not short enough to do that, it is actually painful because in order to do that the tongue will have to be literally folded in half and is not laid out straight! It would also make it impossible to swallow because your throat is open so far and cannot be closed when the tongue is not even there. If there is a nerve somehow RR that needs to be stimulated I will look onto these linked articles for the purpose of talking to other people who may be affected by the problem if that nerve is there, but definitely DONT attempt to move your tongue an ENTIRE HALF INCH behind your teeth! Putting your tongue folded up into positions near the back of the throat and physically preventing you from breathing is obviously not a good idea in part because it's actually impossible to keep that way and oh yeah you'll suffer in the brain from being unable to breathe properly!

    1. Rayvn,
      I have updated the blog and included a photo of a palate bone so you can see the incisive foramen where the trigeminal nerve ends. That's the spot where the tip of your tongue should rest. In a properly developed jaw - one that has grown around a tongue that's resting in this spot, there is plenty of room for the tongue. Unfortunately, most people have a mouth that's too small due to mouth breathing, and incorrect tongue placement during their growing years. So, you might be correct that your tongue won't "fit" up in your palate. That's the entire point of my post- developing a jaw that actually fits the tongue correctly. Prehistoric man had big, wide jaws with teeth that were straight, and room for all 32 teeth to fit perfectly. Modern man, on the other hand, has small, underdeveloped jaws with no room for wisdom teeth, crooked teeth, and as you report, no room for their tongue. With information, hopefully parents will learn how they can help their children grow big, beautiful, straight teeth and jaws.
      And, when your tongue is up on your palate, it forces you to breathe through your nose so you'll actually breathe better, getting more, not less oxygen to your brain.
      Please do read my research links. If you need more information, let me know. I've got lots of resources. Thanks for commenting,

  4. Hi,
    I wanted to ask your opinion on something. I have one of there permanent wire retainers on my bottom teeth. Do you think I should get it removed? Would it prohibit growth in my jaw? Your opinion would be kindly appreciated.
    Thank you


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