Characterized by an anterior or lateral tongue thrust during deglutition, it disrupts the physiological balance of the stomatognathic system.
Beyond being a functional anomaly, atypical swallowing has profound implications for malocclusion, craniofacial growth, and orthodontic stability.
Etiology and Clinical Associations
Recent literature emphasizes that atypical swallowing rarely acts in isolation. It is frequently associated with:
Mouth breathing, often secondary to airway obstruction (adenoids, allergies, chronic rhinitis).
Oral habits, such as thumb sucking or prolonged pacifier use.
Low tongue posture and altered orofacial muscle tone.
Systematic reviews published in the last seven years confirm a significant correlation between atypical swallowing and anterior open bite, as well as its role in orthodontic relapse if not properly addressed.
Moreover, mouth breathing has been identified as a high-risk factor, intensifying the functional imbalance.
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Orthodontic Implications
For orthodontists, the presence of atypical swallowing increases the complexity of diagnosis and treatment planning. Persistent tongue thrusting can:
★ Exert continuous forces on the dentition, maintaining open bite or spacing.
★ Compromise periodontal health by increasing anterior stress.
★ Lead to higher relapse rates post-treatment if myofunctional re-education is neglected.
Therapeutic Strategies
The contemporary approach demands interdisciplinary management:
Orofacial Myofunctional Therapy (OMT): Controlled trials indicate that OMT improves tongue posture at rest, lip competence, and swallowing pattern. While variability in protocols remains, evidence supports its adjunctive value in orthodontics.
Airway evaluation and management: Collaboration with otolaryngologists is crucial when nasal obstruction or enlarged adenoids are present.
Long-term retention protocols: Functional rehabilitation should complement mechanical retention, reducing relapse risk.
► READ ALSO: Malocclusion in Children and Adolescents: A Comprehensive Perspective for Parents and Dental Professionals
Key Takeaways for Clinicians
1. Screen early for signs of OMDs during orthodontic assessments.
2. Adopt an interdisciplinary approach involving speech-language pathologists, pediatricians, and ENT specialists.
3. Integrate myofunctional therapy alongside orthodontic mechanics to achieve stable outcomes.
4. Educate patients and families about the functional component of malocclusions, ensuring better compliance and long-term results.
Conclusion
Atypical swallowing is more than a functional habit—it is a determinant of orthodontic prognosis.
Evidence from the past decade underscores that correcting dental and skeletal relationships without addressing orofacial dysfunction leaves treatment outcomes vulnerable to relapse.
For orthodontists worldwide, the integration of functional therapy with orthodontics is not optional, but essential to ensure stable, esthetic, and functional results.
