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Is your Tongue TOO BIG for your Mouth?

Updated: Aug 1

So many times I’ve had patients during the initial consultation say they feel that their tongue is too big for their mouth. Although they feel that their tongue is too big for their mouth in all actuality it is not true. Their mouth is too small for their tongue!


Many of these patients who feel that their tongue is too big for their mouth have a forward tongue thrust, tongue-tie have issues with mouth breathing, and sometimes speech such as a lisp. Many had orthodontic treatment during their younger years and relapsed. I can never forget an initial consultation with a female patient who had issues with periodontal disease, tongue thrust, open bite, and speech. She shared that she was told by her marketing manager that she would never be able to excel to the next level because of her speech. Ten years later those words still stuck with her. She thought that her tongue was just too big for her mouth and there was nothing that could be done about it. For her case it was a team collaboration; however, Myofunctional Therapy played a key factor.


When the tongue is in a low lying forward position, the upper mandible develops narrow and vaulted. Why? Because your tongue shapes the upper mandible. If it is not in its rightful position the muscles and bone have to compensate. This leads to crowding and many times the bones (teeth) grow around the forward tongue thrust leading to an open bite and overbite.

Orthodontists struggle to close an open bite or overbite because of the tongue. Many have shared that after 12 months post braces the beautiful bite changes. The first step to helping this phenomenon is we all have to start looking at our teeth as bones. Muscle forms the bone. Our tongue is the largest muscle in our oral cavity and it impacts the growth and development of our upper and lower mandible. It also impacts our airways. So you can move the bone with braces and you can cut into the bone to restructure the jaw. If your orofacial muscles, especially the tongue, are not patterned to the new bite or jaw, it will continue to operate with old muscle patterns. These old muscle patterns are what caused the problem with the teeth and the jaw to begin with so then this ends up resulting in relapse.


To prevent orthodontic relapse and jaw surgery relapse, treatment of the tongue, orofacial muscles, and the airway are completely necessary. This is treating the underlying problem and will allow the muscles to readjust to the new bite and new face. Myofunctional Therapy in conjunction with Orthodontic Treatment is necessary to prevent relapse.

How Orofacial Myofunctional Therapy (OMT) Can Help You!


Orofacial myofunctional therapy (OMT), a modality of exercise therapy, has also been suggested for the management of TMD in order to equilibrate the orofacial muscles and to favor the execution of the teeth, jaw, and associated jaw, swallowing, and speech muscles. OMT has the following positive effects in treated patients:


a significant reduction of pain sensitivity to palpation of all muscles studied but not for the TMJs;


● increased measures of mandibular range of motion;


● reduced frequency and severity of signs and symptoms; and


● increased scores for orofacial myofunctional conditions.



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