Your Swallow, Smile, and Sleep Are Connected – How Tongue Posture Shapes Health and Well-Being
- Brainz Magazine
- 3 days ago
- 9 min read
Written by Dr. Michelle Veneziano, Physician Educator
Dr. Michelle Veneziano has been teaching and treating people with orofacial disorders for over 20 years through the American Academy of Osteopathy. She is passionate about supporting people who are inspired to restore and optimize health, balance, and function in their bodies and lives.
Did you know that with one small intervention, you can sleep more deeply, relieve neck, back, and jaw pain, improve the symmetry of your face, avoid costly orthodontic interventions, and even heal your brain?
Decades of research into how bodies develop and change have taught us that the way we swallow, a well-formed bite, sleep, and even brain health are more interdependent than most of us realize.
We have learned that people with well-formed bites also enjoy better vision, better drainage of the ears and sinuses, easier breathing, less spine and jaw pain, and even better sleep. These are conditions that braces and other costly orthodontic interventions rarely improve and can even worsen in some cases.
How do we optimize balance and function?
Enter the tongue. Who knew all that it could do? A well-trained tongue pushes on the roof of the mouth with about a pound of pressure each time we swallow, one to two thousand times a day. This ongoing action of correct swallowing, coupled with chewing, creates the space needed for myriad functions.
How does the tongue learn to do this?
It begins with nursing. Breastfeeding trains the tongue to press just the right way on the roof of the mouth so that its formidable forces, and those of other muscles, exert in all the right directions. And if you were not breastfed, it is never too late to begin or restore healthy function.
What derails the tongue-palate relationship?
Habitual breathing through the mouth due to allergies is perhaps the most common culprit in keeping the tongue from the roof of the mouth. In childhood, we can also unknowingly create problems through thumb sucking, pacifiers, most sippy cups, and even common orthodontic devices.
Difficult births, falls, and blows to the head are also capable of interrupting tongue development if they compress the skull bones and the nerves that feed the tongue.
Not surprisingly, nutrition plays a fairly large role. The fat-soluble vitamins A, D, E, and K are critical in structural development. Processed foods and refined sugars impair the formation of healthy tissues. One difficulty that can arise is tight bands of tissue in the frenum or frenulum, commonly called tongue ties, that can keep the tongue tied down or prevent the lips from sealing well.
Notably, these challenges to proper facial development are largely features of modern times. Pre-industrial cultures enjoyed far superior facial balance than we do today.
What happens when the tongue does not default to the palate?
When the tongue drops away from the palate, known as low tongue posture, the needed pumping action on the palate, throat, and other soft tissues is missing. Sinuses do not drain as well, nor do the ears, so congestion is more common. Circulation to and from the brain is also impaired.
In regard to facial symmetry, including space for the teeth, the dropped tongue cannot push out against the powerful inward forces of the cheek muscles that help us swallow. Unopposed, these muscles can, over time, create long, narrow faces and palates and crowded bites.
I once saw a five-year-old healthy, breastfed child who had a beautifully formed face and lovely bite. She then got a pet that she was allergic to and spent two years breathing through her mouth. At age seven, she had formed classic dark circles under her eyes, a high and narrow palate, crowded teeth, and a receded chin. She was also having problems with bedwetting, sleep, focus, and behavior.
Changes in tongue placement and breathing habits can distort facial structure quickly, and the consequences can be drastic.
How does proper tongue function calm the stress response?
A properly functioning tongue has a profound effect on the nervous system. Sleep, the entire digestive process, the immune system, cognitive function, and even the ability to access our emotions are supported when the tongue rests in its proper place on the roof of the mouth, and we breathe through the nose.
Nasal breathing increases intake of both nitric oxide and carbon dioxide, both of which support blood flow to all of our cells, including the brain. These two gases are also calming, which helps us sleep. All of these effects lower vigilance in the nervous system, which is why rebreathing exhaled air from a paper bag can help during a panic attack.
The fight or flight response, which we associate with teeth grinding, bedwetting, nightmares, and sleep disruption, is further reduced when the tongue stimulates the vagus nerve on the soft palate. A healthy vagal response offsets the fight or flight response.
This lowering of vigilance resets the body to healing mode. I use the mnemonic “Rest, Digest, Heal, and Feel” to summarize some of the critical functions supported by this coveted and often elusive restorative neurological setting.
Nasal breathing also supports better breathing and sleep mechanically. Proper tongue posture moves the tongue muscle out of the airway. Additionally, the nitric oxide we breathe in from our nasal passages has the effect of lifting the mucosal tissues. Simply training the tongue to rest on the palate can prevent or alleviate sleep apnea and greatly improve our sleep, as well as the sleep of those nearby.
When the tongue is working properly, many facial muscles tone up, including the waddle of tissue underneath the chin, which happens to be the root of the tongue. Who would not welcome a natural facelift?
How does tongue function relate to neck and back pain?
If the face does not develop properly, the airway can also fail to widen. This can be seen by simply looking in the throat or by taking an X-ray or CT scan. Since breathing is the body’s highest priority, the head, neck, and jaw will jut forward and drop down to allow air to pass more easily.
This air-seeking neck posture wreaks havoc on the jaw and neck muscles and can ultimately result in many problems, including jaw, neck, and back pain that does not easily resolve.
People with airway issues cannot sit straight, even if they try. Air-seeking postures can distort the entire spine. The head and neck jut forward, causing the torso and pelvis to slump. This also causes the front body to tighten and the back body to lose tone. The legs tend to hyperextend, the back weakens, and the buttocks flatten.
Under the influence of these distortions, the spine and limbs are tense and less able to move with coordination and efficiency. This creates a setup for joint problems and back pain.
To complicate matters, people with narrow airways who also sit for long periods have both issues to contend with. What is more, many air seekers prefer to sleep face down because they can breathe more easily this way. Unfortunately, this position is also hard on the neck and spine and can compress the brainstem and the vagus nerve at the base of the skull.
It is interesting to note that in the equestrian world, if after a fall a horse’s tongue no longer defaults to the palate, the animal is considered unable to fully recover.
Do braces help or hinder?
In an ideal world, kids with crowded faces would correct their tongue function early in life to allow correct swallowing and chewing to “grow” the bite and the face so that braces are not needed. Most current orthodontics address only the alignment of teeth and do not address facial and body functions. Often, appliances themselves create tension in the face that can suppress natural growth in children and complicate facial and spinal remodeling in adults.
So how do we fix it?
To test for mouth breathing, I ask people to try holding a popsicle stick flat between closed lips for a half hour or so. If this is doable, I have them see if their lips will stay closed even longer with a piece of first aid tape. If the tape is comfortable during the day, I have them try to keep it on at night. Nasal breathing will widen the airway over time, so even if you can only tolerate the tape for a short time, stick with it. Adhesive strips that hold the nasal passages open by lifting the skin on either side of the nose can also help, as can the nasal clearing technique taught in the Buteyko breathing method.
Sometimes these simple interventions can greatly improve sleep. If the stick test is not tolerated, we know we have work to do. If sleep improves with taping at night, we know we are on the right track.
To check tongue function, swallow, and note whether the tip of the tongue touches the palate, the teeth, or both. Have kids smile and say a word that starts with an L. If the tongue does not move correctly, it can usually be seen peeking through spaces between the teeth. The tongue should not touch the teeth. It should move across the entire palate with each swallow, and the tip should ultimately rest about a pinky’s width behind the teeth most of the time.
Mealtime is a great time to train your tongue. Imagine your feet and seat moving toward the ground while a cord from the crown of your head moves toward the sky. The shoulder blades drip down the back, the chin is tucked toward the chest, and the pelvic floor and core muscles are active but not clenched. All of this helps stabilize the body so the tongue can do the work of swallowing correctly.
Breathing through your nose while you eat will ensure good chewing function. Chew at least 25 times and press your food forcefully to the roof of the mouth, especially the back of the mouth. When swallowing, grimacing can really help engage the right muscles. Remember the important piece of tucking the chin. Place your hand on your lower belly and make sure it stays relaxed, as all the work of chewing and swallowing is done with the tongue and face.
Basic goals of tongue training include a forceful swallow in which the tongue ripples especially powerfully from the soft palate in the back to the hard palate in the front. Ideally, we would be able to produce loud sounds when suctioning the tongue to the roof of the mouth.
Interestingly, tribes whose languages include sucking and clicking sounds enjoy wide, balanced faces with well-formed dental arches and plenty of room for breathing.
Music can help
Singing and playing wind instruments can really condition the tissue at the back of the throat. On another note, pun intended, I have people use their tongues to beat their palate along to a song once a day. Janelle Monae’s Grammy-nominated song “Make Me Feel” actually uses suction clicks as percussion. I had been texting the song to people to help them practice for months before she performed it at the Grammys. I took this as a sign that upbeat songs are great for tongue workouts too. After all, science has shown that our brains rewire, in other words, we learn more than 20 times faster when we are having fun.
What if DIY is not enough?
Changes, which do come more quickly with kids than with adults, take time. If after many weeks of practice you are not making gains, consultation with a myofunctional therapist, formerly called an orofacial myologist, tongue trainer, or oral rest posture therapist, can be very helpful. Some offer consultation by video. These professionals can help you train all the muscles of your face and airway to perform the way they are intended. They can also help you optimize airway function and recover from asthma, apnea, and other breathing disorders.
If your head was overly compressed at birth or you have had falls or accidents, evaluation and treatment by an osteopathic physician skilled in cranial osteopathy can help. These practitioners use their hands to help the body reset its nervous system, soften restrictions in the skull and elsewhere, and balance forces from head to toe so that the whole body can breathe, align, and support the emergence of a functional swallow and musculoskeletal system.
Complicated cases sometimes benefit from the use of developmentally friendly dental appliances. These interventions work best when the dentist, osteopath, and orofacial myologist work together.
Hold on to your optimism
The reality is that with fairly minor and simple corrections, many common health pitfalls, costly orthodontic interventions, and even surgeries can be avoided. It is wonderful and empowering to realize that sometimes a small shift in habits is all the body needs to rediscover its remarkable ability to heal itself.
For more information on tongue training, visit the International Association of Orofacial Myology and their archive of over 300 related studies. This talk by Dr. Veneziano explores this topic and more. Subscribe to her YouTube channel to be notified when new lectures are posted.
Read more from Dr. Michelle Veneziano
Dr. Michelle Veneziano, Physician Educator
Dr. Michelle Veneziano is a family physician, an intuitive, and an adjunct clinical professor at Touro University in Northern California. She shares practices and insights for living in alignment with nature, connecting with who we really are, and awakening the healer within. She lives in Forest Knolls, California, with her gifted teenage daughter.
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