Oral Habit and Tension Patterns Correspond to Dental Growth, Speech, and Pain Patterns
Karen Alexander SLP, MAT
For additional information please refer to: Streicher Publications http://www.streicherpublications.com/
Forty years of research by Speech Pathologist John P. Streicher reveals habits responsible for virtually every
type of malocclusion, misalignment and excessive wear of teeth, speech and voice problems, language and
learning disorders, and stress-tension-pain patterns. The most damaging habits start in the womb when
something other than the proper thumb suck occurs. Symptoms serve as clues to habit diagnosis. Therapy cures
symptoms by identifying and eliminating responsible habits and conditioning neurological patterns for correct oral
This article is an introduction to a new body of information based on forty years of ongoing research and clinical
practice by Speech Pathologist John P. Streicher. Several dentists and speech pathologists, a school
psychologist, and a school administrator participated in much of the research based on Streicher's theory that
oral habits are the cause of many problems seen by speech and dental professionals. Streicher not only found
habits to be the cause of many symptoms and disorders, he found habits to be the common cause -- the
connection -- for many problems that professionals and patients have long believed to be related. He developed a
diagnostic and treatment program for identifying and eliminating causative habits and to reintegrate nerve
pathways for correct function, which provides a cure for symptoms.
Streicher defined oral habits as anything put into, against, or around the oral structure consistently and
persistently to cause the body to adapt for survival. He found that the reflex or autonomic nervous system makes
it possible for the body to survive habitual misuse. But that survival comes with a price -- dysfunction, disorder,
and deformity of varying degrees. In contrast, Streicher recognized how the human body becomes conditioned for
correct oral function, which he also discovered to be the foundation for successful learning experiences.
Correct neurological patterns are established by nature's provision of a thumb suck pattern that we now know
starts in the womb for most babies. The thumb establishes the swallow reflex and triggers the integration of bodily
systems congruent to human design. It lays the foundation for success with life's first learning event -- feeding.
And the thumb conditions the body for successful speech and learning patterns.
Streicher does not define the proper thumb suck as an oral habit unless it persists beyond weaning. Babies who
start life on the right neurological path suck a thumb in the womb and lose the need for it with a gratifying and
fulfilling feeding experience.
CORRECT THUMB POSITION
The correctly positioned thumb reaches the palate without bending at the knuckle. Fingers curl over the nose to
maintain center position for the thumb. The tongue shape and the jaw position conform to the thumb. The front of
the tongue rests against the inside lower front arch. The remainder billows out, touching the palate without pulling
away from the floor of the mouth. When the thumb is removed, the tongue fills in the oral cavity, resting with equal
pressure against the inner walls of the arches (and later teeth), palate and floor. Thus, the tongue supports the
dental arches and teeth from inside the framework.1
Facial muscles that are relaxed and function correctly provide equal pressure and support from the outside. With
equal pressure applied, and no habits to create an imbalance, the result is nicely rounded arches and aligned
Oral habits create an imbalance in the oral structure via the incorrect use of body parts or foreign objects. The
misuse of body parts includes biting or sucking on fingers, fist, fingernails, toes, skin, or hair. Foreign objects
include cloth, jewelry, toys, and items designed for jobs or classroom use. Although no two individuals perform
their habits in exactly the same way, each individual performs his or her habit(s) in exactly the same way every
time engaged in it.
A child with a four-finger suck habit will place the same four fingers in the mouth in the same way every time he
resorts to his habit, for instance. Another child may habitually suck on his favorite stuffed bunny's right ear by
placing it in his mouth in the same way every time. Wear on the teeth, the speech pattern, and the bunny's
ragged ear serve as clues to the damaging habit.
Habits that misdirect oral function and growth are numerous and varied. It takes detective work to pinpoint the
culprit in many cases, because people generally are unaware of their habits until confronted. But therapists can
be trained to find clues on body parts, in function and growth patterns, through interviews about symptoms and
daily activities, and in the individual's environment. The sufferer's symptoms serve as clues to the very cause.
There is no guess work or need for making assumptions; puzzle pieces fit together to give a complete picture.
The medical term chronic and the behavioral term habit are not coincidentally similar in definition. Streicher found
numerous chronic ailments including aches and pains, stomach disorders, and speech, learning, and dental
disorders to be the result of habitual misuse of the body. For each individual there is a pattern -- sometimes two
patterns to the presented problems or symptoms -- that conform to habit patterns. The damaging habits of any
one individual will fit his particular sucking or biting pattern, and each of his oral habits will fit either his sucking or
biting habits. Symptoms such as pain and excessive tooth wear usually are caused by habits involving muscle
BODILY SYSTEMS INVOLVED
As an individual engages in a habit, the body continues to swallow saliva, breath, think, and speak, etc.
Autonomic functions adapt so the body can survive misuse. Function is rerouted via newly integrated nerve
pathways. The misuse becomes habitual via the reflex system resulting in chronic symptoms or disorders. The
nature and severity of symptoms depends upon how invasive and intensive the causative habit.
Streicher's discoveries unfolded over his 40-year career, which began with a theory that habits cause speech
disorders. He found that habits via conditioned reflexes lurk behind many other disorders and deformities as well.
Another unexpected result is that Streicher's findings compliment and expand upon discoveries made several
When Streicher speaks about conditioned reflexes, he is building on the discoveries of Nobel Prize Recipient Ivan
Pavlov, the Russian physiologist known for his conditioning experiments with dogs. Pavlov also addressed how
higher and lower nerve functions (cortical and motor) are connected. He theorized a connection of higher nerve
processes such as language to conditioned motor functions.2
Streicher's work gives merit to Pavlov. And it was a review of Pavlov's work that helped Streicher understand the
role of the nervous system and reflexes as it related to his findings. This leads to an issue that needs to be
There is disagreement among professionals about the nature of a swallow pattern, whether or not it is reflexive.
Streicher, in the same vein as Pavlov, describes the automatic or habitual swallow as one that is conditioned by
the thumb as intended by design, or by an oral habit. He is not characterizing a swallow pattern as composed of a
simple obligatory reflex arc. It is not a simple reflex like the eye-blink or knee-jerk response. Rather, it is a
conditioned reflex pattern correctly established by the proper thumb suck or disordered by a habit. It is a pattern
that can be altered (reconditioned) by a habit or corrected by therapy to instill (recondition) nature's intended
PRIMARY AND SECONDARY HABITS
Streicher also identifies oral habits as primary or secondary. A teeth-gritting or clenching habit is secondary to a
nail-biting habit in many cases, and a lip-sucking habit may be secondary to a finger-sucking habit. A primary
habit establishes the function and growth pattern and instills sensations that are perceived as correct to the
individual. Secondary habits are acquired to support the familiar sensations when the primary habit isn't allowed
or has been discontinued. Therefore, the successful elimination of habits requires that the habit pattern is
identified and everything the individual does to support that pattern is brought to awareness and stopped.
Streicher often identifies a nail-biting pattern in individuals who do not have an active habit of biting their nails. It
may be an individual who was caught biting fingernails during the first week of kindergarten and stopped. Or it
may be someone who bites the cuticles or the skin of the fingertips.
It only takes one week to establish a reflex pattern. Once it is established, the individual will acquire other habits to
maintain what has become natural -- his new sense of balance and normal. In a nail-biting pattern, the individual
may start gritting or grinding his teeth in the same position(s) that he bit the nails or surrounding tissue. The jaw
will shift to the biting position for the s-sound, and objects like necklaces or body parts like lips or lip corners will
be nibbled on habitually with the same tooth contact established by the primary habit.
Streicher found habits to be as numerous and varied as the number of people on earth. No two habits are
performed exactly alike. But there are similarities -- basic concepts -- that apply to habit patterns including those
performed during sleep. A sleep habit is conditioned while the individual is awake. In cases of teeth gritting and
grinding, most individuals are unaware that they grit or grind during the day. The habit usually is inaudible when
awake; it is performed with a degree of control over the reflex pattern. During sleep there is no control over the
reflexes; the trained reflexes operate without restraint.
Knowing what to look for and with the help of family and friends, an individual can begin to detect his subtle
gritting or grinding behavior while awake. When teeth are in contact the appearance of the face and the jaw
position differ from the relaxed state. There is subtle muscle action or movement of the jaw. This activity must be
brought to the individual's awareness before the sleep version of the habit can be eliminated. At the same time,
facial muscles can be trained to relax to replace the tension pattern. The use of bite plates or placement of the
tongue in between the teeth only reinforce or compound tension patterns; they do not train muscles to relax. Any
relief experienced is not complete or permanent. Tension habits need to be stopped and the relaxed state
conditioned into the muscles.
KNOWING WHAT TO EXPECT
Muscles that have been habitually misused or kept in tension go through a transition phase as they learn to relax
and function correctly. It is crucial that the individual understand what may occur as muscles are retrained.
Otherwise, he will strive to maintain familiar sensations and not recognize constructive change taking place.
Streicher explains that muscles may twitch, spasm, or jerk much like the muscle movements seen in children as
they fall asleep or the sudden jerks experienced by many adults. Often there are sensations of numbness wearing
off, itching, tingling, hot, or cold. The tightly held jaw may feel heavy as muscles start to relax. Some have
reported a feeling of melting as muscles go from the tensed to relaxed state.
When individuals know what to expect as they retrain muscle and when they are alerted to the fact that correct
function and the relaxed state will not feel correct at first, they are able to allow corrective changes to take place.
This can be compared to the mouth breather who physically is able to breathe through the nose but won't make
Streicher points out that the mouth breather’s body has become conditioned to mouth breathing. When he
attempts to breathe through the nose, it feels like he cannot get enough air; it doesn't feel correct. There is a
tendency to take in too much air causing hyperventilation and panic. The habitual mouth breather may not allow
his body to make the natural transition.
The nose breather can understand this by considering his behavior with nasal congestion. He is not comfortable
with mouth breathing, so he resorts to boxes of tissues, nose sprays, and drugs -- anything to allow air to flow
through his nostrils again.
HABITS AFFECT SPEECH
Streicher found cloth habits to cause most cases of delayed speech. Favorite blankets, stuffed toys, clothing, and
even habitually sucking water out of wash cloths literally wipe out speech sounds. The further back in the mouth
the cloth is shoved, the more speech sounds are wiped out. Streicher identifies cloth habits by the way cloth
wears teeth -- by the way the edges of the teeth are rounded off. He also has shown how the body learns to
operate around a habit object such as cloth by having an individual speak while engaged in his habit. Children
with no intelligible speech can be understood with the cloth in their mouth. This usually surprises the child, but it
helps him understand how his habit hurts his speech and how his thumb can help him learn to talk like other
Streicher explains to children and adults that they will be conditioning correct speech sounds into their systems
using a thumb, but he assures them that they will not be sucking the thumb or acquiring an undesired habit. The
thumb is used with conscious awareness only for therapy practice to reintegrate neurological pathways for the
speech pattern intended for the individual.
NOT BY IMITATION OR CONTROL
Current therapies rely on controlling a disordered internal system rather than curing it. Because causes were
unknown, and therefore no cures were developed, therapists have been doing the best they can by relying on the
cortical center of the brain to override a disordered reflex system. By using imitation methods, we are attempting
to get individuals to produce sounds that sound correct -- that sound like what is modeled to them. This is
unnatural and makes learning and concentrating more difficult.
Streicher's therapy, although universal in approach (correct function is according to the design of the human
body and therefore the same for everyone), does not result in identical speech patterns. It is the imitation
approach that requires our clients to sound just like us; Streicher's therapy instills the speech and voice quality
natural to each individual. The result is free-flowing speech characterized by each individual’s physical features.
Cured speech is not controlled speech.
Current therapies define success by how well a person learns to control his speech, cope with his problems, or
compensate for difficulties. Streicher's success rate is determined by the cause being found and eliminated and
symptoms cured. Successful treatment produces a changed individual – one who can function as though the
person never had the habit-caused problems. Streicher treated thousands of patients with his habit therapy with
98 percent success.
Today's therapies claim a success rate lower than 40 percent. Streicher points out that what seems to be
successful actually may be detrimental. This particularly pertains to problems in learning, even stuttering.
The individual who learns to exert cortical control over a disordered reflex pattern must maintain that control to
produce socially accepted speech or a less deviant swallowing pattern, etc. The internalized system remains
disordered. This reduces learning potential by 10 to 15 IQ points that only the very intelligent can sacrifice without
struggle. (This was determined by tests administered to students by a psychologist before and after they received
For reading and learning disabilities, Streicher's discoveries compliment studies by neurologists at the University
of Washington. They found that the speech sound system is the basis of reading disorders, which they related to
detected differences in brain activity. Although they admitted to not knowing how to correct deficient brain
function, they claimed that therapy methods addressing the sound system were more helpful than other
THE SPEECH-LEARNING CONNECTION
Streicher determined that individuals are not able to meet their learning potential when cortical skills for language
and thought are activated to override a disorder reflex system. He presents a variety of case examples in his
introductory book The Pebble in the Shoe.4 He compares the tapped cortical activity for controlling the sound
system to that used in translating words from one language to another. An individual employs decoding and
encoding skills to translate foreign words into his own language for understanding and to produce words for his
foreign listeners or readers to understand. Likewise, an individual with a disordered internalized speech system
must translate acceptable speech to his disordered system for understanding and to produce acceptable speech
The individual with less than above average skills cannot comprehend what he is reading while tapping the same
cortical function for making a translation within his system. With Streicher's therapy to establish a correct
internalized sound system, this cortical activity can be directed to learning and reading needs.
Streicher found that a stuttering pattern is an individual's way of handling an articulation disorder. When an
individual, even a young child, acquires an oral habit causing a change in his speech, it is alarming. The
individual begins struggling to retrieve his familiar speech pattern. He doesn't understand why his speech won't
come out the way it used to. The way he attempts to control his speech is his stuttering pattern. He has two
speech patterns: the disordered pattern and the cortically controlled one. Perceived stress, including efforts to
concentrate on what he wants to say while he is speaking, will throw him to the reflexive level. The stuttering is his
way of trying to regain control.
In a supplement to his book, Streicher describes five cases of stuttering, including two individuals who were not
labeled as stutterers but who secretly avoided using words with the r-sound. They knew they could not produce
the words correctly, but their parents, teachers, and therapists were unaware that they avoided r-words in speech
Streicher explains how suck marks on the finger of one child and chapped tissue around the mouth of the other
helped him determine the responsible habits responsible for their speech and learning disorders. Both students
were failing school before therapy and became top students after their speech was cured.
HABIT THERAPY TRAINING
Streicher's first concern is that therapists understand what correct oral function entails. He addresses human
design when presenting correct function for biting, chewing, and swallowing as well as the overlaid function of
speech. His instruction includes an explanation of jaw function, the purpose of teeth based on their design,
tongue movement, and sound production. Streicher presents normal growth and balance of the oral structure as
that which attains symmetry and balance.
Deviations in growth and function serve as clues to the habits that cause symptoms involving the oral structure.
Streicher teaches therapists to distinguish types of tooth wear and to consider arch shape and tooth misalignment
as clues to habit objects that could cause the particular deviations. Therapists are taught to assess eating and
speaking patterns. We learn to distinguish between speech that sounds correct and speech that is produced
Therapists learn to be habit detectives. They are presented with basic concepts for breaking into habit patterns
along with specific measures that Streicher has found helpful. Therapy instruction includes how to use the thumb
to recondition oral function and how to teach correct biting and chewing. For individuals who begin therapy with a
deficient bite position, there is instruction for modifications until the bite position corrects.
Streicher shows therapists how to take dental pictures and assess progress with the pictures and ongoing
evaluations. He also explains how emotional and personality patterns change for many individuals as a result of
therapy. He explains how emotions connect to habit and tension patterns.
Streicher discusses stress, tension, and pain in a different perspective than other modern treatments. He
recognized how stress-tension patterns develop and how
tension produces numerous bodily ailments and pain seen by today's medical professionals. He determined how
to teach individuals to relax -- to stop habitual tensing of muscles in response to stress. People who live a relaxed
lifestyle -- who do not respond to stress with tension -- do not need stress management, tension-relieving
activities, or drugs to relieve tension-produced pain. Streicher's therapy stops stress-tension-pain cycles that
prevent many people from living their lives to the fullest.
HABITS AND OTHER SYMPTOMS
Streicher, who died in October 2002, began his career in the 1950s with a theory that speech is affected by the
things people do to their mouths, particularly when under stress. His professors did not accept his theory and did
not allow him to design research to test it. He dropped out of graduate school to test current practices and to
conduct private research. As he proved that oral habits cause speech disorders, he began discovering how
habits cause many other symptoms related to the oral structure. As he noted the role of tension, he could see
how the tensing of various muscle groups affect other areas of the body. His next book awaiting publication
addresses stress-tension-pain disorders.
Streicher's discoveries offer us a new paradigm, a new way of thinking, about conditions treated by health-related
professionals. For dental and speech professionals the most significant discovery is how oral habit and tension
patterns correspond to dental growth, speech, and pain patterns.
1 Alexander, K.B. (June 11, 2001) Thumb Plays Crucial Role in Speech, Advance for Speech-Language
Pathologists and Audiologists, King of Prussia, PA: Merion Publications.
2 Babkin, B.P. MD (1974) Pavlov: A Biography, University of Chicago, Chicago Press.
3 American Journal of Neuroradiology, 21:916-922, May 2000
4 Streicher, J.P. & Alexander, K.B. (2000). The Pebble in the Shoe: Detecting the Causes of Distress and Pain in
the Human Body, Enumclaw, WA: WinePress Publishing
5 Streicher, J.P. & Alexander, K.B. (2001). Supplement to The Pebble in the Shoe: Detecting the Causes of
Distress and Pain in the Human Body, Detecting the Cause of Stuttering and Other Speech Disorders and a
Therapy that Cures, Website: Streicherpublications.com, PDF Format