It is not possible to swallow the tongue. Bodily tissue firmly connects the tongue to the mouth, which prevents people from accidentally swallowing it.

It is a common myth that a person can swallow their tongue during a seizure, while asleep, or if they become unconscious. However, these events can cause an individual to have difficulty breathing if the tongue blocks the throat. Sometimes, people can also get oral injuries.

In this article, we look at why it is not possible to swallow the tongue. We also look at some of the issues that can affect the tongue and mouth during a seizure or while unconscious and explain what to do if they occur.

Someone kneeling down to help a woman into the recovery position while having a seizure.Share on Pinterest
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According to Johns Hopkins Medicine, it is not physically possible to swallow the tongue.

The tongue is a muscle that connects firmly to the mouth. A length of tissue called the lingual frenulum connects the base of the tongue to the bottom of the mouth and lower jaw. This connection prevents people from being able to swallow the tongue.

It is a myth that people can accidentally swallow the tongue during a seizure or if they suddenly fall unconscious. However, people may use the term “swallowing the tongue” to refer to the tongue falling back toward the throat, which can block the airway.

When a person falls unconscious, the muscles relax, including the tongue. If a person is lying on their back, the relaxed tongue can block the throat and partially or completely obstruct their breathing.

People with obstructive sleep apnea can experience this during sleep, and there is also a risk of it occurring when a person falls unconscious.

Moving someone who is unconscious into the recovery position prevents the tongue from falling back toward the throat. People can follow these steps to put someone into the recovery position:

  1. Kneel next to the person.
  2. Extend the nearest arm out from the body with the palm facing upward.
  3. Place the opposite arm so that the person’s hand is on the cheek on the nearest side of the face.
  4. Keeping the nearest leg out straight, lift the other knee so that it is bent.
  5. Use that knee as a lever to roll the person onto their side.
  6. Move the bent knee upward into a running position to stabilize the person.
  7. Check that the tongue has fallen forward and that they are breathing normally.

The United Kingdom’s National Health Service (NHS) provide the following video to demonstrate:

Another potential complication of a seizure is oral injury.

In a 2017 survey, 106 people with epilepsy completed a questionnaire about the rate of oral injury during seizures. The researchers found that:

  • 52.4% of the participants experienced oral injuries during epileptic seizures, which most commonly affected the lips, tongue, or cheeks
  • 18% experienced tooth cracks
  • 17% experienced tooth fractures

Tongue biting, which may puncture the tongue on one or both sides, is a common injury in seizures.

However, while first aid advice for seizures used to recommend holding down the tongue to prevent swallowing or injury, doctors now know that this practice is dangerous.

People should never place an object or their fingers inside a person’s mouth while they are having a seizure. According to Epilepsy Ontario, this can cause:

  • a broken jaw
  • broken teeth
  • choking

The following sections outline how to help if a person is having a seizure.

Before a seizure

If someone begins to show signs of a seizure, people can take the following steps:

  1. If the person is near a road, gently guide them away to a safe space.
  2. If the person is indoors, clear away any furniture and other objects that are close to the person, taking particular care to create space around their head.
  3. If moving furniture is not possible, place soft padding, such as a pillow or sweater, around any hard furniture, surfaces, or sharp edges.
  4. Make sure that no electrical equipment or cooking appliances are switched on or able to cause harm.
  5. If in a public place, try to stop lots of people from crowding around.
  6. Gently ease the person to the floor if they are not already on the ground.
  7. Carefully place the person into the recovery position.
  8. Start timing the seizure from when it begins.

During a seizure

If someone is already having a seizure, people can:

  1. Gently ease them onto the ground, if necessary.
  2. Remove their glasses, if they are wearing any.
  3. Remove or loosen tight or restrictive clothing, particularly any items around the neck or head.
  4. Place something under the head to cushion it, such as a folded sweater, or use the hands to cup the head loosely to help prevent a head injury.
  5. Cover the person with a blanket or jacket.
  6. Stay by the person during the seizure, talking to them in a calm, reassuring manner until they recover.

Do not try to restrain the person’s movements, deliver CPR, or offer anything to eat or drink during a seizure. If the seizure lasts longer than 5 minutes, call 911.

After a seizure

People can also take steps to help someone who has just had a seizure.

If the person is unconscious:

  • Roll them into the recovery position to keep the airways open.
  • Check for normal breathing.
  • Until they wake, keep them covered with a blanket and check every few minutes for a response.

If the person is responsive:

  • Remember that the person is likely to feel tired and disoriented.
  • Ask the person their name and location.
  • Reassure the person and explain that they have had a seizure.
  • Stay with them while they recover and help them sit in a safe, comfortable place.
  • Look for a medical bracelet that provides any emergency information or contact details.
  • Check for any injuries that the person may have sustained during the seizure and apply first aid.
  • Try to ensure that the person has someone to accompany them home or can take a taxi back to a safe place.

Head injuries are common during seizures. Research suggests that about 50% of people experience a head injury during a seizure.

It is important that bystanders know what to do if someone injures their head, both during a seizure and in other situations. If someone has a suspected head injury and they are unconscious, people can help by:

  • moving them gently into the recovery position
  • making sure that their airways are clear
  • listening to their breathing
  • calling 911 for an ambulance or asking someone else to do this immediately
  • calling the police if there is any threat to safety
  • checking for a response every few minutes
  • covering any open wounds on the head or discharge from the ears or nose with a sterile dressing
  • avoiding packing dressing into the ears or nose
  • treating any other injuries with first aid
  • keeping them warm with a blanket or coat
  • staying with them until the ambulance arrives

If the person is conscious, it is best to help them move into the position they find most comfortable rather than into the recovery position. However, the other tips still apply.

It is essential to keep checking that the person is still conscious and breathing normally until the ambulance arrives and to avoid leaving them unsupervised.

A person should call 911 or their local emergency department if someone has:

  • their first seizure
  • a seizure in water
  • difficulty breathing or waking up after a seizure
  • a second seizure that starts after the first seizure ends, without the person becoming fully conscious in between
  • a seizure that causes an injury, such as a head injury
  • a seizure during pregnancy
  • a seizure and they have a serious health condition, such as heart disease or diabetes

If a person has epilepsy and has had a seizure before, they can contact their doctor. They do not need emergency care unless a serious injury has occurred or the seizure lasted longer than 5 minutes.

It is impossible to swallow the tongue, even during a seizure. However, people can get oral injuries during seizures or if they suddenly fall unconscious. People with epilepsy can bite their tongue, crack their teeth, or injure their gums.

Despite this, it is important not to insert objects or fingers into someone’s mouth when they are having a seizure. Instead, people should follow the recommended first aid practices.

In some cases, the tongue can fall backward in the mouth and block the airway. Moving someone into the recovery position, if they are unconscious, can prevent the tongue from blocking the throat.