On emoticons

How did we communicate :-P, the tongue-y face emoticon, before there were emoticons? How do you translate :-P into face-to-face communication, telephone calls, or dead-tree letter writing? Most people don’t stick out their tongue in normal day-to-day conversation, although there are a few people who use it as a common gesture, and probably inspired the emoticon.

There appear to be multiple meanings of :-P:
(1) Sillyness
(2) Disgust
(3) Annoyance

Perhaps that is why I find it difficult to replace this surprisingly complex emoticon. How did I survive without it?