Can Orthodontics Fix a Speech Impediment?
Reviewed by Dr. Derek Reznik, DDS, MS
Sometimes, partly, and only when the cause is structural.
That is the honest answer, and it is worth having up front because a lot of what is written about this overpromises. Orthodontic treatment changes where teeth and jaws sit. Where a speech difficulty comes from where teeth and jaws sit, changing that can help. Where it comes from muscle coordination, hearing, neurological differences or habit, moving teeth will not resolve it.
How the mouth makes sounds
Speech sounds are made by moving air past moving parts. The tongue touches the ridge behind the upper front teeth for t, d, n and l; air is channelled between tongue and front teeth for s and z; lips and teeth work together for f and v. The teeth are part of the equipment, so when they sit in an unusual position the tongue and lips have to compensate, and sometimes cannot compensate completely.
The bite problems most likely to affect speech
An open bite, where the front teeth do not meet, lets air escape between them. It is the pattern most often linked to a lisp, because s and z depend on a controlled gap that suddenly is not controlled. Overjet, where the upper front teeth sit well forward, changes the distance the tongue and lower lip have to travel. Underbite changes the relationship between the tongue and the ridge behind the upper teeth. And crossbite, crowding and spacing can all alter where the tongue rests and how air moves around it.
Each is described on the common orthodontic problems page, and each is treatable. Whether treating it changes anybody’s speech depends on whether the structure was the cause.
Where orthodontics is not the answer
Plenty of speech difficulties have nothing to do with tooth position. Stuttering, articulation disorders learned in early speech development, difficulties following hearing loss, and patterns tied to neurological conditions are outside what an appliance can touch.
There is also a common middle case. A child whose open bite was caused by thumb sucking or tongue thrusting may have both a structural problem and a learned pattern. Correcting the bite removes the obstacle; the habit often needs addressing separately, which is what a speech-language pathologist does. An orthodontist changes the shape of the mouth. A speech therapist trains what happens inside it. Neither substitutes for the other.
Braces can also change speech temporarily
A different question, often tangled with the first. New braces, an expander or a new set of aligners can produce a slight lisp for a few days while the tongue adapts. It resolves, and it is not evidence of a speech problem.
What treatment would actually involve
If an examination does find a structural factor, the treatment is not special or different. It is the same orthodontics used for any bite problem: braces, clear aligners or, in a growing child, an appliance such as an expander that changes the shape of the upper jaw.
What changes is the goal that gets written into the plan. Closing an open bite so the front teeth meet, or correcting the position of the upper incisors, is a functional objective rather than a cosmetic one, and it is worth stating explicitly at the consultation so the treatment is designed around it.
Timing matters more than usual here too. Several of the bite patterns most likely to affect speech, particularly open bite and crossbite, are far easier to correct while a child is still growing. That is one more reason the age-7 check exists.
When to get it looked at
The American Association of Orthodontists recommends a first orthodontic check by age 7. If a dentist, teacher or speech therapist has raised tooth or jaw position as a factor, that check will tell you whether there is a structural component and whether it is better corrected now or later. Speech concerns on their own should go to a speech-language pathologist first; the two assessments together give a far clearer answer than either alone.
It is also worth saying that a lisp or an unclear sound in a young child is often developmental and resolves on its own. Age matters to that judgment, which is another reason to get an opinion rather than to worry.
Book a free check
Call the Odessa office at (432) 333-7105 or the Midland office at (432) 682-1222, or request an appointment online.
Dr. Megan Reznik and Dr. Derek Reznik are each a Diplomate of the American Board of Orthodontics. The examination is free, and it will tell you plainly whether orthodontic treatment is relevant to your situation or whether somebody else is the right person to see.