There’s a connection between speech disorders and misaligned teeth, but what if what’s giving you a lisp is the very device that’s supposed to correct your bite? Can braces actually give you a lisp, and does it go away?
Braces can indeed cause a lisp, but in most cases it’s temporary. Appliances that cover the back of the teeth or the roof of the mouth will interfere with the tongue’s movement, causing a transitory speech impediment. Most patients learn to speak normally after a few weeks.
However, some patients might maintain their lisp, or even develop a new one if they don’t correct their tongue positioning or tongue thrusting habit. These patients should consult a speech therapist in conjunction with their orthodontic treatment.
Read on if you want to learn what kind of orthodontic appliances can give you a lisp, and what you can do about it.
What causes a lisp?
Lisps are cute on a small kid, and a normal part of development up until 4.5 years old, but they can quickly become a source of insecurity as that child becomes a teenager or adult.
Speech impediments are caused by many factors – overbites, underbites, open bites, prolonged use of the pacifier or bottle, thumb sucking, tongue thrusting, and tongue ties – but tongue positioning plays the biggest role. If it weren’t so, all patients with misaligned teeth would have a lisp or some sort of speech disorder, and that’s just not the case.
Fortunately, a speech pathologist has more expertise in teaching proper tongue positioning, and we, as orthodontists, can do our best to create healthy support for the lips and tongue.
A lisp is the incorrect production of the “s” and “z” sounds. Ideally, the tongue should sit just behind the top front teeth and its sides should roll up to touch the molars.
The main type of lisps we encounter in our practice are:
- Interdental Lisp. This is the most common. The tongue protrudes between the teeth, making a “th” sound.
- Lateral Lisp. The tongue is close to the correct position, but the sides of the tongue don’t touch the back molars. This creates a slushy sound, which is a mix of air and saliva.
- Dentalized Lisp. The tongue doesn’t quite protrude between teeth, but it pushes against the top front teeth, causing a hissing sound.
- Palatal Lisp. This type of lisp is rare. The middle of the tongue is incorrectly raised to the hard or soft palate.
Can braces actually cause a lisp to develop?
Braces shouldn’t cause a permanent lisp to develop (unless that patient already had a tongue positioning error). However, because of the space they occupy inside the mouth, braces can modify speech temporarily.
Most kids’ braces will cause a lisp at first, but adults get most self-conscious when first getting their braces or aligners and noticing a lisp. If you’re getting one of the appliances below, expect to speak with a lisp for a while.
Appliances that may cause a lisp in orthodontics:
- Kids Braces. Palatal expanders, Nance appliances, expansion plates – anything that covers the hard and soft palate will cause either a lateral or an interdental lisp. Kids usually find this hilarious, and they’re back to their normal selves by the following session.
- Adult palatal appliances. I wish I could say adults react better to these devices, but bite plates and palatal arches can cause a lisp (and a lot of saliva).
- Lingual braces. Because they sit on the backs of teeth, lingual braces take up precious space inside the mouth that was destined for the tongue. The resulting lisp may persist for the entire duration of the treatment.
- Accessories on the back of the front teeth. Just like lingual braces, any spikes that are designed to discourage tongue thrusting, or frontal bite turbos designed to raise the bite will most likely cause a dentalized lisp.
- Clear aligners. They may be thin, but they occupy some space inside the mouth, as well as cover teeth all around. You will notice a slight lisp, but it should go away as you re-learn how to place your tongue.
Tooth Positions that may cause lisp:
If you or your child had an interdental or dentalized lisp, the tongue normally contacted the front teeth. During orthodontic treatment, the front teeth shift into a correct position and angle. However, the tongue is still used to the old pronunciation, so it will struggle to find its familiar support.
In rare cases, shifting the front teeth forward or back can lead to lisps, even for adults. This doesn’t mean the teeth are sitting in an incorrect position, just that the tongue needs to re-learn a new way of making the “s” and “z” sounds. We don’t usually notice this in practice because the tongue gets used to new situations much faster than the rate at which teeth are moving.
Can braces correct a lisp?
Many patients that have always had an interdental lisp also present an open bite malocclusion. In an open bite anomaly, the front teeth are spaced apart, often from canine to canine.
If we pull the lips apart, we’ll notice the patient protruding the tongue in between the teeth whenever swallowing and speaking “s” and “z” sounds.
It’s not the open bit causing the lisp, but rather, the other way around – the tongue thrust causing the open bite. The tongue is a powerful muscle, and years of pushing against the teeth thousands of times a day will lead to permanent skeletal deformation, as well as speech disorders.
That’s why it’s so important to correct the open bite in conjunction with correcting the tongue-thrusting habit. We do this in collaboration with a speech pathologist, as well as using braces and an appliance called ‘tongue crib’ that’s meant to keep the tongue back while we correct the teeth.
If you’ve always been dealing with a lisp, it’s important to see a speech therapist to get a diagnosis and perhaps a referral to the orthodontist. If, however, pronunciation has never been an issue for you and you find yourself unable to make correct “s” and “z” sounds while wearing braces, know that it’s temporary and you’ll soon get back to normal speech.
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