---
title: "Orthodontics and Speech Therapy UK | Bite and Speech"
url: https://virtualconsultant.online/guides/orthodontics-speech-therapy-uk
description: "How open bite, crossbite and a large overjet cause lisps and articulation problems, and what orthodontic treatment can improve."
updated: 2026-08-17T00:00:00Z
publisher: Virtual Consultant Online
---

Speech

Open Bite

Tongue Thrust

Myofunctional Therapy

# Orthodontics and Speech Therapy: When Bite and Speech Are Connected

The relationship between bite and speech is closer than many patients realise. Certain malocclusions directly alter the position and movement of the tongue, lips, and teeth — the structures responsible for producing speech sounds. Understanding this relationship helps patients, parents, and clinicians set realistic expectations for how orthodontic treatment may influence speech.

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## How malocclusion affects speech production

Speech sounds are produced by shaping airflow using the tongue, teeth, lips, and palate in precise ways. Any structural alteration to these components can interfere with sound production. An anterior open bite — where the upper and lower front teeth do not meet — creates a gap through which air escapes when producing sibilant sounds (s, z, sh, ch), typically causing a frontal lisp. A large overjet (protruding upper teeth) forces the tongue to compensate for the increased space, altering 's' and 'th' sounds. A posterior crossbite can affect lateral tongue posture and the production of sounds that require the tongue to contact the hard palate. Severe Class III malocclusion may affect labio-dental sounds such as 'f' and 'v'.

## Open bite and lisping

Anterior open bite is the malocclusion most strongly linked to speech difficulties. The persistent gap between upper and lower front teeth encourages a tongue thrust swallowing pattern — where the tongue protrudes forward between the teeth during swallowing — and a frontal lisp during speech. The tongue thrust may be a cause of the open bite (where prolonged thumb sucking or a resting low tongue posture pushed the teeth apart) or a consequence of the gap (where the tongue automatically fills the available space). Disentangling cause and effect matters for treatment planning: if tongue thrust is driving the open bite, orthodontic treatment alone without myofunctional therapy addressing the habit is likely to result in relapse.

## Tongue thrust and myofunctional therapy

Tongue thrust is an atypical swallowing pattern where the tongue pushes forward against or between the teeth rather than resting on the palate. It affects approximately 30 to 40% of children and typically resolves spontaneously, but persists in a proportion of adults. When tongue thrust is associated with speech difficulties or orthodontic relapse risk, orofacial myofunctional therapy (OMT) — exercises to retrain tongue and lip posture and swallowing pattern — can be effective. In the UK, myofunctional therapy is provided by some speech and language therapists (SLTs) and by a small number of specially trained dental professionals. Referral is usually via the orthodontist or GDP. Evidence for OMT specifically in adults is more limited than for children.

## Orthodontic treatment and speech improvement

Correcting the underlying structural cause of a speech problem through orthodontics can lead to spontaneous speech improvement — particularly when the malocclusion is severe and the speech difficulty is clearly structural rather than habitual. Patients with anterior open bite who have it closed with orthodontic treatment often find that the lisp resolves on its own within weeks to months as the tongue adapts to the new anatomy. Children tend to adapt faster than adults. However, long-standing compensatory speech patterns — habits built up over many years — may persist even after the bite has been corrected. These patients benefit from formal speech and language therapy to establish new patterns.

## Collaboration between orthodontists and speech and language therapists in the UK

In complex cases, particularly children with significant open bite, tongue thrust, or velopharyngeal insufficiency (relevant in cleft palate patients), close collaboration between the orthodontist and an NHS or private SLT is best practice. Hospital orthodontic departments treating complex cases, cleft teams, and multidisciplinary facial growth clinics in major NHS trusts routinely include SLT input. For patients in primary care orthodontic settings, the orthodontist can recommend SLT assessment and it is worth asking GP or health visitor to make a referral if speech difficulties are present. NHS SLT is available for children, with varying thresholds and waiting times by region.

## Realistic expectations for speech after orthodontic treatment

Orthodontic treatment is not speech therapy. For mild speech adaptations caused by structural factors, correction of the bite frequently leads to noticeable improvement. For deep-seated habitual patterns, speech therapy is needed. Patients should not expect immediate speech changes after brace fitting — indeed, fixed braces cause temporary speech changes during the initial weeks of treatment as the tongue adapts to the new hardware. These typically resolve spontaneously. Adults who have had uncorrected open bite for decades may find that even after orthodontic correction, the lisp requires targeted therapy to resolve, as the motor pattern is deeply ingrained.

## Useful related pages

[Speech and Braces UK](https://virtualconsultant.online/guides/speech-and-braces-uk)

[Tongue Thrust Orthodontics UK](https://virtualconsultant.online/guides/tongue-thrust-orthodontics-uk)

[Open Bite Treatment UK](https://virtualconsultant.online/guides/open-bite-treatment-uk)

[Mouth Breathing and Orthodontics UK](https://virtualconsultant.online/guides/mouth-breathing-orthodontics-uk)

[Jaw Surgery and Orthodontics UK](https://virtualconsultant.online/guides/jaw-surgery-orthodontics-uk)

This guide is for general information only. It is not a diagnosis, treatment plan, or substitute for advice from a registered dentist or orthodontist.

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### Frequently Asked Questions

Can an underbite or open bite cause a lisp?

Yes. Anterior open bite is the malocclusion most directly associated with a frontal lisp, because the gap between the front teeth allows air to escape when producing sibilant sounds. A Class III underbite can also affect speech if the jaw discrepancy is significant enough to alter tongue and lip positioning. Correcting these bite problems through orthodontics often improves speech, though long-standing compensatory speech patterns may need specific therapy to resolve.

Will braces give me a temporary lisp?

Fixed braces commonly cause temporary speech changes in the first two to four weeks of treatment, particularly a mild lisp and difficulty with certain consonants. This is caused by the tongue adjusting to the new brackets and wires on the teeth. For most patients this resolves spontaneously as the tongue adapts. Lingual braces (attached to the inside of the teeth) typically cause more significant and longer-lasting speech disruption than labial braces because they sit directly in the path of tongue movement.

Should my child see a speech therapist before or after orthodontic treatment?

If your child has both a speech difficulty and a malocclusion, the ideal sequence depends on the nature of both problems. Where tongue thrust is likely maintaining an open bite, addressing the tongue habit with an SLT before or alongside orthodontic treatment reduces the risk of relapse after braces. Where the speech difficulty appears entirely structural and the bite can be corrected orthodontically, treating the bite first and reviewing speech afterwards is reasonable. Ideally, an orthodontist and SLT should communicate directly about complex combined cases.

How do I access an NHS speech therapist for my child in the UK?

NHS speech and language therapy for children is available via health visitor referral (for young children), GP referral, or direct referral from a school's special educational needs coordinator (SENCO). Some areas allow self-referral. Waiting times vary considerably by region. For children with orthodontic-related speech difficulties, asking the orthodontist to write a summary of the clinical situation for the SLT referral letter is helpful as it clarifies the structural component.

Can myofunctional therapy alone close an open bite?

Myofunctional therapy can help reduce or correct an open bite in cases where tongue thrust is the primary maintaining factor, particularly in children during active dental development. However, myofunctional therapy alone is unlikely to fully resolve a significant open bite, and for adults whose growth is complete, the teeth will not move without orthodontic forces. Myofunctional therapy is most effective as an adjunct to orthodontic treatment — reducing relapse risk rather than replacing mechanical intervention.

Does a large overjet always cause speech problems?

Not necessarily. Many patients with large overjets have no speech difficulties because they have developed compensatory tongue patterns that produce adequate sounds. Others — particularly those with very large overjets or those who develop the overjet during speech-development years — may develop interdental or frontal lisp patterns. Speech problems associated with large overjet typically improve or resolve when the overjet is reduced with orthodontic treatment, as the tongue no longer needs to compensate for an unusually large gap.

Are speech problems after jaw surgery normal?

Temporary changes to speech are expected after orthognathic (jaw) surgery due to swelling, altered proprioception, and changes in jaw position. For most patients, speech returns to normal or improves once swelling resolves over weeks to months. Patients with pre-existing speech difficulties may find that surgery improves their structural foundation for speech, but formal SLT assessment and therapy post-surgery is often advisable for those with persistent speech issues, particularly after complex procedures involving both jaws.

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Citation details

Title Orthodontics and Speech Therapy UK | Bite and Speech

Publisher Virtual Consultant Online

Published 2024-06-01

Updated 2026-08-17

URL [https://staging.virtualconsultant.online/guides/orthodontics-speech-therapy-uk](https://staging.virtualconsultant.online/guides/orthodontics-speech-therapy-uk)