Speech therapy in orthodontic treatment? This question is coming up more and more often – both among parents of young patients and among adults planning to have their bite corrected. Speech therapy is not only about ‘speech’ – it is also therapy for orofacial functions: tongue position, breathing pattern and swallowing pattern, which have a direct impact on jaw development and tooth alignment. In practice, cooperation between an orthodontist and a speech therapist can speed up treatment, reduce the risk of the malocclusion returning after the braces are removed and improve speech.
The tongue, lips and cheek muscles act like an ‘internal orthodontic appliance’ – their constant tension and position shape the forces applied to the teeth and bones. Mouth breathing, a tongue resting between the teeth or a tongue pushing against the teeth when swallowing can contribute to a narrowing of the upper jaw, an open bite or a crossbite. Systematic reviews indicate that myofunctional therapy (OMT) improves muscle function and may support the stability of orthodontic results, although the quality of the studies varies.
When to refer a child (or an adult) to a speech therapist before/after braces
See a speech therapist/orthodontist if you notice: frequent mouth breathing, thumb sucking, difficulty swallowing, unclear pronunciation of ‘s’, ‘z’ and ‘sh’ (Polish ‘sz’) sounds, or facial asymmetry. In adults, the warning signs are temporomandibular joint pain (TMD), recurring problems after treatment has ended and an unstable bite. Clinical authors emphasise the benefit of early diagnosis: the sooner myofunctional therapy is introduced, the greater the chance of stabilisation.
What a speech therapist does – stages of diagnosis and myofunctional therapy
Diagnosis includes a case history, an assessment of muscle tone and tongue position (Mew/OMES scales) and, in coordination with the orthodontist, images and possibly cephalometry. Therapy consists of a set of breathing, lip, tongue and swallowing exercises, as well as proprioceptive exercises (e.g. IOPI to measure tongue strength). Example: a 6-week programme (10–15 minutes daily) includes lip closure exercises, tongue elevation exercises (touching the palate), training of swallowing sequences and breathing exercises (GOPEx). Clinical reports describe improved function and a lower tendency for the malocclusion to relapse when OMT is introduced alongside orthodontic treatment.
Orthodontist + speech therapist cooperation – a step-by-step working model
- Before treatment: functional assessment → if there is a functional problem, OMT starts before the braces are fitted. During treatment: parallel speech therapy sessions + instructions for the patient (home exercises), while the orthodontist monitors changes. After treatment: myofunctional therapy continues during the retention phase to prevent relapse.
What does the scientific literature say? A review of the evidence
Systematic reviews point to the potential benefits of OMT as a complement to orthodontic treatment, but at the same time draw attention to the methodological limitations of the studies: heterogeneous protocols, small samples and risk of bias. More recent reviews and papers (a scoping review, 2024) suggest that OMT has a positive effect on stability and functional improvement, but more rigorous randomised trials are needed. It is worth treating OMT not as a one-off add-on, but as a therapeutic programme linked to the phases of orthodontic treatment – a model with greater potential for lasting results.
Conclusion
Cooperation between an orthodontist and a speech therapist is now standard practice, and its results are confirmed by clinicians and a growing number of studies. Speech therapy in orthodontic treatment? The answer is yes, especially when the problem has a functional basis (mouth breathing, incorrect tongue position, abnormal swallowing). Although the scientific literature points to the need for better RCTs, clinical practice and systematic reviews suggest benefits from integrating OMT into the orthodontic plan (fewer relapses, improved function, shorter adaptation to braces). For parents and patients, the key is not to delay – an early consultation gives the best chance of simpler, longer-lasting treatment.
