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Speech Errors and Orthodontic Appliances

Written by Dr. Marina Gonchar

Orthodontic treatment is an important modality used in children and teens to improve alignment of the dentition, direct growth of the jaws, improve facial balance, help with speech difficulties, and improve self-esteem. Orthodontic appliances are commonly incorporated in orthodontic treatment to achieve these goals, while highly effective they can also cause temporary speech changes and errors during the adjustment period. Three of the most common orthodontic appliances used in the pediatric population are palate expander, dental habit appliance, and a Nance appliance. This blog will help parents understand the utility of these appliances, the speech errors that can be expected with initial placement, and ways to overcome these challenges.

Talk Time Speech and Language Therapy | Color picture of boy at dentist | Speech Errors and Orthodontic Appliances by Dr Marina

Palate Expander

A palate expander is one of the most common orthodontic appliances utilized to correct the width of the upper jaw and allow for improved tooth eruption and alignment, and improved nasal and upper airway function. A palate expander is usually affixed to the back teeth and sits on the roof of the mouth, temporarily affecting speech. Some common speech errors associated with a palate expander include:

1. Lisping-the palate expander creates a gap between the tongue and the roof of the mouth, leading to a lisping sound when trying to articulate sounds that start with “s” or “z.”

Dental Habit Appliance

A dental habit appliance, a tongue crib, is utilized to discourage oral habits like thumb-sucking or tongue-thrusting. It is usually affixed to the top teeth and extends vertically like a small gate to prevent the tongue or the thumb from pushing on the front teeth. While this device is very effective in discouraging oral habits which often leads to positive effects on tooth position and speech development, initial placement can influence speech production and requires adjustment.

2. Altered airflow-the habit appliance can also affect airflow during speech production and in children that experience disturbances in oro-nasal breathing, that can also impact changes in sound production.

Nance Appliance

The Nance appliance is often used in children due to early loss of baby teeth, particularly baby molars, to prevent space loss and to prevent permanent teeth from drifting forward.

3. “N” sound distortion-the Nance appliance has a small acrylic button that sits at the inflection of the palate and can affect tongue position leading to slight distortions or difficulty in producing a clear “n” sound.

Although the speech errors because of orthodontic appliances are temporary and are typically resolved within a few days after appliance placement, here are strategies that can help improve speech while wearing these appliances:

  1. Practice tongue placement-gently resting the tip of the tongue behind the front teeth.

  2. Slow and deliberate speech-slowing downing the speech tempo can help maintain control over tongue and lip movements, minimize errors and distortions.

  3. Use visual and auditory feedback-looking in the mirror while practicing speech, the visual and auditory feedback can be helpful in improving pronunciation.

  4. Patience and persistence-be patient with your child and persistent in your practice, remembering that consistent effort and practice will help your child make the necessary adjustment to their new appliance.

Contact Dr. Marina Gonchar for more information or with any questions and concerns. You can also find more information about her services on her website:

Contact Skin to Smile

Address: 2 Morris Ave, Morristown, NJ 07960-3619

Phone: (973) 998-6266

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