Speech and Expanders

Speech is a complex process involving precise coordination between the tongue, lips, teeth, and jaws. Proper structure allows for proper speech. The position of the tongue, the width of the palate, and the alignment of the teeth all play key roles in forming clear and distinct sounds.

For instance, a narrow or high-arched palate leaves limited room for the tongue to move, making it harder to pronounce certain sounds like “L”, “T”, or “R” accurately. Furthermore, a high palatal vault can affect the resonance and projection of speech, making some sounds come out nasal or unclear.

If a patient has a constricted upper jaw with a high arch, a palatal expander can play a key role in helping a speech therapist achieve precise articulation. Palatal expansion widens the upper jaw, providing more room for the tongue to be positioned properly. Furthermore, palatal expansion allows a high palate to drop down – with the palate lower, the tongue can be positioned correctly much more easily. Widening and dropping the palate can be game-changers for some patients who struggle to achieve proper articulation. Accordingly, speech therapists often refer directly to our office, especially if the patient’s articulation is not improving despite regular speech therapy sessions.

Some patients have a narrow upper jaw and never have an expander. What happens in this case? The body tries to compensate. This means that the patient attempts to develop tongue movements to work around the narrow jaw and tight oral spaces. This works effectively for some, meaning some patients are able to speak beautifully despite a narrow and high palate. For many, though, speaking clearly is a challenge, and improvement in speech can be slow or plateau. If this is happening over the course of speech therapy, the speech therapist may then recommend expansion to correct the jaw structure.

First, we are huge believers in working closely with speech therapists to help coordinate care. If a patient is in speech therapy, we want to first communicate with the therapist to discuss the orthodontic treatment options and coordinate best timing before starting any treatment in our office. Sometimes, a speech therapist is working with a patient on a particular sound or tongue exercise, and they would prefer the expander to be accelerated or delayed based on their therapy plans. We are constantly on the phone with speech therapists discussing treatment plans and coordinating the best sequence of care.

Second, we attend extensive continuing education with speech therapists. For example, we join the Staten Island Airway and Speech Roundtable every three months for a night of Continuing Education. At each meeting, there is a keynote speaker that discusses a topic related to orthodontics, speech and sleep. Then, we discuss mutual challenging cases from all different angles and perspectives – in the room, we have speech therapists, myofunctional therapists, occupational therapists, pediatric dentists, pediatricians, ENTs, sleep-focused dentists, chiropractors, physical therapists, lactation consultants, and airway-focused orthodontists like ourselves. We are bouncing ideas off each other to develop the ideal game plan, incorporating the expertise of all the professionals in the room.