Tag: Orthodontia

Eliminating Lateral Escape of Air

By Pam Marshalla

Q: My 12-year-old client is bright but has a lateral lisp. He has a gap between his side teeth. How can I tell if the dental gap is causing the lateral lisp, and how should I precede? I stuck cotton between the side teeth but it didn’t help. The dental problem may have contributed to the lisp, OR the lisp may have contributed to the dental problem. This is a chicken-and-egg situation that usually has no clear answer. But it doesn’t…

Large Tongue

By Pam Marshalla

Q: I evaluated a 4;6 male with a 4mm open bite. He used a sippy-cup and pacifier. I advised to eliminate the sippy cup and pacifier, but what was noticeable on oral exam was that he had a really long tongue. Is it possible the tongue is just too large for his oral space? Is there a quantitative way to measure this? I find this to be one of those impossible-to-answer questions.  We have no way of knowing clinically if…

Clip a Frenulum Twice?

By Pam Marshalla

Q: Can a clipped frenulum grow back? I have a student with a hearted-shaped tongue and a restricted frenulum but his mom said it was clipped at 9 months of age. As far as I know, it won’t grow back — however a lot of scar tissue can develop, and some people might need to have the procedure done twice.

Lisp Remediation With Anterior Open Bite

By Pam Marshalla

Q: I have a student with a frontal lisp and an anterior open bite. Can you suggest compensatory strategies to help him? If he is going to get his teeth fixed I might wait to do anything until after he teeth are fixed. If he is not going to get his teeth fixed, then the compensation simply involves getting him to produce the best sibilants he can given his dental structure. He needs to stabilize the tongue at the back-lateral…

Frontal Lisp, Small Mandible, Upper Respiratory Problems

By Pam Marshalla

Q: My client is 4;0 with a frontal lisp with a very small mandible (underbite) and chronic upper respiratory problems––congestion, nasal drip, mouth breathing, snoring, etc. He cannot breath through his nose. Do you think he is capable of learning to keep his tongue in for the sibilants given his underbite? Yours is a very common question for which we have no clear answers. In all likelihood both the under-bite and the upper respiratory problems are contributing to his speech…

Sibilants and Tongue Cribs

By Pam Marshalla

Q: Can I expect correct articulation on S, Z, Sh, ZH, CH, J, T, D, N, and L when my client has a tongue crib that fills the entire alveolar ridge? The orthodontist is recommending SL therapy for the phonemes and to fix the swallow. In my experience clients usually cannot produce any of their lingua-alveolar and/or sibilant sounds correctly as long as an appliance like that is in the mouth.  The appliance distorts sound, especially stridency. I usually do…

“Gummy Smile”

By Shanti McGinley

Q: I have a new referral from a dentist for a client with a “gummy smile.” Haven’t seen him yet. What do you think this means? I would assume that the term “gummy smile” means that the upper lip is retracted and the upper gums are exposed.  Assuming that this is the case, the client needs to learn normal oral rest posture.  Normal oral rest consists of the lips resting gently together, the teeth resting a few millimeters apart, and…

Lateral Lisp, Missing Teeth, and Malocclusion

By Shanti McGinley

Q: My client has no incisors and an underbite, and she distorts both S and Z. These errors sound like a lateral lisp, however when I use your straw testing method, there is no airflow coming out the sides, only the front. My colleague tells me that this is a lateral lisp. But how can it be if the air doesn’t come out the sides? Your colleague is wrong: If the airstream is not coming out the sides (as tested…

Oral Habits and Dentition

By Shanti McGinley

Q: Why does an oral habit like thumb sucking effect the oral structures in some children but not others? I have seen kids who suck their thumbs who have no dental problems, and I have seen kids who suck their thumbs who have terrible open bites. As I understand things, any oral habit can affect oral structures depending upon the following three factors–– Frequency –– How often the client engages in the habit. Once per day? Ten times per day?…

The Jay Leno Effect

By Shanti McGinley

Jay Leno's profile

Q: Does your explanation of techniques to address jaw and tongue stability pertain to clients with the Jay Leno phenomenon? Does the E technique help those kids with lisps related to this facial structure? Techniques to address oral movement are for oral movement problems. As you have noted, Jay Leno has an oral structural problem, too. Structure and function are addressed differently together. I have never worked with Leno, so my analysis of his situation is cursory and speculative, of…