My Tongue Tie Story Part II - Thhpeech Therapy

Hello again!

So, in my last post I covered my experience with orthodontia.  Now I will relate my story of speech therapy which was, admittedly, relatively brief.

Though I had figured out in high school I was tongue tied and more than suspected I had a problematic swallow pattern, I wasn't yet savvy enough to realize I could do something about these things.  So for years I did nothing.

Over time however, I began to be bothered by my speech.  Like many tongue tied persons I had trouble with enunciation.  Now, the interesting thing about this is that many people with tongue tie speak fine but when you ask them about their speech they will often describe it as being effortful.  I spoke fine, no one had trouble understanding me, but I noticed that certain sounds were tricky for me, namely Rs and Ss.  

R is one of the trickiest sounds in the English language.  To make it, the tongue must be pulled back somewhat and rise in the middle so that it is touching the insides and bottom of the top teeth on either side of the mouth.  The tip of the tongue comes down from the roof of the mouth but doesn't touch anything.  Your lips slightly purse.  Rrrrr-ed.  As a tongue tied person, I couldn't raise my tongue properly to do this and so I compensated by bringing my lower lip up to my two front teeth, using my lip and teeth to create the R sound.  

How I used to say Rs. Attractive, huh? Notice all the tension in my lips and face.  In posts to come, I will talk extensively about how my tongue tie affected my appearance.

Proper R sound being made. The purse of the lips will vary depending on where in the word the R sound is. Notice how relaxed my lips and face look compared to the top photo.

Because of my open bite, my Ss were distorted which is sort of like having a slight lisp.  That is because air could escape between my front teeth.  The correct S is made with the teeth almost closed in a natural bite position and the lips parted as if you were smiling.  Like the R, the sides of the tongue are raised against the upper side teeth but the tongue should form a groove down the center, through which you direct your breath. The tip of the tongue is raised behind the upper front teeth without touching them.  You actually use your teeth to control the release of air but because I have an open bite I could not do that so air 'escaped' between my teeth and on either side of my tongue, which gave me a distorted S that sometimes sounded more like a Shh than an Sss.

In addition to these difficulties, I also dentalized my consonants.  When saying L, N, D, and T, instead of pressing the tip of my tongue to that hard ridge just behind my upper front gums, the alveolar ridge, I pressed it to my front teeth.  This is part of the tongue thrust pattern that exacerbated my open bite and prevented it from closing.

Many tongue tied people compensate in their speech and that's not a terrible thing but that compensation can make speech difficult because you're not talking in a normal, relaxed fashion.  I could not speak as quickly as everyone else without sacrificing enunciation.  I often tripped over my words and heard myself distorting sounds and even dropping letters to try and speak more quickly.  I would also 'over' enunciate by opening my mouth wider, pursing my lips more, or thrusting my jaw forward. 

When I entered graduate school in my mid-20s I started really noticing how much better other people spoke.  At least, that was my experience.  Admittedly, no one ever thought I had bad speech but my speech didn't feel right to me.  I decided to try speech therapy.  I went to see a private therapist in order to get a referral so I could get therapy at my school which had a speech therapy training program.

At this point, I had researched tongue tie and knew it was connected with a tongue thrust and I knew about the lingual frenectomy procedure.  I had wondered if that was an option for me.  I still had hopes that I could one day get my open bite fixed but I knew that if orthodontics were to work I needed to correct my tongue thrust which meant I needed a lingual frenectomy.  I hoped that the speech therapist would concur.  She didn't.

The speech therapist looked at my tongue, listened to my speech, and felt my throat as I swallowed.  I told her my story of having braces.  When I asked about a lingual frenectomy she discouraged me from getting it, saying my speech and swallowing weren't bad enough to warrant it.  When I told her about wanting to get orthodontics again to fix my open bite she actually discouraged me from getting my teeth fixed.  

"Really? Cuz I kinda think I should get this taken care of..."

That's right.  She told me that a number of people who get their open bites fixed develop lisps when the teeth come together.

Now, here's the thing folks: if I got my tongue tie fixed, I could have therapy to rehabilitate my tongue so it would sit and move properly when I spoke thereby allowing me to get my teeth fixed without developing a lisp.  But this speech therapist, in my opinion, didn't fully understand a tongue tie because if she did she would have realized that I couldn't get my open bite fixed anyway because the problem wasn't my teeth but my tongue.

At the time though, I believed what she said and left her office very disappointed because it looked like I was always going to have an open bite.  I did get a referral for speech which I commenced shortly after.

I worked with a student who conducted therapy under supervision (the supervisor wasn't with us during sessions, she met with them elsewhere).  I told her my story and we decided to focus on my Ss.  I saw her for several months during which my S never improved and I became less and less committed to the therapy.  Admittedly, I was never fully invested in the therapy because it was clear my S was only going to improve marginally.  As long as I had an open bite I could not control the air escaping between my teeth.

Many speech pathologists, in my experience and from online research, have a very conservative approach to tongue ties.  Some of them argue against using lingual frenectomy to correct tongue tie and endorse the view that speech therapy to encourage speech compensation is all that is needed.  In some cases this may be true.

I do believe that any kind of surgery should be approached cautiously.  Risks and complications should be weighed to make sure it's the right decision.  But in my case, I suffered much longer than I had to because the professionals I went to did not fully appreciate how my tongue tie affected me.  In fact, I hope my story shows that a tongue tie is more than just an inability to say a clear S or lick an ice cream cone.  I also want people to know that treating a tongue tie with surgery AND orofacial therapy can lead to gains they wouldn't even have imagined.

Some will tell you that a lingual frenectomy will only gain you a few millimeters. I gained 22 mms after two weeks of orofacial therapy! Therapy is key!

In my next post, I talk about the student dentist I saw whose keen observation led to my decision to finally have a lingual frenectomy, my experience having the procedure, and starting work with my orofacial myologist.


Happy trails!