Speech and discomfort during lingual orthodontic treatment.

The increased use of lingual appliances has meant a continued evolution in the design of lingual brackets. These changes in appliance and bracket design have tended to focus on reducing bracket thickness, with the aim of making appliances more comfortable. A thinner bracket design appears to have had some positive effects on the quality of speech, as well as comfort whilst appliances are in place. However, despite these improvements, some patients do struggle with their speech during treatment, far more than others. It is important therefore, when consenting patients for lingual orthodontic treatment, to ensure that they are made aware of the potential for speech to be disturbed, particularly in the early stages of treatment. The purpose of this article is to outline some of the issues associated with speech problems and discomfort during lingual appliance treatment, so that practitioners are able to advise patients who may be considering this kind of treatment. Advice given during the consent process, including appliance selection, procedures for maintaining oral comfort and management of individual speech issues, will all help lingual patients cope with any speech problems they may experience during their treatment.