Can missing front teeth cause a lisp?

Q. My son has lost his two front teeth and I’ve noticed a slight lisp when he tries to say /s/ and /z/ sounds. His speech can be quite difficult to understand at times, especially when he speaks in sentences. He told me he thinks his speech sounds “funny” and does not want to speak in front of his class. Is this something that will correct itself once the new teeth come in? What are some ways I can help him in the meanwhile?

A. Is there anything cuter than a little one without his two front teeth, especially during Christmas? Ha! You are right, those missing front teeth and your son’s difficulty producing /s/ and /z/ sounds go hand-in-hand.

Without the front teeth, a child may develop what is known as an interdental lisp. This occurs when the tongue protrudes between the front teeth, making his attempts to say /s/ and /z/ sounds come out like “th.” For example, “soup” may sound like “thoop” or “buzz” may come out as “buth.” While the front teeth serve as an important marker for making words containing /s/ and /z/ sound normal, it is not impossible to make these letter sounds correctly without those teeth.

Even with your son’s current struggle, it will be best to wait until his permanent teeth come in before starting any kind of intervention for an interdental lisp. This is because trying to help him now would require teaching him compensatory tongue and mouth movements to produce the /s/ and /z/ sounds which may result in creating a lateral lisp—it would be counterproductive.

While you are waiting for his pearly whites to arrive, there are some strategies that you can use at home with your son to boost his speech confidence.

Be a good speech model.
Make sure you are producing his trouble sounds, /s/ and /z/, correctly and clearly when talking with him. You can also over emphasize the sounds to ensure he is hearing the correct production.

Help him with auditory awareness.
Engage him in a game where he must listen to the words that you say. Ask him to give you a thumbs up when he hears you correctly produce /s/ or /z/ or a thumbs down when he hears you say sounds incorrectly as a “th.” This will help him gain awareness of the correct and incorrect productions of the sounds.

Use recasting.
Recasting is a simple technique that has shown to be effective in encouraging correct sound production. When your son incorrectly produces /s/ and /z/, repeat the words back to him using the correct production. For example, when he says “I thaw that thame dog yetherday!,” you would respond with, “Wow, you SAW the SAME dog yeSterday?” Simply repeat the words back to him correctly without demanding that he imitate you.

Talk with the teacher.
Make sure your son’s teacher is aware of his hesitation to speak in front of the class. Work with her to find ways to help him build confidence so he does not shy away from speaking tasks. You could suggest that your son highlight or underline /s/ and /z/ words in text ahead of time so that he will be ready for them when reading aloud.

I know it’s hard to watch your son struggle with confidence and being understood by others, but do give him sometime to grow his new teeth before you worry too much. Once a child’s teeth come in, his or her interdental lisp will typically correct itself. However, if you continue to hear a lisp after his teeth are in place, then you should speak with your pediatrician about a referral to a speech-language pathologist for further assessment. In the meanwhile, continue to encourage him and implement the strategies I suggested. You will set him up for success at school and at home.

Allison Crumpler is a speech-language pathologist and the director of clinical compliance for Raleigh Therapy Services, Inc., a multidisciplinary pediatric therapy practice in North Raleigh. (919-791-3582)

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