The choice between a physiotherapist and a speech and language therapist depends on the reason for assessment and the practitioner's training in orofacial rehabilitation. Their professional title alone does not tell you who can address your difficulty. The most useful approach is to describe your request, check the expertise offered and coordinate this work with any necessary dental or medical care.
Start with the problem to assess
Work on swallowing, a speech articulation difficulty, jaw discomfort and a sleep-related assessment do not automatically follow the same pathway. Before booking, explain what has been observed and by whom.
If a dentist or orthodontist recommended retraining, ask them to specify the function concerned. If you have difficulty breathing through your nose, a doctor or ENT specialist should assess the obstacle. Associations between mouth breathing and dentofacial development do not mean that an exercise resolves an obstruction. Zhao et al., 2021
What to check with the practitioner
Practices vary between professionals. Ask concrete questions about assessment and the situations they usually manage.
- Do you see patients of my age for this specific reason?
- Do you have training and regular experience in orofacial rehabilitation?
- How do you assess tongue posture and swallowing?
- Do you work with the dentist, orthodontist or doctor referring me?
- How are home exercises explained and checked?
This discussion helps establish whether the professional can see you or refer you elsewhere. It is more informative than a promise that one technique suits everyone.
What does understandable follow-up look like?
After the assessment, you should be able to describe the goal in your own words. For example: working on a specific movement or finding a defined reference point in certain situations. Instructions specify the practice, any equipment and the reassessment date.
Published findings do not justify broad promises of straight teeth, facial transformation or improved speech. The small Van Dyck trial improved some tongue parameters in children with open bite, without improving articulation. Van Dyck et al., 2016
Reviews of therapy alongside orthodontics highlight the low level of evidence. The professional should therefore distinguish the functional goal from the expected orthodontic result. Homem et al., 2014
Is an appliance always necessary?
The assessment may lead to exercises with or without an accessory. An appliance does not replace selecting the indication and checking the movement. If you have already bought a device, bring it and its instructions, and ask whether it fits your programme.
A retraining appliance, a bruxism guard and a retainer serve different purposes. Our guide to tongue positioning appliances helps you prepare this question.
Referral, cost and organisation: practical points
Before the first session, ask the practice about required documents, referral requirements for your situation, fees and coverage conditions. These depend on the service and your care pathway; a general article cannot promise individual reimbursement.
Also clarify availability for follow-up. A single assessment without an opportunity to review a misunderstood exercise may be insufficient for the intended approach. Use our preparation and tracking sheet to keep your instructions and questions.
Sources and method
- Homem et al., 2014. Systematic review of myofunctional therapy in orthodontics.
- Van Dyck et al., 2016. Pilot trial in 22 children with anterior open bite.
- Zhao et al., 2021. Mouth breathing and dentofacial development: a review of observational studies.
Written by: Dr Vladimir Khourda, a dentist who no longer practises. Informational content updated on 1 October 2026 using the references cited. It does not replace an individual assessment.