Ask A Therapist: Jaw Stability with Underbite


I recently attended a TalkTools “Three Part Treatment Plan for Oral Placement Therapy” workshop. I have a patient that I want to complete the jaw stability assessment. However, she has an underbite. The underbite has caused her upper cuspids to be ground down below the level of her central incisors. If I place the bite block for jaw stability it is either too far forward or the central incisors will hold it in place regardless of jaw stability. Does this mean I can’t complete the exercises to improve jaw stability? Or should I skip this placement and still work on bite block and twin bite block placements? Or do you have an alternative suggestion? 

Thank you!


Hello Katherine!

Thank you for your question- it is a good one!

Since alignment is assessed at the back molars you will need to make sure the upper molar and the lower molar are on top of each other when you are doing the exercises. Do not worry about the structural underbite as that is bone not muscle. So with this in mind I believe you may be able to do all 3 exercises with your client.

Let me know if you have any further questions!

Thank you!


Line Kristiansen Avers is a Speech-Language Pathologist who has over 12 years of experience specializing in topics within Apraxia, Alternative and Augmentative Communication (AAC), and Oral Placement Therapy. Line teaches classes in Apraxia and AAC at the University of Oslo, lectures at numerous seminars within Norway, and is a member of the TalkTools® speakers bureau. Line heads a private oral-motor, speech and language clinic in Norway, BARNAS Språksenter. She has an M.S. from Penn State University and was a Fulbright Scholar.

Talktool admin 01 Feb 18

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