Answer: The difference between bite blocks and bite tubes is that bite blocks target isometric jaw stability at set jaw positions (often 2–7), while bite tubes target dynamic jaw grading (smooth open/close control) used for chewing/mastication and speech co-articulation. Many clinicians assess with both and choose based on signs like open-mouth posture, limited grading, sliding, or jutting.
| Tool | Primary goal | What the client does | Common “why now?” signs |
|---|---|---|---|
| Bite blocks | Build stable jaw positions (isometric) | Holds at specific jaw heights/positions | Jaw sliding/jutting, reduced control at certain heights |
| Bite tubes | Build graded jaw movement (dynamic control) | Repeated controlled compressions/“chews” | Limited jaw grading for chewing or speech clarity |
The question
What is the difference between bite blocks and bite tubes? How do you know the difference of when to use them in therapy?
Therapist answer
The difference between the bite blocks and the bite tube is:
- Bite blocks are for isometric resistance at each of the 2–7 jaw positions. In order to have the ability to grade and control the jaw in a fluid movement, we develop the stability in each position.
- Bite tube is for jaw grading for chewing/mastication and for jaw grading in speech (co-articulation).
Bite Tube color hierarchy (how to progress)
Starting with the red, then yellow, purple and green. As long as the client has gotten at least 2 compressions on the color you can add in the next color.
For example, if a client is able to do 4 chews on the left and right with red chew then I can add in yellow. I could possibly have a client do red, yellow, purple and green as a set depending upon where their level of fatigue was evaluated.
How to decide which to use
You will always assess with bite blocks and bite tube depending upon if you see jaw instability (open mouth posture, limited jaw grading, jaw sliding or jutting just to name a few). Based on your assessment will determine what you do in therapy.
Hope this provides some clarity!
– Monica Purdy, MA, CCC-SLP, COM®
In-Depth Breakdown
Bite Blocks: train stable jaw positions (isometric holds)
Bite blocks are used to assess and train jaw control by creating isometric resistance at discrete jaw positions. It is often described in a 2-7 position hierarchy in Oral Placement Therapy (OPT). The goal is to develop stable, repeatable jaw placement (and reduce compensations like sliding or jutting) so the client can better coordinate speech and feeding tasks.
When bite blocks tend to be the priority
- Open-mouth posture with difficulty sustaining a closed/controlled jaw
- Jaw “wiggle,” sliding, or jutting during speech or feeding
- Inconsistent jaw height when trying to place the tongue/lips accurately
Bite Tubes: train jaw grading for chewing and speech co-articulation
Bite tubes are typically used in a progression to support jaw stability, symmetry, and grading through controlled compressions—skills that can carry over to safer chewing and speech clarity (including smoother transitions between sounds, i.e., co-articulation).
When bite tubes tend to be the priority
- The client can “hold” a jaw position but struggles to move smoothly between jaw heights
- Chewing looks choppy, one-sided, or poorly graded (too big/too small jaw movements)
- Speech becomes less clear in connected speech due to unstable/inefficient movement patterns
How to decide which to use (assessment → target → tool)
If you’re asking, “What’s the difference between bite blocks and bite tubes and how do I choose?” a practical approach is:
| Step | Assessment focus | If you see… | Use | What you’re targeting |
|---|---|---|---|---|
| 1 | Assess stability (static control) | If the jaw can’t hold steady at set heights | Bite blocks | Isometric jaw stability at specific jaw positions |
| 2 | Assess grading (dynamic control) | If the jaw can hold but can’t smoothly open/close for chewing or speech | Bite tubes | Graded open/close movement for chewing and co-articulation |
| 3 | Sequence based on what you see | Many clinicians use both; start with the most limiting finding (e.g., sliding/jutting vs. limited grading) | Both (sequence) | Prioritize the biggest barrier first, then layer in the other tool |
Bite tube color hierarchy (quick guide)
TalkTools’ Bite Tube Hierarchy is typically: red → yellow → purple → green. Introduce the next color once the client can do at least two strong, controlled compressions on the current color, while monitoring fatigue and mechanics.
Safety and expectations (especially for home programs)
TalkTools frames bite tubes as exercise tools used as directed in a plan, not for all-day chewing. Ensure caregiver instructions emphasize form, short sets, and supervision.
Quick takeaways
- Use bite blocks to train stable jaw positions with isometric holds (positions 2–7).
- Use bite tubes to train graded open/close movement for chewing and speech co-articulation (red → yellow → purple → green).
- Let the assessment findings guide tool choice and sequencing (e.g., open-mouth posture, sliding/jutting, limited grading).
FAQ
Do I assess with both bite blocks and bite tubes?
Often, yes—clinicians commonly assess with both and choose the sequence based on what they observe (jaw instability, limited grading, sliding, or jutting).
Which bite tube color should I start with?
TalkTools’ hierarchy typically progresses red → yellow → purple → green. Start where the client can do controlled compressions, then progress when they can achieve at least two strong compressions on that color.p>
Are bite tubes meant to be used all day like a chewy?
Bite tubes are typically framed as exercise tools, used as directed in a therapy plan rather than for all-day chewing.