A guide for patients and families
How to communicate after tongue or mouth surgery
After tongue or mouth surgery, a person hears, thinks and feels just as before. What changes is how words are pronounced, and sometimes it is hard to be understood. This guide explains why this happens and the ways to communicate while recovery moves forward. Every decision is made with the healthcare team and the speech-language pathologist (also called a speech therapist).
Why speech changes
The tongue makes many small movements that change the shape of the mouth. Those movements produce almost all the sounds of speech.
After surgery, the tongue may move less. That is why some words sound less clear. How much speech changes depends on how much tissue is removed and how the area is rebuilt. Which part of the tongue is operated on also matters.
When a large part is removed, the surgeon may rebuild the area with tissue from another part of the body, called a flap. Studies describe speech as most affected at first, then improving over time. How much it improves is different for each person.
The speech-language pathologist assesses speech and teaches exercises to make it clearer. This therapy can last several months after treatment.
The first days and weeks
After the operation, the area is usually swollen. At first, speech may sound slurred. In many cases it gets better as the swelling goes down.
Sometimes, after surgery, a breathing tube is placed in the neck for a while (tracheostomy). It may stay in for a few days or weeks. While it is in, there may be no voice or only a whisper. The healthcare team decides when to remove it.
How to communicate in the meantime
It helps to have the options ready before surgery. The speech-language pathologist can help prepare them.
- WritingA notepad and pen, or a whiteboard that can be wiped clean.
- A phone or tabletText-to-speech apps say out loud what the person types or picks.
- Yes or noQuestions that can be answered with a gesture help a lot when the person is tired.
Tips for family
- A quiet placeTurn off the TV or radio and avoid talking over background noise.
- Face to faceLook at each other. Seeing the face and gestures helps you understand.
- Ask them to repeat or write itIt's better to ask again than to guess.
- Don't pretend to understandIf you didn't understand, say so calmly and ask for another way to say it.
- Give timeWait until they finish. Talking can be tiring, especially at first.
If surgery is scheduled: save your own voice
Before the operation, you can record your voice while you still speak as usual. Later, your phone can say your phrases in a voice that sounds like yours.
Tocavox offers two ways. A quick copy takes about 2 minutes. There is also a longer guided recording, kept on your own phone. It's a free option that the person or their family can set up on their own. It's a good idea to mention it to the healthcare team early. tocavox.com/en/tu-voz explains how.
Where Tocavox helps
Tocavox does not replace speech therapy. It is one more support while therapy moves forward. It helps in noisy places and in face-to-face conversations. Its talking calculator helps say numbers and amounts clearly. You tap a phrase and your phone says it out loud, in a natural voice. It is a social project, free and ad-free.
Frequently asked questions
Can you talk after a glossectomy?
Many people can, although speech may sound different, especially at first. How much it changes depends on how much tissue is removed and how the area is rebuilt. The healthcare team can explain what to expect in each case.
Why is it hard to understand someone after tongue surgery?
The tongue shapes almost all the sounds of speech. If it moves less, some words sound less clear. Swelling in the first days also plays a part.
How long does it take for speech to improve after tongue surgery?
It is different for each person. Studies describe speech as most affected at first, then improving over time. Speech therapy can last several months.
Can you talk with a tracheostomy?
While the tube is in, there may be no voice or only a whisper. During that time, writing, yes-or-no questions and text-to-speech apps help. The healthcare team decides when to remove it.
How can I help a family member who is hard to understand?
Find a quiet place and talk face to face. Ask them to repeat or write it down, and don't pretend to understand. Give them time, and use yes-or-no questions when they are tired.
Other guides
Sources
- Queen Victoria Hospital NHS · Surgery to remove part of the tongue (glossectomy)
- Cancer Research UK · Changes in your speech with mouth and oropharyngeal cancer
- ASHA · Head and Neck Cancer (Practice Portal)
- Oral Oncology (2013) · Speech and swallowing following tongue cancer surgery and free flap reconstruction: a systematic review
- Institut national du cancer · Cancers de la sphère ORL : la chirurgie
- BC Cancer · Communication Difficulties
- MD Anderson Cancer Center · 5 ways to help a cancer patient with speaking challenges
This guide is for information only and does not replace care from your doctor or speech-language pathologist. · Updated October 11, 2026