GOOD MORNING
PHONETICS IN COMPLETE
DENTURES
Dr Zarir Ruttonji
CONTENTS
1. Introduction
2. Definition
3. History
4. Mechanism of sound production
5. Types/Classification of speech sound...
INTRODUCTION
DEFINITION
• Speech:- The faculty or act of expressing or
describing thoughts, feelings, or perceptions
by the articulatio...
HISTORY
• In 1949 ‘Sears’ recommended grooving the palate
just above the median sulcus of the patient.
• In 1951 ‘Pound’ w...
• 1953 & 1956, ‘Silverman’ used ‘speaking method’ to
measure patient’s vertical dimension in natural teeth
with dentures &...
1. The motor( lungs, associated muscle
that supply the air).
MECHANISM OF SPEECH PRODUCTION
Normal speech depends on prope...
COMPONENTS
OF SPEECH
RESPIRATION
PHONATION
RESONATIONS
ARTICULATIONS
NEUROLOGIC
INTEGRATIONS
AUDITION
COMPONENTS OF SPEECH...
RESPIRATION
• The movement of air in
the inspiratory and
expiratory phase is
important in production
of speech.
Ref:- Chie...
PHONATION
• Air from the lungs
courses through the
trachea.
• Sound is produced in
the larynx
• Vibration of vocal cord
ta...
RESONANCE
Sound that is produced by
the vocal cord is
modified by various
chamber.
• Resonators are
– pharynx
– oral cavit...
SPEECH ARTICULATION
• Sound that is produced
is formed into
meaningful words
• Tongue,lips,palate,
teeth and mandible
play...
NEUROLOGIC INTEGRATION
Factors for speech
production are highly
coordinated, some
sequentially and some
simultaneously by ...
TYPES OF SPEECH
• 1.VOWELS: a,e,i,o,u. they are voiced sounds,
• 2.CONSONANTS: may be either voiced or produced
without vo...
CLASSIFICATION OF SPEECH
• According to Boucher
• Vowels.
• Consonants.
– Plosives/stops
– Fricatives
– Afficatives
– Nasa...
STRUDS:-
1. Voiceless sounds
2. Produced by the separation of
vocal cords
Eg:- s,h,sh,zh
ACCORDING TO SONORITY
SONANTS
1. ...
CLASSIFICATION OF
CONSONANTS:
Divided into groups depending on their
characteristic production and use of different
articu...
• Fricatives: are also called sibilants and are
characterized by their sharp and whistling sound
quality created when air ...
• Nasal consonants :are produced without oral exit of
air. Production involves the coupling of nasal cavity as
resonators....
• Liquid consonants(semi vowels) : are , as the name
implies , produced with out friction.
Ex: R (rose), L(lily)
• Glides:...
CLASSIFICATION OF CONSONANTS BASED
ON THE PLACE OF THEIR PRODUCTION
• Consonant sounds are most important from the dental
...
PALATOLINGUAL SOUNDS FORMED BY TONGUE AND
HARD PALATE
Word like S, T D N and L belong
to this catogory
S- the sound ‘s’ as...
CLINICAL SIGNIFICANCE
1. Thus we can say that the sound S
can be used to check the
proper placement of the
anterior teeth
...
CLINICAL SIGNIFICANCE
3. Silverman also used
this word to establish
and check a proper
vertical dimension of
occlusion
Ref...
T, D, N and L word
Rugae area is very important
for the production of these
sounds
Tongue must be placed firmly
against th...
• Therefore…. Should rugae be duplicated in the
denture or no is the question that arises….
Slaughter say.. The smoothness...
CLINICAL SIGNIFICANCE
• If teeth too lingual – T will sound like D
• If teeth too forward - D will sound like T
PALATOLINGUAL SOUNDS FORMED BY
TONGUE AND SOFT PALATE
Consonant k, ng and g are
representative of the palatolingual
group ...
CLINICAL SIGNIFICANCE
• If the posterior borders are over extended or if there is
no tissue contact k becomes ch sound.
Re...
LINGUODENTAL SOUNDS
Consonant Th is representative of the
linguodental group of sounds
Dental sounds are made with the tip...
LINGUODENTAL SOUNDS
• Sound is actually made closer to the alveolus
(the ridge) than to the tip of the teeth.
• Careful ob...
CLINICAL SIGNIFICANCE
• If about 3mm of the tip of the tongue is not visible, the
anterior teeth are probably too far forw...
LINGUOALVEOLAR SOUNDS
Formed with the valve
formed by contact of the tip
of the tongue with the most
anterior part of the ...
LINGUOALVEOLAR SOUNDS
• Sibilants (sharp sounds) s, z, sh, ch & j
(with ch & j being affricatives) are alveolar
sounds, be...
CLINICAL SIGNIFICANCE
Upper and lower incisors should approach end to
end but not touch.
Failure indicates a possible erro...
LABIODENTAL SOUNDS
• F and V are
representatives of the
labiodental group of
sounds.
• Formed by raising the
lower lip int...
CLINICAL SIGNIFICANCE
Upper anterior teeth are too
short (set too high up), V
sound will be more like an F.
• If they are ...
BILABIAL SOUNDS
• B,p and m are
representatives of the
bilabial group of
sounds.
• Formed by the stream
of air coming from...
CLINICAL SIGNIFICANCE
1. Used to asses the correct
interarch space
2. Correct labiolingual
positioning of the anterior
tee...
VOWELS
PHONETICS IN RECORDING JAW
RELATION
• Also called as the speaking
method
• Sibiliant sounds like S and M is
used.
• S soun...
S-SOUND AND THEIR PROSTHODONTIC
COSIDERATIONS
• Say now shibboleth; and he said
sibboleth, for he could not frame to
prono...
CLINICAL SIGNIFICANCE
1. Thickness of denture
2. Antero-posterior position of teeth
3. Vertical dimension of occlusion
4. ...
DIFFERENT PARTS OF ORAL CAVITYAND
THEIR INFLUENCE ON SPEECH
TONGUE: LIPS
PALATE TEETH
PROSTHODONTIC IMPLICATION IN
DENTURE DESIGN AFFECTING
SPEECH
1. Denture thickness and peripheral outline
2. Vertical dimen...
DENTURE THICKNESS AND
PERIPHERAL OUTLINE
• If the denture bases are
too thick.
• Lisping will occur with
the word like S C...
VERTICAL DIMENSION
• Bilabials are mostly
affected P B and M
• If both rims touch
prematurely it
indicated excessive
verti...
OCCLUSAL PLANE
• Labioldental sounds F and
V are affected.
• If occlusal plane is too
high the correct positing of
the low...
ANTERIORPOSTERIOR
POSITIONING OF TEETH
• F and V sounds are
hampered.
• labiopalatal positions of
the teeth is very
import...
POST DAM AREA
• Palatolingual consonants are affected (K,
NG and G)
• Thick post dam areas will irritates the
dorsum of th...
WITDH OF DENTAL ARCH
• If teeth are set into an
arch that is too narrow
the tongue will be
cramped
• Consonants like T, D,...
RELATIONSHIP OF THE UPPER
AND LOWER INCISORS
• The chief concern is the
S CH, J and Z sound.
• These sounds need a
near co...
SPEECH TEST
• The speech test should be made after satisfactory
esthetics, correct centric relation, proper vertical
dimen...
TEST 1:TEST OF RANDOM SPEECH
• Engage the patient in a conversation and obtaining a
subjective speech analysis by asking t...
TEST 2: TEST OF SPECIFIC SPEECH SOUNDS
• This is best accomlpished by having the patient say 6-8
words containing the soun...
S,Sh Six, sixty, ships, sailed
Mississippi, sure ,sign, sun,
shine
Sixty six ships sailed
Mississippi. Sure sign of sun
sh...
TEST 3: TEST OF READING A PARAGRAPH
Make the patient read a paragraph containing abundance
of S, Sh, Ch sounds.
John. Shar...
SPEECH ANALYSIS
• 2 categories
• 1) Perceptual / acoustic
• Based on broad band spectrogram, recording by
Sonograph
• Obje...
2) Kinematic movement analysis :
– Ultrasonics
– X-ray mapping
– Cineradiography
– Optoelectronic articulatory movement tr...
PALATOGRAPHY
• What is palatography?
• a group of techniques to record contact between the
tongue and the roof the mouth t...
PREREQUISITE FOR MAKING
PALATOGRAM
1. The artificial palate made must be uniformly adapted,
no adhesive must be used.
2. P...
5. The palate has to be thoroughly dried before the
medium is applied and the medium must have a
contrasting colour so tha...
PALATOGRAM OF
VOWELS.
PALATOGRAM OF
CONSONANTS.
TERMINLOGIES RELATED TO
SOME SPEECH DISTURBANCES
1. APHASIA (DYSPHASIA): Means defective speech due
to damage of cortical ...
DISORDERS OF SPEECH
Hypernasality Hyponasality
Denasality
NASAL BALANCE
Eg: m, n & ng
  
b d g
Morning  bordig
ARTICULATOR DEFETCS
Distortion
Eg: Vowel  pop for pipe
Consonants  cah for car
Substitution
Eg: teef for teeth
Omission
...
RELATION TO MAXILLOFACIAL DEFECTS
Acquired
Accidental or surgical
Nervous system – cerebral
palsy, lateral sclerosis,
poli...
CORRECTING SPEECH DEFECTS
RELATED TO IMPLANT PROSTHESIS
• A fully bone anchored prosthesis in maxilla can cause
phonetic p...
CONCLUSION
REFERENCES
1. John. Sharry. Complete denture Prosthodontics 3rd
edition; Phonetics.
2. Zarb- Bolender:Speech consideration...
THANK
YOU
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1.phonetics in cd

  1. 1. GOOD MORNING
  2. 2. PHONETICS IN COMPLETE DENTURES Dr Zarir Ruttonji
  3. 3. CONTENTS 1. Introduction 2. Definition 3. History 4. Mechanism of sound production 5. Types/Classification of speech sounds 6. S sounds and their prosthodontic considerations 7. Different parts of oral cavity and their influence on speech 8. Prosthodontic implication in denture design affecting speech 9. Speech tests 10. Speech analysis 11. Speech defects 12. Conclusion 13. List of references
  4. 4. INTRODUCTION
  5. 5. DEFINITION • Speech:- The faculty or act of expressing or describing thoughts, feelings, or perceptions by the articulation of words. • Phonetics:- The branch of linguistics that deals with the sounds of speech and their production, combination, description, and representation by written symbols. http://www.thefreedictionary.com
  6. 6. HISTORY • In 1949 ‘Sears’ recommended grooving the palate just above the median sulcus of the patient. • In 1951 ‘Pound’ was successful in improving phonetics by contouring the entire palatal aspect of the maxillary denture to simulate the normal palate • ‘Landa’ suggested the use of ‘s’ sound to determine the adequacy of ‘free way space’ & ‘M’ sound to establish a desirable ‘rest position’.
  7. 7. • 1953 & 1956, ‘Silverman’ used ‘speaking method’ to measure patient’s vertical dimension in natural teeth with dentures & without dentures. • ‘Morrison’ suggested the use of the word, ‘sixty six’ & ‘Mississippi’ to determine closest speaking space • 1967, ‘Kaire’ reported & determined the palatal pressure of the tongue in the pronunciation of selected palatolingual speech sounds, by electronic means under predetermined vertical dimensions of occlusion.
  8. 8. 1. The motor( lungs, associated muscle that supply the air). MECHANISM OF SPEECH PRODUCTION Normal speech depends on proper functioning of 5 essential mechanism 2. The vibrator ( vocal cord that give pitch to the tone). 3. The resonator ( consist of the oral,nasal, pharyngeal cavity and paranasal sinuses). 4. The enunciators or articulators( lip, tongue, palate and teeth) 5. The initiator( motor area of the brain)
  9. 9. COMPONENTS OF SPEECH RESPIRATION PHONATION RESONATIONS ARTICULATIONS NEUROLOGIC INTEGRATIONS AUDITION COMPONENTS OF SPEECH Ref:- Chierici, Lawson; Clinical speech consideration in prosthodontics. J Prosthet dent;1973;29;1:29-39
  10. 10. RESPIRATION • The movement of air in the inspiratory and expiratory phase is important in production of speech. Ref:- Chierici, Lawson; Clinical speech consideration in prosthodontics. J Prosthet dent;1973;29;1:29-39
  11. 11. PHONATION • Air from the lungs courses through the trachea. • Sound is produced in the larynx • Vibration of vocal cord takes place Ref:- Chierici, Lawson; Clinical speech consideration in prosthodontics. J Prosthet dent;1973;29;1:29-39
  12. 12. RESONANCE Sound that is produced by the vocal cord is modified by various chamber. • Resonators are – pharynx – oral cavity – nasal cavity – Paranasal sinuses Ref:- Chierici, Lawson; Clinical speech consideration in prosthodontics. J Prosthet dent;1973;29;1:29-39
  13. 13. SPEECH ARTICULATION • Sound that is produced is formed into meaningful words • Tongue,lips,palate, teeth and mandible play are very important role. Ref:- Chierici, Lawson; Clinical speech consideration in prosthodontics. J Prosthet dent;1973;29;1:29-39
  14. 14. NEUROLOGIC INTEGRATION Factors for speech production are highly coordinated, some sequentially and some simultaneously by the central nervous system. • Speech is a learned function and requires adequate hearing, vision, and normal nervous system for its full development. Ref:- Chierici, Lawson; Clinical speech consideration in prosthodontics. J Prosthet dent;1973;29;1:29-39
  15. 15. TYPES OF SPEECH • 1.VOWELS: a,e,i,o,u. they are voiced sounds, • 2.CONSONANTS: may be either voiced or produced without vocal cord vibration, in which case they are called breathed sounds. eg: p, b, m, s, t, r, z etc… • 3.COMBINATION: Is blend of a consonant and vowel, articulated in quick succession that they are identified as single phonemes. EX:- WORD Zarb- Bolender:Speech consideration with complete dentures ;Prosthodontic treatment For Edentulous Patients
  16. 16. CLASSIFICATION OF SPEECH • According to Boucher • Vowels. • Consonants. – Plosives/stops – Fricatives – Afficatives – Nasal – Liquid – Glides Zarb- Bolender:Speech consideration with complete dentures ;Prosthodontic treatment For Edentulous Patients
  17. 17. STRUDS:- 1. Voiceless sounds 2. Produced by the separation of vocal cords Eg:- s,h,sh,zh ACCORDING TO SONORITY SONANTS 1. Voiced sound 2. Produced by vibration of a portion of the vocal cords 3. Oral resonators modify the airstream 4. All vowels and vowel like sounds are representatives. CONSONANTS:- 1. Articulated speech 2. Airstream has to be modified at the proper place and time for producing these sound 3. Most important for dentist John. Sharry. Complete denture Prosthodontics 3rd edition; Phonetics pg 132
  18. 18. CLASSIFICATION OF CONSONANTS: Divided into groups depending on their characteristic production and use of different articulators and valves. They are as follows. • Plosive consonants: These sounds are produced when overpressure of the air has been built up by consonants between the soft palate and pharyngeal wall and released in an explosive way. Ex: P (pay), B (bay), T (to), D (dot) Zarb- Bolender:Speech consideration with complete dentures ;Prosthodontic treatment For Edentulous Patients
  19. 19. • Fricatives: are also called sibilants and are characterized by their sharp and whistling sound quality created when air is squeezed through the nearly obstructed articulators. Ex: S (so), Z (zoo) • Affricative consonants: are a mix between plosive and fricative ones. Ex: Ch (chin), J (jar) Zarb- Bolender:Speech consideration with complete dentures ;Prosthodontic treatment For Edentulous Patients
  20. 20. • Nasal consonants :are produced without oral exit of air. Production involves the coupling of nasal cavity as resonators. Ex: M (man), N (name), NG (bang) Zarb- Bolender:Speech consideration with complete dentures ;Prosthodontic treatment For Edentulous Patients
  21. 21. • Liquid consonants(semi vowels) : are , as the name implies , produced with out friction. Ex: R (rose), L(lily) • Glides: that is sounds characterized by a gradually changing articulator shape Ex: W (witch), Y (you) Zarb- Bolender:Speech consideration with complete dentures ;Prosthodontic treatment For Edentulous Patients
  22. 22. CLASSIFICATION OF CONSONANTS BASED ON THE PLACE OF THEIR PRODUCTION • Consonant sounds are most important from the dental point of view. They may be classified according to the anatomic parts involved in their formation: (1) Palatolingual sounds, formed by tongue and hard or soft palate, (2) Linguodental sounds, formed by the tongue and teeth, (3) Labiodental sounds, formed by the lips and teeth, and (4) Bilabial sounds, formed by the lips. Robert Rothman; Phonetic consideration in denture prosthesis, J Prosthet Dent;1961;11:214-223)
  23. 23. PALATOLINGUAL SOUNDS FORMED BY TONGUE AND HARD PALATE Word like S, T D N and L belong to this catogory S- the sound ‘s’ as in sixty six- is formed by a hiss of air as it escapes form the median groove of the tongue when the tongue is behind the upper incisor If groove is decreased s is softened towards sh (Lisping) If groove is deep a whistling will be heard when s is pronounced Robert Rothman; Phonetic consideration in denture prosthesis, J Prosthet Dent;1961;11:214-223)
  24. 24. CLINICAL SIGNIFICANCE 1. Thus we can say that the sound S can be used to check the proper placement of the anterior teeth 2. Also the thickness of the denture base can be adjusted in case the sound S is not produced correctly Robert Rothman; Phonetic consideration in denture prosthesis, J Prosthet Dent;1961;11:214-223)
  25. 25. CLINICAL SIGNIFICANCE 3. Silverman also used this word to establish and check a proper vertical dimension of occlusion Ref:- Robert Rothman; Phonetic consideration in denture prosthesis, J Prosthet Dent;1961;11:214-223)
  26. 26. T, D, N and L word Rugae area is very important for the production of these sounds Tongue must be placed firmly against the anterior part of the hard palate for the production of these words Robert Rothman; Phonetic consideration in denture prosthesis, J Prosthet Dent;1961;11:214-223)
  27. 27. • Therefore…. Should rugae be duplicated in the denture or no is the question that arises…. Slaughter say.. The smoothness of the denture is disturbing and the tongue looses its capacity for local orientation Landa says that rugae is useless or even detrimental because it adds more bulk to the denture… Ref:-Robert Rothman; Phonetic consideration in denture prosthesis, J Prosthet Dent;1961;11:214-223)
  28. 28. CLINICAL SIGNIFICANCE • If teeth too lingual – T will sound like D • If teeth too forward - D will sound like T
  29. 29. PALATOLINGUAL SOUNDS FORMED BY TONGUE AND SOFT PALATE Consonant k, ng and g are representative of the palatolingual group of sounds. Sound is formed by raising the back of the tongue to occlude with the soft palate and then suddenly depressing the middle portion of the back of the tongue realising the air in a puff
  30. 30. CLINICAL SIGNIFICANCE • If the posterior borders are over extended or if there is no tissue contact k becomes ch sound. Ref:- Robert Rothman; Phonetic consideration in denture prosthesis, J Prosthet Dent;1961;11:214-223)
  31. 31. LINGUODENTAL SOUNDS Consonant Th is representative of the linguodental group of sounds Dental sounds are made with the tip of the tongue extending slightly between the upper and lower anterior teeth.
  32. 32. LINGUODENTAL SOUNDS • Sound is actually made closer to the alveolus (the ridge) than to the tip of the teeth. • Careful observation of the amount of tongue that can be seen with the words - this, that, these and those will provide information as to the labio-lingual position of the anterior teeth. Robert Rothman; Phonetic consideration in denture prosthesis, J Prosthet Dent;1961;11:214-223)
  33. 33. CLINICAL SIGNIFICANCE • If about 3mm of the tip of the tongue is not visible, the anterior teeth are probably too far forward, • If more than 6mm of the tongue extends out between the teeth when such sounds are made, the teeth are probably too lingual . Robert Rothman; Phonetic consideration in denture prosthesis, J Prosthet Dent;1961;11:214-223)
  34. 34. LINGUOALVEOLAR SOUNDS Formed with the valve formed by contact of the tip of the tongue with the most anterior part of the palate (the alveolus) or the lingual sides of the anterior teeth. T, D, S, Z, V & 1 are representative of the linguoalveolar group of sounds Robert Rothman; Phonetic consideration in denture prosthesis, J Prosthet Dent;1961;11:214-223)
  35. 35. LINGUOALVEOLAR SOUNDS • Sibilants (sharp sounds) s, z, sh, ch & j (with ch & j being affricatives) are alveolar sounds, because the tongue and alveolus forms the controlling valve. • Important observations when these sounds are produced are the relationship of the anterior teeth to each other. Robert Rothman; Phonetic consideration in denture prosthesis, J Prosthet Dent;1961;11:214-223)
  36. 36. CLINICAL SIGNIFICANCE Upper and lower incisors should approach end to end but not touch. Failure indicates a possible error in the horizontal overlap of the anterior teeth Ref :- Robert Rothman; Phonetic consideration in denture prosthesis, J Prosthet Dent;1961;11:214-223)
  37. 37. LABIODENTAL SOUNDS • F and V are representatives of the labiodental group of sounds. • Formed by raising the lower lip into contact with the incisal edge of the maxilliary anterior teeth. Ref:- Robert Rothman; Phonetic consideration in denture prosthesis, J Prosthet Dent;1961;11:214-223)
  38. 38. CLINICAL SIGNIFICANCE Upper anterior teeth are too short (set too high up), V sound will be more like an F. • If they are too long (set too far down), F will sound more like a V. Ref:- Robert Rothman; Phonetic consideration in denture prosthesis, J Prosthet Dent;1961;11:214-223)
  39. 39. BILABIAL SOUNDS • B,p and m are representatives of the bilabial group of sounds. • Formed by the stream of air coming from the lungs which meets with no resistance along its entire path until it reaches the lip. Robert Rothman; Phonetic consideration in denture prosthesis, J Prosthet Dent;1961;11:214-223)
  40. 40. CLINICAL SIGNIFICANCE 1. Used to asses the correct interarch space 2. Correct labiolingual positioning of the anterior teeth 3. Labial fullness of the rims can also be checked Ref:-Robert Rothman; Phonetic consideration in denture prosthesis, J Prosthet Dent;1961;11:214-223)
  41. 41. VOWELS
  42. 42. PHONETICS IN RECORDING JAW RELATION • Also called as the speaking method • Sibiliant sounds like S and M is used. • S sound gives the approximate closest speaking space • M sound gives us the freeway space • Approximately 2mm of space must be there between the two occlusal rims Meyer M Silverman :The speaking method in measuring vertical dimension; J prosthet dent 1953;3:193-199
  43. 43. S-SOUND AND THEIR PROSTHODONTIC COSIDERATIONS • Say now shibboleth; and he said sibboleth, for he could not frame to pronounce it right…..” (THE BIBLE )
  44. 44. CLINICAL SIGNIFICANCE 1. Thickness of denture 2. Antero-posterior position of teeth 3. Vertical dimension of occlusion 4. Width of dental arch: 5. Relationship of upper teeth to the lower anterior teeth by “S-POSITION
  45. 45. DIFFERENT PARTS OF ORAL CAVITYAND THEIR INFLUENCE ON SPEECH TONGUE: LIPS PALATE TEETH
  46. 46. PROSTHODONTIC IMPLICATION IN DENTURE DESIGN AFFECTING SPEECH 1. Denture thickness and peripheral outline 2. Vertical dimension 3. Occlusal plane 6. Anteriorposterior positioning of teeth 5. Post dam area 7. Width of dental arch 4. Relationship of the upper and lower teeth Fenn, clinical dental prosthetics, 3rd edition pg 138
  47. 47. DENTURE THICKNESS AND PERIPHERAL OUTLINE • If the denture bases are too thick. • Lisping will occur with the word like S C and Z • Palatolingual sounds most affected. (T,D). Ref:-Fenn, Clinical dental prosthetics, 3rd edition pg 138
  48. 48. VERTICAL DIMENSION • Bilabials are mostly affected P B and M • If both rims touch prematurely it indicated excessive vertical dimension. • In try in stage teeth clicking will be heard. Ref:-Fenn, clinical dental prosthetics, 3rd edition pg 139
  49. 49. OCCLUSAL PLANE • Labioldental sounds F and V are affected. • If occlusal plane is too high the correct positing of the lower lip is difficult • If the occlusal plane is too low there is overlap of the lower lip on the labial surface of upper teeth Ref:-Fenn, clinical dental prosthetics, 3rd edition pg 138
  50. 50. ANTERIORPOSTERIOR POSITIONING OF TEETH • F and V sounds are hampered. • labiopalatal positions of the teeth is very important • Teeth if placed to palatally the lower lip will not meet the insical edge of the upper teeth. Ref:-Fenn, Clinical Dental Prosthetics, 3rd edition pg 138
  51. 51. POST DAM AREA • Palatolingual consonants are affected (K, NG and G) • Thick post dam areas will irritates the dorsum of the tongue • Patient feels nausea like effect while speaking • If inadequate the plosive sound of the word is hampered • This area is very important in singers who wear complete denture Ref:-Fenn, Clinical Dental Prosthetics, 3rd edition pg 138
  52. 52. WITDH OF DENTAL ARCH • If teeth are set into an arch that is too narrow the tongue will be cramped • Consonants like T, D, N K and S are affected Ref:-Fenn, Clinical Dental Prosthetics, 3rd edition pg 138
  53. 53. RELATIONSHIP OF THE UPPER AND LOWER INCISORS • The chief concern is the S CH, J and Z sound. • These sounds need a near contact of the upper and lower teeth so that the air stream is allowed to pass. Ref:-Fenn, Clinical Dental Prosthetics, 3rd edition pg 138
  54. 54. SPEECH TEST • The speech test should be made after satisfactory esthetics, correct centric relation, proper vertical dimension and balanced occlusion have been attained and after wax up for esthetics has been completed. John. Sharry. Complete denture Prosthodontics 3rd edition; Phonetics pg 132
  55. 55. TEST 1:TEST OF RANDOM SPEECH • Engage the patient in a conversation and obtaining a subjective speech analysis by asking the patient say how he feels, how his speech sounds to him and what words seem most difficult to pronounce. John. Sharry. Complete denture Prosthodontics 3rd edition; Phonetics pg 132
  56. 56. TEST 2: TEST OF SPECIFIC SPEECH SOUNDS • This is best accomlpished by having the patient say 6-8 words containing the sound and then combining these words into a sentence.The following is the list of sounds to be tested John. Sharry. Complete denture Prosthodontics 3rd edition; Phonetics pg 132
  57. 57. S,Sh Six, sixty, ships, sailed Mississippi, sure ,sign, sun, shine Sixty six ships sailed Mississippi. Sure sign of sun shine T,D,N,L Locator, located, tornado, near, Toledo Locator located tornado near Toledo Ch,J Joe, Joyce, joined, George, Charles, church Joe and Joyce joined George and Charles at church K Committee, convented, political, convention, Connecticut The committee convented at the political convention in connecticut. F,V Vivacious, Vivian, lived, five, fifty, five, fifth, avenue Vivacious Vivian lived at five fifty-five fifth avenue
  58. 58. TEST 3: TEST OF READING A PARAGRAPH Make the patient read a paragraph containing abundance of S, Sh, Ch sounds. John. Sharry. Complete denture Prosthodontics 3rd edition; Phonetics pg 132
  59. 59. SPEECH ANALYSIS • 2 categories • 1) Perceptual / acoustic • Based on broad band spectrogram, recording by Sonograph • Objective opinion of performance (Zarb- Bolender:Speech consideration with complete dentures ;Prosthodontic treatment For Edentulous Patients
  60. 60. 2) Kinematic movement analysis : – Ultrasonics – X-ray mapping – Cineradiography – Optoelectronic articulatory movement tracking – Electropalatography Ref:- Zarb- Bolender:Speech consideration with complete dentures ;Prosthodontic treatment For Edentulous Patients
  61. 61. PALATOGRAPHY • What is palatography? • a group of techniques to record contact between the tongue and the roof the mouth to get articulatory records for the production of speech sounds.
  62. 62. PREREQUISITE FOR MAKING PALATOGRAM 1. The artificial palate made must be uniformly adapted, no adhesive must be used. 2. Patient who have severe gagging must not be used for making palatograms. 3. The patient has to be trained to open his mouth after uttering the desired word. 4. The tracing material must not be distasteful and its consistency should permit easy application
  63. 63. 5. The palate has to be thoroughly dried before the medium is applied and the medium must have a contrasting colour so that it can be easily identified 6. Talc is considered the best material that can be used for palatogram, although activated charcoal, chocolate powder where also used
  64. 64. PALATOGRAM OF VOWELS. PALATOGRAM OF CONSONANTS.
  65. 65. TERMINLOGIES RELATED TO SOME SPEECH DISTURBANCES 1. APHASIA (DYSPHASIA): Means defective speech due to damage of cortical area required for speech making. (Broca’s area, Wernicke’s area). 2. DYSARTHRIA: Motor speech problems caused, not due to sensory loss or mental retardation. 3. SPEECH AND LANGUAGE RETARDATION: Delay in acquistion of communicating skills
  66. 66. DISORDERS OF SPEECH Hypernasality Hyponasality Denasality NASAL BALANCE Eg: m, n & ng    b d g Morning  bordig
  67. 67. ARTICULATOR DEFETCS Distortion Eg: Vowel  pop for pipe Consonants  cah for car Substitution Eg: teef for teeth Omission Eg: bow for boat Zarb- Bolender:Speech consideration with complete dentures ;Prosthodontic treatment For Edentulous Patients
  68. 68. RELATION TO MAXILLOFACIAL DEFECTS Acquired Accidental or surgical Nervous system – cerebral palsy, lateral sclerosis, poliomyelitis, myasthenia gravis, myotonic dystrophy Congenital Cleft palate, Short palate, Large velopharyngeal space, Limited velar mobility, Submucous cleft palate
  69. 69. CORRECTING SPEECH DEFECTS RELATED TO IMPLANT PROSTHESIS • A fully bone anchored prosthesis in maxilla can cause phonetic problems, • Normal pronunciation is possible after approximately 3 months, • removable appliances like artificial gingival extensions made of silicones or resin materials should be given.
  70. 70. CONCLUSION
  71. 71. REFERENCES 1. John. Sharry. Complete denture Prosthodontics 3rd edition; Phonetics. 2. Zarb- Bolender:Speech consideration with complete dentures ;Prosthodontic treatment For Edentulous Patients. 3. Fenn, Clinical Dental Prosthetics, 3rd edition pg 138. 4. Chierici, Lawson; Clinical speech consideration in prosthodontics. J Prosthet dent;1973;29;1:29-39. 5. Robert Rothman; Phonetic consideration in denture prosthesis, J Prosthet Dent;1961;11:214-223). 6. Meyer M Silverman :The speaking method in measuring vertical dimension; J prosthet dent 1953;3:193-199.
  72. 72. THANK YOU
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