Phonetics in complete denture/certified fixed orthodontic courses by Indian dental academy

PHONETICS IN
COMPLETE DENTURE
INDIAN DENTAL ACADEMY
Leader in continuing Dental Education
www.indiandentalacademy.com

INTRODUCTION

CONTENTS
 REVIEW OF LITERATURE
 SPEECH PRODUCTION
 COMPONENTS OF SPEECH
 CONSONANTAL ARTICULATION
 PALATOGRAMS
 SPEECH TESTS
 THE MANDIBULAR MOVEMENT OF SPEECH
 SPEECH IN DETERMINING VERTICAL DIMENSION
 SPEECH EVALUATION FOLLOWING OBTURATOR PLACEMENT
 SPEECH ANALYSIS
 PROSTHODONTIC CONSIDERATIONS OF SPEECH
 SUMMARY AND CONCLUSION
 REFERENCES

REVIEW OF LITERATURE
 Meyer M. Silverman (1952) suggested the use of the speaking
method to measure a patients vertical dimension before the loss
of the remaining natural teeth, and to reproduce this measurement
in full dentures at a later stage

 Barnett Kessler (1955) analyzed the tongue factor and its
functioning areas in dental prosthesis. He suggested that
comprehension of the tongue function and its operating area ,in
both the buccal cavity and the vestibular space is a prerequisite in
achieving or approaching the ideal dental prosthesis

Anthony K. Kaires (1956) in his article –“ Palatal pressures of the
tongue in phonetics and deglutition” quantitatively measured the
variations in the palatal pressures of the tongue at definite
vertical dimensions:
- During pronunciation of palatolingual sounds
-During swallowing.
-It was concluded that the tongue was capable of adapting itself to
the different predetermined vertical dimensions of occlusion.

 Alexander L. Martone and John W. Black (1962) in his
fifth article in the series of articles titled “An approach to
prosthodontics through speech science” discussed the speech
science research of prosthodontic significance. He pointed that the
loss of teeth alters the articulatory cavity and affects the speech
pattern of the individual.
 Earl Pound (1966) suggested that by recording and interpreting
certain mandibular movements of speech, the patient reveals seven
informative facts that are directly related to restoring the original
mandibular tooth position, phonetic sharpness and occlusal
harmony.

 George Chierici and Lucie Lawson (1973) studied on the clinical speech
considerations in prosthodontics, from the perspective of a prosthodontist
and speech pathologist. He considered the various dimensions of speech
production separately. For this seven related functions and their importance
were assessed.
Respiration
Phonation
Resonance
Speech articulation
Audition
Neurological function
Emotional behaviour
He concluded that each patient’s condition should be thoroughly
evaluated so that the prosthesis is able to provide an optimal environment
for its accommodation and acceptance towards a more natural speech.

 Vijay Prataph Singh, Girish Bharadwaj and K.Chandrashekaran
Nair (1997) conducted a clinical study to observe the tongue
position in speech and tongue position for four selected consonants,
/s/, /k/, /l/, and /t/, through an opening in the cheek of a patient and
found that the variations in tongue position were negligible. Although
the patient had a large facial defect, speech clarity was also not
affected.

 Christopher Runte, Djfar Tawana, Dieter Dirksen, Bettini Runte,
Antoinette Lamprecht-Dinnesen, Friedhelm Bollmann, Eberhard
Seifert and Gholamreza Danesh. (2002) Concluded that the
maxillary incisor position influences /s/ sound production.
Displacement of the maxillary incisors must be considered a cause
of immediate changes in /s/ sound distortion. Therefore, denture
teeth should be placed in the original tooth position as accurately as
possible.

 A study was conducted by Dr Manish Sharma (2001) under the able
guidence of Sir “To evaluate the phonetic sounds in two different
pontic designs of the maxillary anterior fixed partial dentures”and he
concluded that the inclusion of cingulum in the pontic for maxillary
anterior fixed partial denture,should be done for the purpose of the
correct articulation and subsequent production of linguodental
phonetic sound.

MECHANISM OF SPEECH PRODUCTION
 MOTOR
 VIBRATOR
 RESONATOR
 ARTICULATOR
 INITIATOR

PHYSIOLOGIC VALVES IN SPEECH PRODUCTION
The speech mechanism include
three principal physiologic
valves.
Valve I : the glottis
Valve II : the palatopharangeal
valve
Valve III : the orifice of the
mouth.

THE TONGUE
 The tongue is the principle articulator for speech.

Functional Tongue Classification
 The occupational tongue.
 The still tongue
 The normal tongue
 The habitual tongue.

CLASSIFICATION OF SPEECH
 SURDS
 SONANTS
 CONSONANTS

CONSONANTAL ARTICULATION
 Stops
eg:- p,b,t,d
 Fricatives
eg:-f,v
 The Affricatives
eg:- j,ch
 Diversions
eg:- m,n www.indiandentalacademy.com

ENGLISH CONSONANTS: - THEIR POSITION AND
MODE OF PRODUCTION
The production of English consonants involves six valves:-
1. Bilabial
2. Labiodental
3. Linguodental
4. Lingeoalveolar
5. Linguopalatal
6. Linguovelar

Bilabial Sounds
 The sounds b, p and m are made by contact of the lips.
 Insufficient support of lips by teeth and / or denture base can cause
these sounds to be defective.

Labio-dental Sounds
 The labio-dental sounds f and v are made between the insial edge
of upper incisors and lower lip.
 If the upper anterior teeth are too short (set too high up), the V
sound will be more like an ‘f’. If they are too long (set too far down),
the f will sound more like a v.

Linguodental Sounds
 Dental sounds (eg. Th) are made with the tip of the tongue
extending slightly between the upper and lower anterior 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.

Linguoalveolar Sounds
 Alveolar sounds (eg. t, d, s, z,& l) are made with the valve formed by
contact of the tip of the tongue with the most anterior part of the
palate
 The important observations when these sounds are produced are
the relationship of the anterior teeth to each other.
 A failure of the incisal edge to approach exactly end to end indicates
a possible error in the overlap of the anterior teeth.

The S Sound
 From a dental point of view, the S sound is the most interesting one.
Because its articulation is mainly influenced by the teeth and palatal
part of the maxillary prosthesis

In nearly all languages of the world, S is a common speech sound.

Linguovelar sounds
 The truly palatal sounds (example: year, she, insion and onion)
present less of a problem for dentures.
 The velar sounds (k, g and ng) have no effect on dentures, except
when the posterior palatal seal extension encroaches on the soft
palate.

PALATOGRAM
 It’s a recording of tongue-palate contact during the production of
given sound.
 Palatograms are the area of tongue contact for a given sound
displayed on an artificial palate through a medium of non scented
talcum powder.
 Prerequistes for making a palatogram-

Speech tests
 The phonetic aspect of denture construction should be checked at the time
of the waxed try-in when it is possible to alter palatal contour to
accommodate speech articulation.
 The trial denture evaluation should not be considered complete until a
phonetic test has been made.
 The first test is of random speech.
 The second test is to test specific speech sounds.
 In the third test, the patient is asked to read a short paragraph containing
an abundance of s, sh, and ch sounds.

s and sh Six, sixty, ships, sailed,
Mississippi, sure, sign,
sun, shine.
Sixty-six ships sailed the
Mississippi. Sure sign of
sunshine
t, d, n, and l Locator, located,
tornado, near, Toledo
The locator located the
tornado near Toledo.
ch and j Joe, Joyce, Joined,
George, Charles,
church
Joe and Joyce joined
George and Charles at
the church.
k Committee, convened,
political, convention,
Connecticut
The committee
convened at the political
convention in
Connecticut.
f and v Vivacious, Vivian, lived,
five, fifty-five, fifth,
avenue
Vivacious Vivian lived at
five fifty-five Fifth
Avenue

THE MANDIBULAR MOVEMENT OF SPEECH
AND THEIR SEVEN RELATED VALUES
 By recording and interpreting certain mandibular movements of
speech, the patient reveals seven informative facts that are directly
related to restoring the original mandibular tooth position, phonetic
sharpness, and occlusal harmony.
 These are:-
 The vertical overlap
 Horizontal overlap
 Lower anterior tooth display
 Class of occlusion
 Maximum usable vertical dimension
 Index for incisal guidance
 The maximum serviceable cusp height

The Speaking Method of determining
vertical dimension

1)Silverman closest speaking space: Physiological phonetic method

 The closest speaking space to measure the vertical dimension in
this speaking method must not be confused with free way space of
determining the vertical dimension.
 The free way space establishes vertical dimension when the
muscles involved are at complete rest, and the mandible is in its rest
position.
 The closest speaking space measures vertical dimension when the
mandible and muscles involved are in the active full function of
speech.

 The “F”or “V’ and ‘S’speaking anterior tooth relation –
Pound and Murrel:
 Insisal guidance is established by arranging the anterior teeth in the
occlusal rims before recording the vertical dimension of occlusion.
 Maxilary anteriors – F and V
 Mandibular anteriors - S
 Speech in establishing vertical dimension at rest:

Communication problems associated with
cleft palate:-
 Clefts of the lip and palate affect speech in two major ways:
 The voice quality becomes deviant, and the articulation is
impaired.
 The voice quality is that of excessive nasality.
 They have more trouble with the plosives, fricatives and
affricatives
 Voiced sounds seem to be easier than the unvoiced ones, but
the consonant blends present considerable difficulty.
 The distortion errors are primarily due to nasal emission, the
person snorting the sounds out of his nose.

Speech evaluation following obturator
placement:-
 The prosthodontist may require the assistance of a speech
pathologist.
 Cleft palate patients will invariably require speech therapy
 Patients often exhibit hypernasality
 The obturator is adjusted to the point where the patient can
produce a clear “p” and a sustained “f” or “s” sound without
emission of air through the nose
 Several authors suggested that the sustained pressure required
for the “s” phoneme may be a reliable method of evaluating the
effectiveness of the obturator.
 Whereas greater intraoral pressure may be required for stop-
plosives, such as “p”, the sustained pressure required for “s”
mitigates the compensatory elevation of the tongue to assist with
closure.

SPEECH ANALYSIS
 Platograms
 Sound spectrograms
 Videofluoroscopy
 Oral or nasal endoscopy

PROSTHODONTIC CONSIDERATIONS OF
SPEECH:
 1) Effect of denture thickness:
• If the thickness of the denture base covering the palatal area is
more, then lipsing of the sounds will occur.
• Allen (1958) found that an additional thickness of 1mm in the
anterior palatal area made speech awakward and indistinct
• The denture base thickness in the postdam area
• The thickness of the lingual flange in the anterior region

 2) Effect of tooth position on speech:
 If upper anteriors are too short of occlusal plane
 3) Effect of dental arch form on speech:
 If the arch is narrow, faulty articulation of the consonants like ‘t, d, l,
n, s, r will results, where lateral margins of the tongue makes
contact with palatal surfaces of the upper posterior teeth.
 The correction can be done by the slight thickening of the denture
base in the center of the palate, so that tongue does not have to
extend up as far as into narrow palatal vault.

 4) Effect of vertical dimension on speech:
 Fymbo (1936) - increased vertical dimension results in difficulty in
pronouncing sounds like ‘b, m, p, f, v’.
 Landa (1947) recommended various phonetic tests to determine
proper vertical dimension using sounds such as ‘s, c, z’.
 Silverman (1956). He established the “closest speaking space” and
used this as clearance area between the dentures.
 The bilabial sounds like ‘m’ is helpful in determining the vertical
dimension.

 5) Whistle and Swish sounds:
 Silverman (1967) stated that the Whistle and Swish sounds are
produced during speech due to air abnormally passing over the
tongue and through the interincisal space. These sounds may be
caused due to decreased overjet.
 6) Effect of denture esthetics on speech:
 Speech is some times related to patients emotional attitudes
towards the denture esthetics.
 Lawson (1973) stated that when there is any change in patient
mouth, then there will be anxiety reaction and to overcome this
problem they shows abnormal movement of lip, jaws, and tongue
during speech.

CONCLUSION

REFERENCES
 Allen L.R. “Improved phonetics in denture construction”. J Prosthet Dent1958; 8(5):
753-763.
 Boucher’s Prosthodontic treatment for edentulous patient 11th
edition
 Chierici G. and Lawson L. “Clinical speech considerations in prosthodontics:
Perspectives of the prosthodontist and speech pathologist”. J. Prosthet. Dent.
1973; 29(1): 28-39.
 Kaires A.K. “Palatal pressures of the tongue in phonetics and deglutition”. J.
Prosthet. Dent. 1956; 305-315.
 Kessler B. “An analysis of the tongue factor and its functioning areas in dental
prosthesis”. J. Prosthet. Dent. 1955; 5(5): 628-635.
 Martone A.L., and Black J.W. “The phenomenon of function in complete denture
prosthodontics- An approach to prosthodontics through speech science Part V.
Speech Science Research of Prosthodontic significance”. J Prosthet Dent 1962;
12(4): 628-636.
 Mehringer E.J. “The use of speech patterns as an aid in prosthodontic
reconstruction”. J Prosthet Dent 1963; 13(5): 824-838.

 Pound E. “The mandibular movements of speech and their seven related values”. J
Prosthet Dent 1966; 16(3): 834-843
 Rothman R. “Phonetic considerations in denture prosthesis”. J. Prosthet Dent.
1961; 11(2): 214-223.
 Sharry J.J Complete denture prosthodontics ; third edition
 Silverman M.M. “Determination of vertical dimension by phonetics”. J Prosthet
Dent 1956; 6(4): 465-471.
 Silverman M.M. “The speaking method in measuring vertical dimension”. J.
Prosthet. Dent. 1952; 3(2): 192-199.
 Singh V.P., Bharadwaj G., Nair K.C. “Direct observation of tongue positions in
speech – A patient study”. Int J. Prosthodont 1997; 10: 231-234.
 Sheldon winkler. Essentials of complete denture prosthodontics;2nd
edition

 THANK YOU

Phonetics in complete denture/certified fixed orthodontic courses by Indian dental academy

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