Phonitics In Complete Denture (with animations)

PHONETICS IN COMPLETE DENTURE
DR MUHAMMAD JUNAID AJMAL KHAN
FCPS RESIDENT
PROSTHODONTIC DEPARTMENT

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.

MECHANISM OF SPEECH
PRODUCTION
al
,
Normal speech depends on proper functioning of 5
essential mechanism
1. The motor ( lungs, associated muscle
that supply the air).
2. The vibrator ( vocal cord that
give pitch to the tone).
3. The resonator ( consist of the
oral,nas pharyngeal cavity and
paranasal sinuses).
4. The articulators
( lip, tongue, palate and teeth)
2. The initiator( motor area of the brain)

COMPONENTS OF SPEECH
RESPIRATION
PHONATION
AUDITION
NEURALGIC
INTERGRATION
RESONATIONS
ARTICULATIONS

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 Prosthetdent;1973;29;1:29-39

PHONATION
• Air from the lungs
courses through
the trachea.
• Sound is
produced in the
larynx
• Vibration of vocal
cord takes place

RESONANCE
Sound that is produced by
the vocal cord is
modified by various
chamber.
• Resonators are
– pharynx
– oral cavity
– nasal cavity
– Paranasal sinuses

SPEECH ARTICULATION
• Sound that is produced
is formed into
meaningful words
• Tongue,lips,palate, teet
h and mandible play
are very important role.

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

TYPES OF SPEECH
• 1.VOWELS:
They are voiced sounds,
eg: a,e,i,o,u.
• 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,
• EX:- WORD
Zarb- Bolender:Speech consideration with complete dentures ;Prosthodontic treatment For EdentulousPatients

CLASSIFICATION OF SPEECH
• According to Boucher
• Vowels.
• Consonants.
– Plosives/stops
– Fricatives
– Afficatives
– Nasal
– Liquid
– Glides

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)

• 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)

• 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)

• 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)

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 ProsthetDent;1961;11:214-223)

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 deep a whistling will be heard when s is
pronounced
If groove is decreased s is softened towards th (Lisping)
: pass > path , sleep > Theep

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

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)

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

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 SOFTPALATE )
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

• 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 ProsthetDent;1961;11:214-223)

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.

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.

• 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
.

LINGUOALVEOLAR SOUNDS
T, D, S, Z, V & 1 are
representative of the linguoalveolar
group of 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.
Robert Rothman; Phonetic consideration indenture prosthesis, J Prosthet
Dent;1961;11:214-223)

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.

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 ProsthetDent;1961;11:214-223)

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 ProsthetDent;1961;11:214-223)

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)

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.

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 ProsthetDent;1961;11:214-223)

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

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 dimension
3. Occlusal plane
4. Relationship of the upper and lower teeth
5. Post dam area
6. Anteriorposterior positioning of teeth
7. Width of dental arch
Fenn, clinical dental prosthetics, 3rd edition pg 138

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

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

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

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

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 pg138

WITDH OF DENTALARCH
• 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

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.

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

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 pg132

TEST 2: TEST OF SPECIFIC SPEECHSOUNDS
• 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

TEST 3: TEST OF READINGAPARAGRAPH
Make the patient read a paragraph containing abundance
of S, Sh, Ch sounds.

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 EdentulousPatients

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

P
ALA
TOGRAPHY
• 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.

REQUIREMENT 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

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

PALATOGRAM
OF VOWELS.
PALATOGRAM OF
CONSONANTS.

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

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.

REFERENCE
S
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.

Phonitics In Complete Denture (with animations)

Phonitics In Complete Denture (with animations)

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