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Speech consideration IN COMPLETE 
DENTURES 
BY EKRAMUL HAQUE 
UNDER THE GUIDANCE OF 
DR SHAISTA AFROZ
CONTENTS 
1. Definition 
2. History 
3. Mechanism of sound production 
4. Types/Classification of speech sounds 
5. S soun...
DEFINITION 
• Speech:- Vocalised form of human communication describing 
thoughts, feelings, or perceptions by the articul...
HISTORY 
• In 1951 ‘Pound’ was successful in improving phonetics by 
contouring the entire palatal aspect of the maxillary...
• 1953 & 1956, ‘Silverman’ used ‘speaking method’ to measure 
patient’s vertical dimension in natural teeth with dentures ...
MECHANISM OF SPEECH PRODUCTION 
Normal speech depends on proper functioning of 5 essential 
mechanism 
1. The motor( lungs...
COMPONENTS OF SPEECH 
RESPIRATION 
COMPONENTS 
OF SPEECH 
PHONATION 
RESONATIONS 
ARTICULATIONS 
AUDITION 
NEUROLOGIC 
INT...
RESPIRATION 
• The movement of air in the 
inspiratory and expiratory phase 
is important in production of 
speech.
PHONATION 
• Air from the lungs courses 
through the trachea. 
• Sound is produced in the larynx 
• Vibration of vocal cor...
RESONANCE 
Sound that is produced by 
the vocal cord is 
modified by various 
chamber. 
• Resonators are 
• pharynx 
• ora...
SPEECH ARTICULATION 
• Sound that is produced is 
formed into meaningful words 
• Tongue,lips,palate, teeth and 
mandible ...
NEUROLOGIC INTEGRATION 
Factors for speech production 
are highly coordinated, some 
sequentially and some 
simultaneously...
TYPES OF SPEECH 
• 1.VOWELS: a,e,i,o,u. they are voiced sounds, 
• 2.CONSONANTS: may be either voiced or 
produced without...
CLASSIFICATION OF SPEECH 
• According to Boucher 
• Vowels. 
• Consonants. 
• Plosives/stops 
• Fricatives 
• Affricatives...
CLASSIFICATION OF 
CONSONANTS: 
Divided into groups depending on their 
characteristic production and use of different 
ar...
• Fricatives: are also called sibilants and are 
characterized by their sharp and whistling sound quality 
created when ai...
• Nasal consonants :are produced without oral exit of 
air. Production involves the coupling of nasal cavity as 
resonator...
CLASSIFICATION OF CONSONANTS BASED 
ON THE PLACE OF THEIR PRODUCTION 
• Consonant sounds are most important from the denta...
BILABIAL SOUNDS 
•B,p and m are 
representatives of the 
bilabial group of 
sounds. 
•Formed by the stream 
of air coming ...
CLINICAL SIGNIFICANCE 
1. Used to asses the correct 
interarch space 
2. Correct labiolingual 
positioning of the anterior...
LABIODENTAL SOUNDS 
• F and V are representatives 
of the labiodental group of 
sounds. 
• Formed by raising the lower 
li...
CLINICAL SIGNIFICANCE 
Upper anterior teeth are too 
short (set too high up), V 
sound will be more like an F. 
• If they ...
LINGUODENTAL SOUNDS 
• Sound is actually made closer to the alveolus (the 
ridge) than to the tip of the teeth. 
• Careful...
LINGUODENTAL SOUNDS 
Consonant Th is representative of the 
linguodental group of sounds 
Dental sounds are made with the ...
CLINICAL SIGNIFICANCE 
• If about 3mm of the tip of the tongue is not visible, the 
anterior teeth are probably too far fo...
LINGUOALVEOLAR SOUNDS 
T, D, S, Z, V & L are 
representative of the 
linguoalveolar group of sounds 
Formed with the valve...
T, D, N and L word 
Rugae area is very important 
for the production of these 
sounds 
Tongue must be placed firmly 
again...
CLINICAL SIGNIFICANCE 
• If teeth too lingual – T will sound like D 
• If teeth too forward - D will sound like T
LINGUOPALATAL SOUNDS 
• Sibilants (sharp sounds) s, z, sh, ch & j 
(with ch & j being affricatives) are alveolar 
sounds, ...
LINGUOPALATAL SOUNDS FORMED BY 
TONGUE AND HARD PALATE 
Word like S, T D N and L belong 
to this catogory 
S- the sound ‘s...
CLINICAL SIGNIFICANCE 
Upper and lower incisors should approach end to 
end but not touch. 
The minimal amount of space be...
CLINICAL SIGNIFICANCE 
1. Thus we can say that the sound S 
can be used to check the 
proper placement of the 
anterior te...
CLINICAL SIGNIFICANCE 
3. Silverman also used 
this word to establish 
and check a proper 
vertical dimension of 
occlusio...
PALATOLINGUAL SOUNDS FORMED 
BY TONGUE AND SOFT PALATE 
Consonant k, ng and g are 
representative of the palatolingual 
gr...
CLINICAL SIGNIFICANCE 
• If the posterior borders are over extended or if there is 
no tissue contact k becomes ch sound.
PHONETICS IN RECORDING JAW 
RELATION 
• Also called as the speaking 
method 
• Sibiliant sounds like S and M is 
used. 
• ...
S-SOUND AND THEIR 
PROSTHODONTIC CONSIDERATION 
1. Thickness of denture 
2. Antero-posterior position of teeth 
3. Vertica...
PROSTHODONTIC IMPLICATION IN 
DENTURE DESIGN AFFECTING 
SPEECH 
1. Denture thickness and peripheral outline 
2. Vertical d...
DENTURE THICKNESS AND PERIPHERAL 
OUTLINE 
• If the denture bases are 
too thick. 
• Lisping will occur with 
the word lik...
VERTICAL DIMENSION 
• Bilabials are mostly 
affected P B and M 
• If both rims touch 
prematurely it indicated 
excessive ...
OCCLUSAL PLANE 
• Labiodental sounds F 
and V are affected. 
• If occlusal plane is too 
high the correct positing 
of the...
ANTEROPOSTERIOR POSITIONING OF 
TEETH 
• F and V sounds are 
hampered. 
• labiopalatal positions of 
the teeth is very 
im...
POST DAM AREA 
• Palatolingual consonants are affected 
(K, NG and G) 
• Thick post dam areas will irritates the 
dorsum o...
WITDH OF DENTAL ARCH 
• If teeth are set into an 
arch that is too narrow 
the tongue will be 
cramped 
• Consonants like ...
RELATIONSHIP OF THE UPPER AND 
LOWER INCISORS 
• The chief concern is the S CH, J 
and Z sound. 
• These sounds need a nea...
SPEECH TEST 
• The speech test should be made after satisfactory 
esthetics, correct centric relation, proper vertical 
di...
TEST 1:TEST OF RANDOM SPEECH 
• Engage the patient in a conversation and obtaining a 
subjective speech analysis by asking...
TEST 2: TEST OF SPECIFIC SPEECH SOUNDS 
• This is best accomlpished by having the patient say 6- 
8 words containing the s...
S,Sh Six, sixty, ships, sailed 
Mississippi, sure ,sign, sun, 
shine 
Sixty six ships sailed 
Mississippi. Sure sign of su...
TEST 3: TEST OF READING A PARAGRAPH 
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
2) Kinematic movement analysis : 
• Ultrasonics 
•X-ray mapping 
• Cineradiography 
• Optoelectronic articulatory movement...
MCQ 
Q. The maxillary teeth if placed too far 
anteriorly and superiorly in a complete 
denture result in faulty pronuncia...
Q. Silverman’s closest speaking space 
indicates 
a) Vertical dimension of the patient 
b) Horizontal dimension of the pat...
Q. If the gap between upper and lower 
incisor is very narrow while speaking 
sibilant sound will result in 
a) Whistling ...
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Speech consideration in complete denture

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Definition
History
Mechanism of sound production
Types/Classification of speech sounds
S sounds and their prosthodontic considerations
Prosthodontic implication in denture design affecting speech
Speech tests

Published in: Health & Medicine
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Speech consideration in complete denture

  1. 1. Speech consideration IN COMPLETE DENTURES BY EKRAMUL HAQUE UNDER THE GUIDANCE OF DR SHAISTA AFROZ
  2. 2. CONTENTS 1. Definition 2. History 3. Mechanism of sound production 4. Types/Classification of speech sounds 5. S sounds and their prosthodontic considerations 6. Prosthodontic implication in denture design affecting speech 7. Speech tests
  3. 3. DEFINITION • Speech:- Vocalised form of human communication 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.
  4. 4. HISTORY • In 1951 ‘Pound’ was successful in improving phonetics by contouring the entire palatal aspect of the maxillary denture to simulate the normal palate Also explain the key role the ‘s’ sound play in establishing the vertical dimension of occlusion • ‘Landa’ suggested the use of ‘s’ sound to determine the adequacy of ‘free way space’ & ‘M’ sound to establish a desirable ‘rest position’.
  5. 5. • 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 linguopalatal speech sounds, by electronic means under predetermined vertical dimensions of occlusion.
  6. 6. MECHANISM OF SPEECH PRODUCTION 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,nasal, pharyngeal cavity and paranasal sinuses). 4. The enunciators or articulators( lip, tongue, palate and teeth) 5. The initiator( motor area of the brain)
  7. 7. COMPONENTS OF SPEECH RESPIRATION COMPONENTS OF SPEECH PHONATION RESONATIONS ARTICULATIONS AUDITION NEUROLOGIC INTEGRATIONS
  8. 8. RESPIRATION • The movement of air in the inspiratory and expiratory phase is important in production of speech.
  9. 9. PHONATION • Air from the lungs courses through the trachea. • Sound is produced in the larynx • Vibration of vocal cord takes place
  10. 10. RESONANCE Sound that is produced by the vocal cord is modified by various chamber. • Resonators are • pharynx • oral cavity • nasal cavity • Paranasal sinuses
  11. 11. SPEECH ARTICULATION • Sound that is produced is formed into meaningful words • Tongue,lips,palate, teeth and mandible play are very important role.
  12. 12. 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.
  13. 13. 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
  14. 14. CLASSIFICATION OF SPEECH • According to Boucher • Vowels. • Consonants. • Plosives/stops • Fricatives • Affricatives • Nasal • Liquid • Glides
  15. 15. 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)
  16. 16. • 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)
  17. 17. • 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)
  18. 18. 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) Bilabial sounds,formed by lips, (2) Labiodental sounds,formed by lips and teeth, (3) Linguodental sounds,formed by tongue and teeth, (4) Linguoalveolar sounds,formed by the tip of the and anterior most part of palate (5) Linguopalatal and Linguovelar sounds,truly palatal sounds
  19. 19. 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.
  20. 20. 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
  21. 21. 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.
  22. 22. 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.
  23. 23. 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.
  24. 24. 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.
  25. 25. 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 .
  26. 26. LINGUOALVEOLAR SOUNDS T, D, S, Z, V & L 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.
  27. 27. 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
  28. 28. CLINICAL SIGNIFICANCE • If teeth too lingual – T will sound like D • If teeth too forward - D will sound like T
  29. 29. LINGUOPALATAL 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.
  30. 30. LINGUOPALATAL 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 narrow a whistling will be heard when s is pronounced If groove is broad s is softened towards sh (Lisping)
  31. 31. CLINICAL SIGNIFICANCE Upper and lower incisors should approach end to end but not touch. The minimal amount of space between upper and lower teeth in this position is called silverman’s closest speaking space
  32. 32. 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
  33. 33. CLINICAL SIGNIFICANCE 3. Silverman also used this word to establish and check a proper vertical dimension of occlusion
  34. 34. 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
  35. 35. CLINICAL SIGNIFICANCE • If the posterior borders are over extended or if there is no tissue contact k becomes ch sound.
  36. 36. 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
  37. 37. S-SOUND AND THEIR PROSTHODONTIC CONSIDERATION 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
  38. 38. 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. Anteroposterior positioning of teeth 7. Width of dental arch
  39. 39. 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).
  40. 40. 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.
  41. 41. OCCLUSAL PLANE • Labiodental 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
  42. 42. ANTEROPOSTERIOR 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.
  43. 43. 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
  44. 44. 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
  45. 45. 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.
  46. 46. 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.
  47. 47. 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.
  48. 48. 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
  49. 49. 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
  50. 50. TEST 3: TEST OF READING A PARAGRAPH Make the patient read a paragraph containing abundance of S, Sh, Ch sounds.
  51. 51. SPEECH ANALYSIS • 2 categories • 1) Perceptual / acoustic • Based on broad band spectrogram, recording by Sonograph
  52. 52. 2) Kinematic movement analysis : • Ultrasonics •X-ray mapping • Cineradiography • Optoelectronic articulatory movement tracking • Electropalatography
  53. 53. MCQ Q. The maxillary teeth if placed too far anteriorly and superiorly in a complete denture result in faulty pronunciation of a) F and V sounds b) S and T sounds c) B and P sounds d) K and G sounds
  54. 54. Q. Silverman’s closest speaking space indicates a) Vertical dimension of the patient b) Horizontal dimension of the patient c) Both of the above d) None of the above
  55. 55. Q. If the gap between upper and lower incisor is very narrow while speaking sibilant sound will result in a) Whistling b) Lisping c) Clicking d) No effect

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