Phonetics in complete dentures./ dentistry course in india

Phonetics in complete
dentures.
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com

Table of contents.
• Introduction
• Review of literature.
• Speech production.
• Phonemics

• Factors in denture affecting
speech
-position of teeth.
-denture thickness.
-Occlusal plane.
-Vertical dimension.
-width of the dental arch.

• Use of phonetics in denture
construction.
• Speech tests.
• Summary
• Conclusion
• references.

Introduction.
Speech is a very sophisticated,
autonomous and unconscious
activity. Its production involves
neural, muscular, mechanical,
aerodynamic, acoustic and
auditory factors.

Because orodental morphological
features also may influence an
individuals speech, the dentist
should recognize the possible role
of prosthetic treatment on speech
activity.

The oromotor functions, such as
mastication and speech are
interrelated because the mouth ,
lower jaw, lips, teeth and tongue
are used for both the activities.
Any alterations in these structures
will inevitebly mediate a
disturbance in the system.

Articulatory deficits may be generally
classified into three categories:
omission of a phoneme,
substitutions and distortions.
Distortions is most usual
consequence after the
prosthodontic treatment.

• What is Phonetics?
• Phonetics is the study of the
articulatory and acoustic
properties of the sounds of
human language.

Review of literature.

Leslie R. Allen etal., Improved
phonetics in complete dentures.
JPD1958;8(5)573-83.
The article describes that the labio-
dental sounds are recommended
for arriving at the proper
arrangement of the anterior
teeth , and vertical dimension for
s pronunciation.

Phonetics can be improved by
contouring the entire palatal
surface of the maxillary denture to
simulate the natural palate.
.

• It was found that good results can
be obtained by thickening the
areas necessary to produce
normal tongue contact without
meticulous carving and
contouring

Edward J. Mehringer. The use of
speech patterns as an aid in
Prosthodontic reconstruction.
JPD1963;13(5):825-35).
.

The purpose of this article was ;
To show how the speech patterns
develop physiologically .
To illustrate graphically the basic
formats established by
neuromuscular patterns in
articular speech

To show how the speech patterns can
be utilized under functional conditions
fit record making purpose.

The author says that the integration of
the artificial teeth to the functional
movements take precedence over
the fit of the denture base to its
foundation.
When teeth donot conform to these
functional patterns, the fit of the base
cannot endure.

Meyer M. Silverman The whistle
and swiss sound in denture
patients. JPD 1967;17(2):144-48
.

• The article describes the causes
of certain abnormal sounds , such
as whistle and swish sounds, that
occur in the speech of the
patients wearing fixed and
removable restorations involving
the anterior teeth.

• Ideally, the artificial teeth should
be located in the same position as
the natural teeth they replace for
proper phonetics.

Joseph G. Agnello etal., A study of
phonetics in edentulous patients
following complete denture treatment
• JPD 1972;27(2):133-39.

• The aim of this study was to asses
the speech changes in complete
denture patients
1. In the edentulous state .
2. Immediately following denture
insertion
3. Two weeks following insertion of
dentures
4. Twelve weeks following the insertion
of dentures.

• They concluded that words spoken in
the edentulous state were paired with
words spoken in the different stages
of denture wear.
• Analysis revealed that the s, sh, t
showed improvement .
• The voiced th sound did not show any
general improvement.

Earl Pound; Utilizing speech to
simplify a personalized denture
service .
• JPD 1970;24(6):586-600.

• A fresh approach toward the
solution of many of the debatable
problems in complete denture
construction consists of simple
recording, as guided by muscle
memory, the extent of the
downward and forward
mandibular movements made
during speech.

• This automatically restores the
patients original horizontal and
vertical overlaps which can be used to
control the factors of occlusion.

• The values derived by
progressive function refinement of
this information, through the
controlled use of diagnostic
treatment dentures incorporating
tissue treatment material, and
free occlusal scheme.

George A. Murrell. The problems of
functional conflicts between
anterior teeth.
• JPD1972;27(6):591-99.

• Phonetic positioning of the
anterior teeth usually produces a
natural, esthetic tooth
arrangement and provides
occlusal clearence during the
function of speech with complete
dentures.

• Natural tooth positioning,
however, frequently results in
increased horizontal and vertical
overlaps which magnify the
possibility of functional conflicts in
anterior teeth.

Interferences in speech can be
avoided during denture
construction, but those of
mastication and swallowing must
be corrected after the dentures
are constructed.

Hisatoshi Tanaka. Speech patterns of
edentulous patients and morphology
of the palate in relation to the
phonetics.
• JPD1973:29(1):16-28.

• The purpose of this study was to
investigate
1. Changes in the speech patterns
of patients with new complete
dentures before and various
times after insertion of the new
dentures.
2. The relationship between the
speech and the palatal contours
of the denture.www.indiandentalacademy.com

• On the basis of analysis of the
data collected ,the following
conclusions were made:
1.Most of the patients made
speech improvement when the
dentures were first inserted.

2.With increased length of time of
wearing the dentures, the speech
intelligibility was improved.
3.The speech of the patients can be
improved by experience with their
new dentures.

4.Individual sounds showed different
levels of speech intelligibility, and this
level improves with the length of the
denture usage.
5.Acoustic distortions occurred more
frequently In the s, sh, ch, zh, and j
sounds than in z, t, n, d, and l sounds.

6.The s sound is a poor prognostic
sound for intelligibility of speech.
7.The palatal ridge formation
(palatal contour) of the complete
dentures will affect the acoustic
distortion of the affricative and the
fricative sounds.

Carl A. Hansen . Phonetic
considerations of the chromium
alloy plates in complete dentures.
• JPD 1975; 34(6);620-24.

• The author says that there is valid
indications for the use of
chromium alloy plates,
• The contour of the entire palatal
surface must, however be
considered for optimum
phonetics.
• Both resins and metal must be
related to each other

in an intelligent manner to insure
precise contours, minimum
weight, and maximum strenght.
• Two approaches to these
techniques will be described.

Earl Pound. Let /s/ be your guide.
• JPD 1977;38(5):482-89.

• This article reviews the new
guidelines for establishing the
vertical dimension of occlusion .

• They are based on the fact that
the body of the mandible
assumes an easily recordable ,
repetitive horizontal and vertical
position when the patient is at /s/
position during speech.

• This controlled method of
developing vertical dimension
correlates the posterior speaking
space with the placement of
upper and lower anterior teeth
when set to phonetic standard.

• This permits the development of a
dependable vertical dimension of
occlusion for most patients and
also serves as a guide for the
more difficult to treat classII and
tongue – thrusting patients.

Bal k. Goyal etal.,. Functional
contouring of the palatal vault for
improving speech with complete
dentures
• JPD1982;48(5):640-46.

• According to the study :
• The slight bulging of the denture
base palatal to the anterior teeth
probably helps in improved
pronunciation of /s/ and /sh/
sounds .

• Earl Pound; Utilizing speech to simplify a
personalized denture service .

• Also suggest that placing the non-
anatomic papilla somewhat
posterior to the incisive papilla
location provides tactile sensation
location.
• The s curve in the molar area is
important for proper enunciation
of the sounds.www.indiandentalacademy.com

Emily A. Tobey. Active versus passive
adaptation: an acoustic study of vowels
produced with and without dentures.
• JPD1983;49(3):314-20.

• Data from this study indicate the close
examination of vowels , as well as
consonants , assists in delinating
active articulatory versus passive
acoustic changes to orofacial
reconstruction.
• Data from the study reveal that
consonants and vowels are influenced
by the prostheses.

• Moreover, the data suggest that
adjusting prostheses by listening
for changes in the consonant
sounds may change only the
passive acoustic characteristics of
the prostheses and may not
necessarily influence active
accommodation by the patient.

Ronald J. Hammond. Increased
vertical dimension and speech
articulation errors.
• JPD1984;52(3):401-6.

• The study evaluates the effects of
speech articulation of increasing the
vertical dimension of occlusion.
• This study indicates that gross
articulatory adaptation to increased
vertical dimension occurs within 4-6
days and that thereafter adaptation is
a matter of refinement and fine
adjustment.

J. FMcCord Phonetic determinants
of tooth placement in complete
dentures
Quintessence Int 1994;25:341-45.

• The provision of complete
dentures requires that dentist,
technician and the patient
adequately fulfill their respective
roles in provision and adaptation
to, these dentures.

• An increasing number of
replacement of the dentures are
being prescribed for older
patients.

• Thus , the need to utilize
functional factors to determine
tooth placement is reviewed.
• This review demonstrates
demonstrate the overall
relationship between speech and
denture construction.

Christina A. Gitto. A simple method
of adding palatal rugae to complete
dentures.
• JPD1999;81:237-9.

• Restoring patient’s speech is an
important goal in complete denture
fabrication.
• For those patients who have difficulty
with their speech patterns
accommodating to the introduction of
the a prosthesis, texture in the palatal
region may prove helpful.
.

• Article describes method of
incorporating palatal rugae in
newly fabricated and existing
dentures.

Ederhard Seifert etal.,. Can dental
prosthesis influence vocal
parameters?
• JPD1999:81:579-85.

• This study evaluated the effects of
changes on phonation by varying the
dentures of 20 subjects in line with
those of the first patient.

• They concluded that variation of
thickness and or volume of
dentures and of the vertical and
horizontal dimensions of
occlusion may result in
unpredictable audible changes to
the voice.

Christoph runte.The influence of
maxillary central incisor position in
complete dentures on /s/ sound
production.
• JPD2001:85:485-95.

• The study investigated the effect of
different maxillary central incisor
position on phonetic patterns.

• They concluded that immediate
phonetic adaptation of prosthetic
restorations in the maxillary
incisor region can be achieved
only if the original position of the
natural teeth is transferred to the
dentures.

• Although these misarticulations
are likely to disappear in many
cases within few weeks ,they may
persists and even lead to
psychological problems.

R.C Matheus rodrigues .effect of
new dentures on inter occlusal
distance during speech.
• Int J Prosthodont2003;16:533-37.

• The study investigated the changes
in the interocclusal distance during
pronunciation of /m/ and /s/ sounds.

• They concluded that insertion of
new dentures , with the vertical
dimension corrected ,changes
interocclusal distance of speech
during phonation of /m/ and /s/
sounds.

Speech production.
Any vibrating body will make sound
and the prerequisites for sound
are a source of energy and a
vibrator.
The source of energy for the voice
is air in the lungs.
The vibrators for the voice are the
vocal folds in the larynx.www.indiandentalacademy.com

Controlled airstem that is initiated in
the lungs and passes through the
larynx and the vocal cords
produces all speech sounds.
Speech sounds need more air than
quite exhalation.

• The larynx contains folds of muscle called
the vocal folds (sometimes called vocal
cords).

• Sounds that are produced with
relaxed vocal folds are known as
voiceless sounds, and sounds
that are produced with tensed
vocal folds are known as voiced
sounds. If the folds are only
partially closed, a whispered
sound is produced.

• The adjustments in the airflow
contribute to the variations in
pitch and intensity of the speech
sounds.
Structural controls for speech
sounds are: the valves in the
pharynx and the oral and nasal
cavities. www.indiandentalacademy.com

• Nearly all sounds are emitted
from the mouth.
• The nasopharynx is closed off
from oropharynx during speech.
• This closure is done by upward
closure of the soft palate.

• As the air passes through the
mouth the tongue ,lips and
mandibular oscillations modify it.
• The tongue has a critical impact
on the speech production.

• Jaw and tooth relationships
enable the tongue to articulate
against the maxillary teeth or the
alveolus ,permit the maxillary
teeth and the lips to make easy
contact and allow lips to contact
to produce speech.

Neurophysiologic background
• A complex and imperfectly
understood mechanism governs
the speech.
• A large no of oral
mechanosensitive receptors are
involved in motor control.

• Therefore all prosthodontic
treatment will have an influence
on speech performance because
a great no of these structures will
be involved.

• It has been hypothetised that less
cortex area is required processing
skills once they become
automatised.

• A prerequisite to satisfactory
speech sounds and adaptation is
intact general feedback system
that is orosensory and auditory
feedback.

• Gradual hearing loss could be
present in older ages and the
process of adaptation to the
dental prosthesis could be
impaired.

• Adaptation to the complete
dentures is by feedback
mechanism to speech motor
programming.

How does dental treatment affects
speech?
• Since most of the articulations
takes place in the oral cavity, any
alterations of these structures will
affect speech.

• For ex:
• a missing bicuspid
• Missing anterior teeth.
• Gross removal of the gingival tissue.
• Mechanical movement of the teeth in
the maxillary arch.

• high % of sounds are
produced by contact of the
tongue with some portion of
the palate and the teeth .
Since these areas are covered
or replaced by the CD speech
rehabilitation becomes
onerous task to the
prosthodontist.

Phonemics.
• Articulation is usually considered to
be joining of the parts.
• Speech articulation takes place when
any approximation or movement of
the articulators constricts or diverts
the airstem to produce single sound.

• The single sounds that are
produced are innumerable.
• Many cccur as noise and are
unclassified.
• But those which are learned as
speech are called phones.

• The closely related phones have
been combined to form
recognizable sounds and are
called phonemes.

• The phoneme, then is a unit of
speech by which we can
distinguish one utterence from
another and which collectively
make up phonemics of language.
• Study of these phonemics is
known as phonetics.

Classification of speech.
Since speech production can be
used as a guide for the
arrangement of the teeth, it is
necessary to be familiar with the
different types of speech sounds.

Speech sound can be classified as
• Surds
• Sonants
• consonants.

• Surds : these are any voiceless
sound produced by separation of
the vocal cords with no marginal
vibration.

• Example:
• The initial h sound as in huh.
• Voiceless sibiliants s, sh, zh
produced initially.

Sonants: these are voiced sounds
that include all vowels and vowel-
like sounds.
They require minimum articulation
and are classified according to
tongue position and position of the
lips.

• consonants: are produced as
a result of airstem being
impeded, diverted, or
interrupted before its release.
• Ex: p, g, m, b, s, t, r, z.

• Consonants also are divided into
groups, depending on their
characteristic production and use
of different articulators and
valves.

• Plosive consonants: produced
when an overpressure of air has
been built up by contact between
the soft palate and the pharyngeal
wall and released in an explosive
way.
• Ex: p and t.

• Fricative consonants: also called
sibilants and are charecterised by
their sharp and whistling sound
quality created when air is
squeezed through the nearly
obstructed articulators.
• Ex: s and z.

• Affricate consonants: are
produced by combination of stops
and friction, accomplished by
articulation of tongue and anterior
hard palate.
• Ex: j and ch.

• Nasal consonants: produced
without oral exit of air.
• Ex: n and m.

• Liquid consonants: they are
produced with friction.
• Ex: r

• Glides: sounds characterized by
gradually changing articulator
shape.

• Depending on the contacts made by
the lips and tongue on the teeth and
the palate the sounds are classified
as :
• Bilabial sounds: b, p, m.
• Labiodental sounds: f, v.
• Linguo dental sounds: th in this.
• Linguoalveolar sounds: t, d, s, z, l.
• Linguopalatal sounds: year, she,
vision.

Phonetic changes in edentulous
patients following complete denture
treatment.
• JPD1972;27(2):133-39.

The absence of teeth creates
difficulties in speech sounds.
Some patients donot exhibit any
speech problems, because it
appears that the tongue
makes compensatory
adjustments for the absence of
the sounds.

• Allen (1958) says that a patient fitted
with complete dentures generally
adjusts to the speech pattern to the
appliance and thus improves.

• Kaires(1957) and Sovijarvi(1962)
reported that in the absence of
dentures, the concentration of the
higher frequencies in the overall
acoustic spectrum of speech was
reduced.

• Angello and Wictorin (1972) they
made a study to asses speech
changes in edentulous state and
following insertion of dentures.
• They concluded that /s/ /sh/ /t/
sounds showed improvement.

Factors in denture design affecting
speech.
• Keuebeker (1984) investigated
speech problems that occurred
after fitting the dentures and listed
following causes.
1.Incorrectly positioned anterior
teeth.
2.Vertical dimension.
3.Occlusal plane

4.width of the dental arch.
5.Relationship of the upper and
lower anterior teeth
6.Denture thickness.
7.Postdam area.

Tooth positions.
Tooth positions are sometimes
critical to the production of certain
sounds and not at all for others.

Because the teeth are arranged for
esthetics, it is not only the speech
sound itself that is critical but
rather the interrelationship of the
tongue ,lips, teeth and denture
base.

• Bilabial sounds: they are made by
the contact of the lips. b, p,m.
• Insufficient support of the by the
teeth can cause these sounds
defective.
• Therefore anterioposterior
positioning of the anterior teeth
can effect production of these
sounds.

• Labiodental sounds: these are f,v
sounds made between the upper
incisors and the labiolingual
center to the posterior third of
lower lip.

• If the upper anterior teeth are set
too short (set too high) the v
sound will be more life an f.
• If they are set too long (set too far
long) f will sound more like v.

• If the teeth touch labial side of the
lower lip when these sounds are
made the upper teeth are too
forward.
• If the teeth are set too far back in
the mouth they will contact the
lingual side of the lower lip.

• Linguodental sounds: these are
made with the tip of the tongue
extending slightly between the
upper and lower teeth.
• If 3mm of the tongue tip is not
visible then the teeth are probably
too forward.

• Or there may be excessive
overlap that does not allow the
tongue to protrude.
• If more than 6mm of tongue
extends out the teeth are set too
lingually.

• Linguoalveolar sounds: are made
with the tip of the tongue with
most anterior part of the palate.
• Ex: t, d, s, z, l

• The important observation is
when these sounds are produced
in relation to the upper and lower
anterior teeth.
• The upper and lower incisor
should approach each other but
not touch.

The influence of maxillary central
incisor position in complete
dentures on /s/ sound production.
• (JPD 2001;85:485-95)

Acc to this study the change in the
inclination angle of the central
incisors in a range of -30deg to
+30deg caused poor execution
of /s/ sounds .
The labial angulation seemed to
have greater effect than the
palatal angulation.

The whistle and Swiss sound in
denture patients.
• JPD 1967;17(2):144-48.
The whistle sound is a familiar shrill
musical sound which is prolonged
sibilant or whistling s lisp.
The Swiss is a lateral lisp is the
substitution of sh and zh when
trying to say s sound.

• These are caused by the
abnormal emmision of air passing
over the tongue between the
upper and lower central incisors
while trying to produce sibiliant
sounds such as s and z.

• When the upper teeth are set too
far posteriorly , the space for the
tongue is reduced.
• When s sound is attempted there
is lack of space to allow narrow
stream of air to pass over the tip
of the tongue.

• The air is pressed past all the
anterior teeth in a wider stream
causing the s to resemble sh

Phonetics in complete
dentures
By – Dr. Vijayalaxmi.

Denture base
• One of the reasons for the loss of
tone are and incorrect articulation
of speech is the decrease in the
air volume and loss of tongue
space in the oral cavity resulting
from unduly thick denture base.

Most important is the denture base
covering the center of the palate.
Because for here no loss of the
tissue of the natural tissue has
occurred, and the base reduces
the tongue space and oral air
volume.

• Any thickening of the denture
base in the anterior region of the
hard palate cause incorrect
formation of palatolingual sounds
such as t, d.

• In case of s,c,z sounds, a slit like
channel is formed between the
tongue and the palate through
which the air hisses.
• If the artificial rugae are too
pronounced or the denture base
is too thick in this area the air
channel is blocked and noticeable
lisp may occur.

• The linguoalveolar components
such as Ch and j are also affected
if the denture base is too thick in
the region of rugae.

• Allen (1958) said that the
thickness in the palatal vault is
critical to speech in the anterior
section from canine to canine.
• He advised that the thickening the
area of the incisive papilla
facilitates proper enouciation .

• Palmer(1979) indicated that some
patients develop problem after
insertion of the CD because they
experience a loss of tactile
location skills.
• He recommended that non
anatomic papilla to be placed an
the denture posterior to the
incisive papilla to foster normal
speech. www.indiandentalacademy.com

Occlusal plane
• The labiodentals f and v are
produced through the narrow gap
between the lower lip and inicisal
edges of the upper anterior teeth.

• If the occlusal plane is too high
the correct positioning of the
lower lip may be difficult.
• If the plane is low the lip will
overlap the labial surface of the
upper teeth to a greater extent
and the sound might be affected.

Vertical dimension
• Ribner (1965)
• With a correctly trimmed maxillary
rim in place ,the mandibular rim is
trimmed so that 1mm of space
exists between the two when the
patient says /s/. If there is
insufficient vertical height, the
bilabials /p/, /b/ are affected.www.indiandentalacademy.com

• This is because these require the
lips to contact to check the air
stream.

Increased vertial dimension and
speech articulation errors.
Ronald J. Hammond (JPD1984;52(2)).
In his study he found that :
Most frequently misarticulated were
fricatives ie., /s/ and /sh/.

• The second most consistently
made error after increased VD
were affricatives /th/.
• Thirdly it was the plosives /t/.

Width of the dental arch.
• If the teeth are set in an arch
which is too narrow the tongue
will be cramped , thus affecting
the size of the air channel.

• This results in faulty articulation of
consonants t, d, s, n, k, c, where
the lateral margins of the tongue
make contact with the palatal
surface of the upper posterior
teeth.

• Hence the artificial teeth should
be placed in place previously
occupied by the natural teeth.

Postdam area.
• Errors in construction in this
region involve the vowels u, o and
the palatolingual consonants g
and k

• In this group the air stream is
checked by the base of the
tongue being raised upwards &
backwards to make contact with
soft palate.

• If the denture is thick in this area
or the posterior edge is not sloppy
it irritates the tongue thus
impending speech.

Use of phonetics in denture
construction.

Contouring the palatal vault
• This is done after processing of
the dentures.
• This was done according to the
tongue contact made by the
patient while speaking different
vowels and consonants.

• Contouring the palate:
1. The external surface of the palatal
section of the denture was
roughened and painted with
physiologic wax lingual to the
premolars and molars, in the midline,
and palatal to the anterior teeth.

2.The waxed up denture is placed
in the mouth along with the
mandibular denture and patient
was asked to read 10 stimulus
sentence having /ch/, /j/, sh/,
/zh/, /t/, /n/, /d/, /s/ ,/t/, /n/, /d/, /z/.

3. After completion of 10
sentences ,the maxillary denture
was removed from the mouth and
chilled in the cold water.
Freshly developed wax contour
was examined.

• A positive contact with wax was
smooth and shiny, while lack of
contact appeared dull and
irregular.

• Converting the wax contour into
acrylic resin.

The use of speech patterns as an
aid in prosthodontic reconstruction
• Edward J. Mehringer. JPD196313(5).
• He described denture
construction to conform with the
neuromuscular patterns for
speech.

• The wax rims are fabricated to
provide esthetically accepted lip
fullness and lip line.
• Then a tentative centric relation
record is made.

• The occlusal rims are contoured
to simulate the shape of the
natural teeth.
• The phonetic formats are
evaluated as to their conformity
with patients own neuromuscular
speech pattern.

• This is accomplished by having
patient count slowly and distinctly
from 3-10 three times.

1-1.5mm space for sibilants.

2-4mm space for nasal consonants.

5-10mm space for diphthongs.

• If the patient phonetic spaces
during counting procedures, the
centric occlusion is recorded and
transferred to the articulator.

Vertical dimension.
• Determination of vertical
dimensions by phonetics.
• Meyer M. Silverman.

• The occlusal rims are fabricated .
• They are trimmed to allow normal
space for the tongue .
• The palatal and lingual surfaces
of the teeth are trimmed to
simulate the width and shape of
the teeth.

• The patient is instructed to
pronounce the s sound and then
to speak or read a magazine.
• By sight or measuring the
approximate closest speaking
space is noted.
• A closest speaking space of 2mm
is decided arbitrarily.

• Why /s/ sound is used?
1.Most forward and most closed
position of the mandible during
speech is assumed when /s/
sounds are enounciated.
2./s/ sound is created when air is
forced through a 1-1.5mm gap
between the incisal edges of the
lower CI and coronal surfaces of
the upper CI.www.indiandentalacademy.com

Determining the class of occlusion.

Ribner (1965)
• Summarized the benefits of
utilizing phonetics exercises in
denture prescription by listing
following examples.

1.Posterior border of the denture
/ah/
2.Vertical dimension 1mm space
exists between the upper and
lower rim when patient says /s/.
3.Height of the anterior teeth and
thus occlusal plane /f/, /v/.

• Thickness in the anterior region of
the palate a lisp in /t/ indicates
excessive thickness.
• Thickness of postdam difficulty
in saying /g/ indicates excessive
thickness.

Summary.

Conclusion.

References.
• Prosthodontic treatment for edentulous
patients.12 ed.
• Clinical dental prosthetics 3 Edn
• Speech patterns of edentulous patients
JPD1973;29(1).
• A study of phonetic changes in edentulous
patients following complete denture
treatment. JPD 1972;27(2).

• Phonetic determinants of tooth placement
in complete dentures. Quint Int
1994;25:341-45.
• The speaking method of determining
vertical relation. JPD 1953;3(2).
• Palatal pressures of the tongue in
phonetics and deglutation. JPD1957;7(3).

• Controlling anamolies of vertical
dimension. JPD 1976;36(2).
• A simple method of adding palatal rugae
to complete dentures. JPD1999;81:237-9.
• The whistle and swiss sound in denture
patients. JPD 1967;17(2).

• Can dental prostheses influence vocal
parameters. JPD 1999.81:57-85.
• The influence of maxillary central incisors
in complete dentures in /s/ sound
production. JPD2001;85:485-95.

• Phonetic considerations of chromium
cobalt alloy plates for complete dentures.
JPD 1975;34(6).
Analysis of speech in prosthodontics. JPD
1974;31(6).
The whistle and swiss sound in denture
patients. JPD 1967;17(2).

• Effect of new dentures on interocclusal
distance during speech. JPD 2003;
16:533-37.

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