PHONETICS IN COMPLETE

DENTURE

Dr. JASMINA TABEEN

BHAT
MDS 1ST YEAR
 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. Conclusion
12. List of references
 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.
 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’.
• 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.
 MECHANISM OF SPEECH PRODUCTION
Normal speech depends on proper functioning of 5 essential MECHANISMS

The motor( lungs, associated muscle that supply the air).

The vibrator ( vocal cord that give pitch to the tone).

r
The resonator consisting of the lips tongue, soft palate, hard palate and teeth,
which form musculoskeletal valves to obstruct the passage of air, breaking up
the tones and producing the individual speech sounds
The enunciators or articulators( lip, tongue, palate and teeth)

The initiator Consisting of the motor speech area of the brain and the nerve
pathways which convey the motor speech impulses to the speech organs.
Trick is
PRAN

Ref:- Chierici, Lawson; Clinical speech consideration in prosthodontics. J Prosthet dent;1973;29;1:29-39

 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

 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

 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

 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

 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: a,e,i,o,u. they are voiced sounds,

• 2.CONSONANTS: may be either voiced or breathed.

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.

Zarb- Bolender:Speech consideration with complete dentures ;Prosthodontic treatment For Edentulous Patients
 CLASSIFICATION OF SPEECH
• According to Boucher

• Vowels.
• Consonants.
— Plosives/stops
— Fricatives
— Affricatives
— Nasal
— Liquid
— Glides

Zarb- Bolender:Speech consideration with complete dentures ;Prosthodontic treatment For Edentulous Patients
 ACCORDING TO SONORITY

STRUDS:- SONANTS
1. Voiceless sounds 1. Voiced sound
2. Produced by the separation of 2. Produced by vibration of
vocal cords a portion of the vocal cords
Eg:- s,h,sh,zh 3. Oral resonators modify
the airstream
4. All vowels and vowel
like sounds

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

 CLASSIFICATION OF
CONSONANTS:
1. 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
 • 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.

Zarb- Bolender:Speech consideration with complete dentures ;Prosthodontic treatment For

Edentulous Patients
 • 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)

Zarb- Bolender:Speech consideration with complete dentures ;Prosthodontic treatment For Edentulous Patients
 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.
(5) Linguoalveolar

Robert Rothman; Phonetic consideration in denture prosthesis, J Prosthet Dent;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 from 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 sh (Lisping)

Robert Rothman; Phonetic consideration in denture prosthesis, J Prosthet Dent;1961;11:214-223)

 The essential factor in the production of a correct
s is the proper grooving of tongue.As the depth of
this groove is decreased, s is soft’ened toward sh,
and as the groove is further decreased, toward th
as a lisp. Excessive thickness of the denture base
in the anterior part of the palate is often the
cause of lisping. Where the groove of the tongue
is too deep, the patient may whistle when making
the sound s.
 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 releasing the air
in a puff
 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)

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

• 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)

 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)

 LINGUOALVEOLAR SOUNDS
T, D, S, Z, V 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 in denture

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.

Robert Rothman; Phonetic consideration in denture prosthesis, J Prosthet Dent;1961;11:214-223)

 CLINICAL SIGNIFICANCE
Upper and lower incisors should approach end to
end but not touch.
Failure indicates a possible error .
 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)

 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)
 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)

 CLINICAL SIGNIFICANCE

Affected by the
anteroposterior
positioning of the teeth

and the thickness of the labial

flange

Ref:-Robert Rothman; Phonetic consideration in denture prosthesis, J Prosthet Dent;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
 S-SOUND AND THEIR PROSTHODONTIC
LINICAL SIGNIFICANCE
COSIDERATIONS

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
 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

 Borders- should not be

overextended.
 Palate- no loss of natural
tissue
Base reduces tongue space .
Palatolinguals are affects T, D
S, C , Z, R , L

Ref:-Fenn, Clinical dental prosthetics, 3rd edition pg 138

 VERTICAL DIMENSION
• Bilabials are mostly affected P B and M , M- passive
lip contact

• If both rims touch prematurely it indicates excessive

vertical dimension.

• In try in stage teeth clicking will be heard.

• C, S, Z- Teeth come very close but don’t contact . But
in case of increased vertical dimension, clicking of
teeth will occur.

Ref:-Fenn, clinical dental prosthetics, 3rd edition pg 139

 OCCLUSAL PLANE

• Labiodental sounds F and

V are affected.
• If teeth are low
v will sound like f
• If teeth are too high
f will sound like v
Upper anterior teeth are too
long. During the pronunciation
of f, they will contact the lower
lip in a position similar to v, and
the sounds may sound alike

Ref:-Fenn, clinical dental prosthetics, 3rd edition pg 138

 ANTERIORPOSTERIOR
POSITIONING OF TEETH
F and V sounds are hampered.

Bilabial sounds (P,B) , S,C ,Z are

also affected ,

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.
T will sound like v is the anterior
teeth are placed too lingually.

Ref:-Fenn, Clinical Dental Prosthetics, 3rd edition pg 138

 BILABIALS
P and B
If the anterior teeth are placed too far back some
effect may be noticed on the quality of the
palatolinguals, S, G , and Z, in which the tip of
the tongue makes slight contact with the upper
and lower incisors- this will result in a lisp due to
the tongue making contact with the teeth
prematurely
 POST DAM AREA
• Palatolingual consonants (K, NG and G)and
vowels (I and e) are affectes.
• Thick post dam areas will irritate the dorsum
of the tongue
• Patient feels nausea like effect while
speaking

• If the denture is inadequate, it will unseat

during the formation of explosives
• This area is very important in singers
who wear complete denture

Ref:-Fenn, Clinical Dental Prosthetics, 3rd edition pg 138

 WITDH OF DENTAL ARCH

• If teeth are set into an

arch that is too narrow
the tongue will be
cramped

• Consonants like T, D,
S,M,N. K and S are
affected

Ref:-Fenn, Clinical Dental Prosthetics, 3rd edition pg 138

 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

 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 pg 132

 TEST 2: TEST OF SPECIFIC SPEECH SOUNDS

• This is best accomplished by having the patient say 6-8

words containing the sound and then combining these
words into a sentence.

John. Sharry. Complete denture Prosthodontics 3rd edition; Phonetics pg 132

S.Sh Six, sixty, ships, sailed Mississippi, Sixty six ships sailed Mississippi.
sure .sign, sun, shine Sure sign of sun shine

T.D.N.L Locator, located, tornado, near, Locator located tornado near

Toledo Toledo

Ch.J Joe, Joyce, joined, George, Joe and Joyce joined George
Charles, church and Charles at church

K Committee, convented, political, The committee convented at

convention, Connecticut the political convention in
connecticut.

F,V Vivacious, Vivian, lived, five, fifty, Vivacious Vivian lived at five
five, fifth, avenue fifty-five fifth avenue
 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

 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
 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 Patient
 PALATOGRAPHY
• a group of techniques to record contact between the tongue
and the roof the mouth to get articulatoryrecords for the
production of speech sounds.
palatograms are the areas of tongue contact for a given sound displayed
on an artificial palate through a medium of talcum powder
 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
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
 CONCLUSION
 THE PROPER KNOWLEDGE OF SPEECH
PRODUCTION AND PHONETIC PARAMETERS
WILL ENABLE A CLINICIAN IN FABRICATION OF
DENTURES WITH GOOD PHONETIC
CAPABILITIES.
 ACHIEVEMENT OF THE OPTIMUM PHONETIC
POTENTIAL IS POSSIBLE BY PROVIDING
CORRELATION BETWEEN MECHANICS,
ESTHETICS AND PHONETICS.
 REFERENCES
1. John. Sharry. Complete denture Prosthodontics 3 rd
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.
 Robert Rothman; Phonetic consideration in
denture prosthesis, J Prosthet
Dent;1961;11:214-223).
 Meyer M Silverman :The speaking method in
measuring vertical dimension; J prosthet dent
1953;3:193-199