Speech Consideration in CD

Introduction
Phonetics is a branch of linguistics that deals with the sounds of speech and their production, combination, description, and representation by written symbols.

Speech is vocalised form of human communication describing thoughts, feelings, or perceptions by the articulation of words.

According to Boucher, speech is classified as;

• vowels
• consonants

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 andanterior most part of palate

(5) Linguopalatal and Linguovelar sounds,truly palatal sounds

A. 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.

Clinical significance:

• Used to asses the correct interarch space
• Correct labiolingual positioning of the anterior teeth
• Labial fullness of the rims can also be checked.

B. 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.

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.

C. 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.
• 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.

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.

D. 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.
• 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

E. 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.
• 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).
• 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. It is around 1.5mm.

Clinical Significance:

• to check the proper placement of the anterior teeth.
• to check the thickness of the denture base
• to establish and check a proper vertical dimension of occlusion.

F. Palatolingual Sounds

• 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.

Clinical Significance:

• If the posterior borders are over extended or if there is no tissue contact, "k" becomes "ch" sound.

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