Speech changes in patients with a full rehabilitation for severe tooth wear, a first evaluation study

Bernadette A.M.M Sterenborg,Marie-Charlotte D N J M Huysmans,Bas A.C Loomans,Simone Knuijt,Stanimira I Kalaykova

doi:10.1007/s00784-019-03174-7

Bernadette A.M.M Sterenborg, Marie-Charlotte D N J M Huysmans + Show 3 more

Open Access

https://doi.org/10.1007/s00784-019-03174-7

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Abstract

ObjectiveThe aim of this study was to evaluate changes in speech characteristics and self-perceived quality of speech in tooth wear patients, after occlusal rehabilitation.Materials and methodsPatients with tooth wear were included in this study after informed consent. The amount of tooth wear was scored with Tooth Wear Evaluation System (TWES). To assess the perspective of the patient, the Dutch Speech Handicap Index was used (SHI). Acoustic analysis was performed to evaluate changes with the use of voice recordings. These were made before treatment, T0; directly after treatment, T1; 1 month after treatment, T2. With the use of PRAAT software, the spectral characteristic centre of gravity (COG) was evaluated for the sounds /s/, /f/, /v/, /d/, /t/, /m/.ResultsRecordings of 17 patients (14 men, 3 women, mean age 41.2 ± 10.4 years) were included. SHI scores did not change significantly between T0 and T2 (p = 0.054). A multiple regression model showed that for all sounds the intercept was negative, but statistically significant only for /s/ and /f/ between T0 and T1. The effect of the initial change (between T0 and T1) on the change between T1 and T2 was clearly negative for all sounds (p < 0.001), showing a rebound effect ranging between 29 and 68% of the initial change.ConclusionTooth wear patients perceive improvement in speech function after treatment.Clinical significanceClinicians may explain to patients that speech is likely to alter for a short period due to treatment but that there will be a good adaption to the new situation.

Highlights

Tooth wear and its management present new challenges in dentistry [1]
The loss of occlusal tooth substance in tooth wear may result in a reduced vertical dimension of occlusion (VDO) and altered shape of teeth
The size of the rebound varied between 29 and 68% of the initial change in centre of gravity (COG) (Table 4). This is a first evaluation study to investigate the effect of a full occlusal rehabilitation of tooth wear with increase in VDO on speech characteristics

Summary

Introduction

Tooth wear and its management present new challenges in dentistry [1]. Tooth wear is increasingly common, especially among children and adolescents [2, 3]. Tooth abnormalities or missing teeth are most likely to have an effect on articulation. The teeth are, for example, involved in the production of /f/ and /v/ and help to produce the frication in sounds like /s/ and /z/ as the breath stream passes over the lower edges of the incisor teeth [9]. Speech sounds which are thought to be most frequently misarticulated after an increase in VDO include /s/ and /sh/, Clin Oral Invest (2020) 24:3061–3067 sounds which are produced when exhaled air enters the mouth and is guided by the tongue [10]. Previous studies have investigated the effect of tooth wear on oral functions [11,12,13], there is to our knowledge little to no research about the effect on speech of a full rehabilitation of the worn dentition with an increase in VDO

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