The use of speech patterns as an aid in prosthodontic reconstruction

Abstract

Speech patterns are invaluable as an aid in denture fabrication. The restoration of the oral functions is one of the major objectives in the science of prosthodontics. Therefore, a comprehension of the muscle dynamics, motor innervation, memory factors, and sensory feedback, all of which make up the neuromuscular patterns is a requirement. Since the neuromuscular patterns for speech are the least affected by the removal of the teeth, they can be incorporated, under actual functional conditions, into other record making procedures. The reason is that during speech the sensory feedback, which consists of the combined kinesthetic senses of the facial musculature, the maxillomandibular musculature, and the temporomandibular joints, is little affected by the loss of the teeth. On the other hand, in the functions of mastication and salivary deglutition, occlusion is a major component of the kinesthetic sense. Consequently, the sensory feedback emanating from the periodontium is destroyed with the loss of the teeth. Hence, the neuromuscular patterns are made inoperative. When the artificial teeth are so arranged that their position is different than that of the natural teeth, they are foreign and antagonistic to the speech patterns and to the other functional patterns as well. They become obstacles in the way of functional movements. Tongue movements are impeded and speech sounds are obscured when the normal tongue space is encroached upon. Similarly, invasion of the normal interocclusal distance causes interceptive occlusal contacts in speech, in the swallowing threshold for salivary deglutition, and in mastication. Interference with functional movements causes the dentures to be buffeted about, thereby damaging, breaking down, and altering the underlying foundations. 7 For these reasons, the integration of the artificial teeth to the functional movements takes precedence over the fit of the denture base to its foundation. When the teeth do not conform to these functional patterns, the fit of the base cannot endure. Impression making, the recording of jaw relations, and the fabrication of dentures are basically technical procedures which may be adequate for the restoration of missing teeth, but quite inadequate for the restoration of the oral functions. To disregard the functional movements is to but half treat the edentulous patient, and that is not enough.