Page 146 - Impact of implant retained overdenture treatment and speech, oromyofunction, social participation and quality of life.

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Chapter 6
different institutes or enrollment of patients in the study for several consecutive years would be needed. To make this possible, it is extra important to have a broad and collaborating inter-professional network to provide the best research diagnostics and treatment for the wellbeing of the patient. Another unresolved question is how long patients need to adapt to their new oral situation and what characteristics could influence this adaptation time. This information could help in the optimalisation of the design of future research on this topic.
Clinical guidelines
People are after finalization of the overdenture treatment very satisfied with their speech and oral situation, despite persisting speech problems. Therefore it is very important to ask patients opinion about their speech and oral situation and the impact of it on their quality of life before pointing out possible problems you notice as a professional. It is important to inform patients before treatment about the possible difficulties they may encounter during treatment, especially in professional speakers (e.g. professors, ministers, news readers...). To avoid speech problems it is necessary to check if the retention of de denture is sufficient and if the coverage of the palate (in maxillary rehabilitation) isn’t obstructing good speech production. The shape of the denture should get as close as possible to the shape of a normal oral cave. To manage that, it is very important that the surgeon and the dentist collaborate to provide the least possible harm for the patient. Proper implant placement to ensure that the attachment system can be placed within the normal denture size is essential and may overcome many phonetic issues.
When you are, as a dentist, convinced of the functionality and size of the denture and the patient still complaints about speech problems, don’t get tempted to correct the denture too often. It is important that the patients get used to speaking with their denture. Especially elderly patients, who often have reduced numbers of social contact, and lack speaking a lot, need to be encouraged to ‘practice’ first for some weeks before demanding correction of the denture. The use of an integrated, multidisciplinary view on a patients’ health and health consequences or disability (e.g. by using the ICF model) is helpful and nowadays required to provide the best standard of care in dental practice and beyond.