Page 46 - Impact of implant retained overdenture treatment and speech, oromyofunction, social participation and quality of life.

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Chapter 2
interaction is disturbed and articulation in speech production is affected. The most frequently heard complaint in dental rehabilitation is the occurrence of /s/ sound disorders.3,12–18 The /s/ sound is produced by forcing air through a narrow tunnel between the tongue and the palate where the airflow becomes turbulent and generates the /s/ sound at the anterior end of this constriction.19 The tongue makes contact with the alveolar ridge of the upper jaw in the (pre) molar region, making the specific /s/ sound. Most people lift the apex of the tongue in the direction of the upper frontal teeth but others position their tongue against the lower frontal teeth. The angle of the frontal teeth and the width of the prosthesis are especially important factors, influencing this sound.20–23 Overall, the slightest alteration in the oral cavity can affect articulation, especially directly after treatment. In general, research focused on the influence of rehabilitation in the upper jaw on articulation 12–16, as most speech sounds are formed by making an upper movement with the tongue against or close to the teeth, alveolar ridge, palate or uvula.11 However, alterations in the lower jaw, especially in fully edentulous people, may also cause articulation disorders and problems with oromyofunctional behavior. Previous studies encountered distortions of the /s/, /t/ and /d/, others encountered no speech distortions in this population.12,17,24
In order to make functional movements, the oral and facial muscles need to move together in a harmonious way.11 Due to organic reasons such as dental rehabilitation, this balance can be disturbed. This can result in problems pronouncing speech sounds and oromyofunctional behavior. Until now there are no studies reporting difficulties in oromyofunctional behavior in mandibular rehabilitation.12,24
The impact of dental treatment on OHRQoL has been well documented in literature.25 Overall, people are very satisfied and report minimal impact on OHRQoL after their treatment. 9,15,16,18,21,25,26 Nonetheless, there is a difference in impact on OHRQoL depending on the initial problem as well as with the kind of prosthetic rehabilitation that has been performed. Patients are seemingly more satisfied with the treatment of a dental implant when rehabilitated with single crowns compared to fixed dentures or removable implant retained overdentures.15 On the other hand, the effect of one missing tooth on OHRQoL is minimal whereas it is overwhelming jeopardized in totally edentulous patients wearing removable prostheses. Compared to fixed dental prostheses