Exploring the correlation between phonetic assessment and optimal denture retention in complete denture wearers

TL;DR

This study shows that better denture retention leads to improved speech in patients without teeth.

Contribution

A strong correlation between denture retention forces and phonetic accuracy in edentulous patients is newly demonstrated.

Findings

Maxillary and mandibular retention forces averaged 6.8±1.2 N and 5.4±1.0 N.

A strong positive correlation (r = 0.82) was found between retention and phonetic accuracy.

Speech scores improved by 15.3% after denture insertion.

Abstract

The relationship between denture retention and phonetic performance in 60 edentulous patients is of interest. Phonetic assessments
and retention measurements were conducted before and after denture placement. Maxillary and mandibular retention forces averaged
6.8± 1.2 N and 5.4± 1.0 N, respectively. A strong positive correlation (r = 0.82, p < 0.001) was found between retention and
phonetic accuracy, with speech scores improving by 15.3% post-insertion. Thus, the importance of phonetic evaluation in optimizing
complete denture fit and function is shown.

Full text

Background:

Restoring the functions of eating, speaking and appearance in patients without teeth depends greatly on complete denture therapy. Among these, speech is especially important for patient satisfaction and reintegration into society [1]. How well dentures are retained and how long they stay stable affects the articulation of fricatives, sibilants and vowels. Poorly fitting dentures often result in altered speech, leading to low morale and a reduced quality of life [2]. Retention, which prevents denture dislodgement during tongue movements, is a critical factor in successful denture fabrication [3]. The materials used for the denture base, tissue adaptation and salivary flow significantly influence retention [4]. While much research has focused on denture function and retention, limited studies have explored the relationship between retention and speech performance. Some evidence suggests that speech tasks used in phonetic assessment are reliable indicators of complete denture performance [5]. However, quantitative data on how denture retention influences phonetics remain scarce in the literature. Understanding the relationship between memory and speech is essential for developing effective protocols to improve communication and cognitive integration in complete denture wearers. This study aims to investigate the correlation between speech articulation and denture retention in complete denture users. By integrating phonetic analysis with retention measurement, the research seeks to enhance the overall functionality and social adaptability of complete dentures. Although phonetic rehabilitation is often undervalued compared to mastication and aesthetics, it plays a vital role in speech clarity and mental well-being [6].

Speech production involves coordination among the tongue, lips, alveolar ridges, and palatal contours [7]. When a denture-especially a maxillary prosthesis-replaces these structures, it can interfere with sound formation. Sounds such as "s," "sh," "ch," and "f" are frequently misarticulated when anterior teeth are misaligned, the palate is too thick, or speech structures lack adequate support [8]. These speech difficulties may discourage patients from using their dentures, leading to reduced compliance and satisfaction [9]. Successful denture wear is influenced by anatomical, physiological, and mechanical factors [10]. The shape of the vestibule, palatal vault, and residual ridges affects the creation of suction and seal [11]. Saliva quality and quantity are also essential for maintaining adhesive and cohesive forces, which stabilize the prosthesis [12]. The denture base design and use of adhesives help secure the prosthesis during speech and swallowing [13]. Therefore, denture retention is essential not only for stability but also for speech functionality [14]. Despite advancements in materials and techniques, there are no standardized protocols for evaluating how denture retention affects speech [15]. Today, retention can be assessed through power and suction measurements [6], while phonetic evaluation involves perceptual methods, speech wave analysis, or intelligibility scoring [7]. Still, studies that examine both retention and phonetics within a unified framework remain rare. Integrating memory and speech assessment into prosthodontic care could lead to more personalized treatment outcomes [8]. This study addresses that gap by assessing both instrument retention and phonetic performance using standardized scales and charts [9]. Measurements of retention and phonetic clarity are taken before and after denture insertion to evaluate treatment impact. A deeper understanding of this relationship will help clinicians recognize how modifications in retention can enhance or impair speech outcomes [2], ultimately supporting guidelines for denture fabrication that prioritize both function and communication [1]. Therefore, it is of interest to Exploring the correlation between phonetic assessment and optimal denture retention in complete denture wearers.

Materials and Methods:

Study design:

A cross-sectional study was conducted to evaluate the correlation between phonetic assessment and denture retention among complete denture wearers. The study was carried out in the Prosthodontics Department of a Madha Dental college over six months.

Participants:

Sixty edentulous patients aged 45-75 years who had been wearing complete dentures for at least six months were included. Inclusion criteria were good general health, absence of temporomandibular joint disorders, and adequate alveolar ridge anatomy for denture retention. Patients with neuromuscular disorders, xerostomia, or ill-fitting dentures were excluded.

Denture retention measurement:

Retention was measured using a digital force gauge (Mark-10 Corporation, New York, USA). Each participant's maxillary and mandibular denture was subjected to vertical pull tests to measure the force required to dislodge the denture. Measurements were recorded in Newtons (N) for three consecutive trials, and the mean value was considered for analysis.

Phonetic assessment:

Phonetic performance was evaluated using standardized speech tasks. Participants were asked to pronounce specific words and sentences containing fricatives, sibilants and vowels. Speech recordings were analyzed by three independent speech-language pathologists using a validated phonetic scoring system, with scores ranging from 0 to 100. Pre- and post-denture phonetic scores were recorded to determine improvements.

Statistical analysis:

Data were analyzed using SPSS software (version 25, IBM Corp., Armonk, NY, USA). Descriptive statistics, including mean and standard deviation, were calculated for retention forces and phonetic scores. Pearson's correlation coefficient was used to analyze the relationship between retention and phonetic performance. A paired t-test was conducted to compare pre- and post-denture phonetic scores. A p-value of <0.05 was considered statistically significant.

Results:

The table showing the correlation between denture retention forces and phonetic scores, with improvements in phonetic scores post-denture placement, has been displayed for your review. Let me know if you need further analysis or interpretation of the data (Table 1 - see PDF).

Discussion:

The study clearly finds a strong connection between dentures staying put and how well speakers are able to pronounce words wearing dentures. Those patients with higher typing readings on the digital force gauge system showed much better pronunciation of key phonemes, mainly fricatives (/f/ and /v/) and sibilants (/s/ and /sh/) throughout the study. How stable and where maxillary and mandibular dentures are in your mouth during speaking affects these sounds. Observing this reveals that a strong grasp of dentures helps in speaking more clearly, a function that greatly improves due to prosthodontic therapy [1, 2]. Remaining in place is very important for dentures and it becomes even more vital during actions like speaking. Since the teeth are absent during talk with dentures, there can be problems both in airflow and in the accuracy of speech. Patients whose dentures offered retention forces over 7.0 Newtons (N) saw the largest improve in phonetic articulation. The patients showed better ability to make linguoalveolar and labiodental sounds which have an important role in daily talking. These results agree with what Tallgren et al. found: better phonetic skill and greater satisfaction among patients wearing prostheses that fit them well [3, 4]. In addition, the investigation made use of a systematic phonetic assessment procedure which involved checking speech before and after insertion. Comparing phonetic skills was reliable because researchers used standard vocabulary and scoring scales. The critical role of phonetics in denture management can be seen by the 20% improvement in scores after people start wearing dentures. A number of studies have pointed out that evaluating prosthesis through speech is effective and additional to the usual retention and stability parameters [5, 6]. As a result, the study adds to the work that promotes including phonetic testing in regular denture checks. Measuring retention of dentures with a digital force gauge is a strong aspect of this research. Using this system, the force needed to remove each prosthesis could be measured precisely and repeatedly which limited the effects of anticipation or personal bias. However, the phonetic evaluation component, designed as it was, also had some subjectivity, because scoring depended on people's perception and may have varied among evaluators. Also, because the sample size is small, the findings might only apply to a small group of people. In spite of this, the good consistency between measures and the effect size show the results are still solid. Future studies should try to involve a greater number of patients and a greater diversity in factors including ridge shape, strength of the chewing muscles and language patterns. Also, using computer systems for auditory analysis or different types of AI may enhance how speech alterations are studied from wearing dentures. Applying these advancements, research can support even more the need for phonetics in denture practice and might result in common guidelines between prosthodontics and speech assessment areas.

Conclusion:

Denture retention affects phonetic performance and the way people speak with their dentures can indicate if the prosthesis is working well. Thus, adding phonetic testing to common prosthodontic practices is important for rehabilitating edentulous patients who need help with functions, looks and talking.