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Speech disorders in wearers of different modalities of oral rehabilitation prosthesis and its relationship to muscle aspects

Grant number: 08/10280-2
Support Opportunities:Scholarships in Brazil - Scientific Initiation
Effective date (Start): March 01, 2009
Effective date (End): December 31, 2009
Field of knowledge:Health Sciences - Speech Therapy
Principal Investigator:Katia Flores Genaro
Grantee:Flávia Ferlin
Host Institution: Faculdade de Odontologia de Bauru (FOB). Universidade de São Paulo (USP). Bauru , SP, Brazil


For the motor and acoustic phenomenon to occur without any alterations there must be an integrity and harmony of the structures involved in speech production. The teeth are articuladors which participate in the process by determining some sound production. Space relations between the upper/superior and lower/inferior teeth, as well as relations with the tongue and lips are determining factors in speech production. It fits the Dentistry to act in the replacement of missing teeth and toothless in order to return the aesthetics and function and for theses replacements there are the fixed or removable partial prosthesis and the total prosthesis. In some cases, the prosthesis causes a speech disorder due to the bad functional adaptation, yet if the prosthesis is well made, the speech disorder will be brief due to the oral structures process of adaptation, especially of the tongue. Considering that elderly citizens already possess neuromuscular alterations, which can modify the speech production, and many lose dental elements being rehabilitated to different prosthetic procedures, the objective of this study is to relate the existence of elderly speech disorders, users of different types of dental prosthesis, with mobility and tonus alterations of the oral structures, comparing to a control group formed by dentate. This study will examine the sample of a research project previously approved by the Committee of Ethics in Research, which a dentist surgeon conducted a dental evaluation to verify the condition of prosthesis stability. Thirty (30) elderly over the age of 60, of both genders, will be studied. There are 10 elderly, who has natural teething, at least up to the second pre molar, there are 10 toothless, users of total prosthetic upper and lower mucosa-supported, and 10 toothless rehabilitated with prosthesis mucosa-supported in the superior arc and implant-supported in the inferior arc. Samples of spontaneous speech, repetition of words and phrases, and counting of numbers were recorded by a camera (Panasonic Palmcorder VJ98), then digitalized and recorded on DVD-R. Five speech therapists analyzed these samples. From this analysis there are cases with and without speech disorders, as well as the alterations frequency and the type presented, this way it will be calculated the Percentage of Correct Consonants (PCC). Moreover, the orofacial miofunctional evaluation by a non-verbal motor activity was performed including the lips, tongue, cheeks and jaw mobility. They were filmed and will be analyzed by two judges to verify the ability to perform the movements. Also verified in the miofunctional evaluation was the state of muscle contraction (tonus) of the lips, cheeks and tongue, classifying as reduced or increased. It will be examined the incident of the different types speech disorders and which phonemes are affected, besides the association between the presence speech disorder with the mobility and tonus alteration of the evaluated structures.

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