English-Speaking Dentures

Among dentists whose patients had trouble enunciating "s," or "t," or "th," there used to be a standard joke: "What we need is English-speaking dentures." In the March Journal of the American Dental Association. Dentist Howard E. Kessler of Cleveland reports that the jokesters were right. It is much harder to make dentures for English-speaking patients than for those with another mother tongue.

Cleveland, with a big foreign-born population, has given Dr. Kessler ample opportunity to see the differences. The vast majority of patients whose native language is not English, he finds, form the sounds of n, l, t, d, s and z with the tip of the tongue placed near to or against the back of the upper front teeth. No matter what a dentist does in fitting new plates, he is unlikely to interfere with this process. But patients with English as their native language hold the tongue higher -- against the alveolar ridge just behind the base of the upper front teeth -- to make the same sounds. And that is precisely where the average dentist making an upper plate puts part of the denture base. Result: the English-language patient's tongue hits a foreign object right behind the alveolar ridge and doesn't know what to make of it. This causes especially severe trouble when the base is too thick.

Dr. Kessler's prescription: dentists fitting upper plates should make tape recordings of their patients' speech before, during and after fitting. And they should be sure to leave plenty of room for the English-speaking tongue to move.

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