April 02, 2021
Cosmetic dentistry is a branch of dentistry that focuses on aesthetics and at the same time retains the functions of the oral cavity. In order to produce an aesthetic smile, it is important that the teeth, lips and the facial musculature are in harmony with each other. When the front teeth are decayed, eroded or abraded, they can be restored with the help of dental crowns or dental veneers.
It is important to understand the difference between crowns and veneers. Crowns are placed when the tooth structure is severely compromised. Following a root canal procedure, placement of crowns is necessary so that the tooth retains its strength. Veneers on the other hand are for purely aesthetic purposes. The main difference between crowns and veneers is that crowns cover all surfaces of the teeth, including the back surfaces of the front teeth. Veneers however cover only the front surface of the teeth and extend till the edges of the teeth.
Once a prosthesis like veneer or crown is placed, there is a chance that the patient's speech becomes impaired. Our speech is a result of interactions between the tongue, lips, palate and teeth. The tongue has muscle memory. This means it knows in order to produce a certain sound, it needs to brush against another organ like the teeth or palate. When this mechanism is compromised by the introduction of a foreign material like crowns or veneers, the speech becomes impaired. One such impairment is called lisp.
A lisp is a speech defect caused when the patient has difficulty in pronouncing sounds like S, L, H, Th, Sh, Ch, G, R, F, W. Lisp can be caused due to many reasons and is commonly seen in children below 5 years of age. It becomes self-corrected as they begin to speak normally with progressing age. Apart from a habit of tongue thrusting, swallowing or digit biting, lisps can happen because of the placement of crowns or veneers. Crowns are more likely to be a cause of lisp compared to veneers as they cover that part of the tooth that touches the tongue during speech. Since veneers only cover the front surface, it is highly unlikely that the lisp is because of them as the tongue never moves that far ahead during speech.
The only possible way a lisp occurs because of veneers is when the veneers are ill-fitting or are not dimensionally stable. Interdental lisp occurs when a person tries to speak Sh and Z sounds but ends up pronouncing Th. If the veneers are not accurately placed at the edges of the tooth, an interdental lisp can occur. However, the chances of such a lisp occurring is very rare. Other forms of lisp are bilateral lisp, dentalized lisp and palatal lisp. Bilateral lisp is due to improper positioning of the tongue, whereas dentalized and palatal lisp is when there is an improper contact of the tongue with the teeth and the palate. Veneers do not cause these three types of lisps.
Lisp caused by veneers can be corrected on its own once the tongue accommodates to the new setting. However, when the lisp persists for a longer period of time, a cosmetic dentist should be consulted who can evaluate and reshape the veneer as needed. Usually, it is the thickness of the veneer that is trimmed down. At times the veneers can be longer than the actual length of the tooth and may also be responsible for the lisp. If there is no problem associated with the veneer, the dentist might recommend you to go to a speech therapist if the lisp persists for more than two weeks. If a lisp doesn't get corrected within six weeks of veneer placement, it should be corrected as soon as possible else it might then turn into a habit.
Dental veneers made of porcelain are of the highest quality and are extremely durable. They rarely pose any problems to speech. If at all there is a speech defect, it usually gets self-corrected in a few days. It is important for the dentist to educate the patient about the difference between crowns and veneers and tell them the reason behind their lisp. A lisp can often impair the social life of many and hence it is important to reassure the patient that the condition can be corrected with the veneers placed in the right areas.