How do we Manage Speech Complications with the “T-H” sounds?

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The TH sound is all these sounds we do every day unconsciously. And that’s tongue to teeth again. The TH sound is formed when the tip of the tongue passes through the anterior teeth having light contact with the maxillary teeth. And this is something that pertains to vertical dimension also. And freeway space and vertical dimension in freeway space are intertwined to a point. And what happens if there is not enough freeway space is the TH sound is restricted because the tongue doesn’t have room to move. And that means that the anterior teeth are too high or too low, or the VDO is open too much, and we need to change that. So one of those three things are usually the culprit. There should be a minimum of two to three millimeters of maximal interposition force freeway space with these patients at rest. And if you don’t have that and there are speech problems, then you know that that’s something that needs to be looked at and corrected simply by grinding or adding.

If you suspect that the teeth are set too low, restrict restricting freeway space, too much vertical dimension, just reduce the plane, whether it’s the upper or lower, and you’ll have to check to see which one is the prudent one to fix, or do you need to reduce anterior teeth, lower or upper? Any of those things are possible to improve the TH sound. And 33 is a good exercise for the patient to say until we get this problem solved. If the teeth are set too high with not enough anterior tooth display, then you can add, just add composite to the length and have the patient say, 33, 33, 33. You might have to do this a few times with your composite until the patient can say that sound properly. And by adding to that length, there might have to be other adjustments made to the opposing, whether it be moving lower anterior teeth or vertical dimension. Any of those things are possible. So with every action, when you’re trying to solve these sound problems, there’s a reaction. So you fix one thing, it may affect another, and all those things need to be taken into consideration as you go through this process of correcting speech.


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