I developed an issue with my speech about a week after getting 4 top front crowns - initially I had no issues whatsoever and spoke normally. However now when I say any words that contain the letter 's' I can hear a hiss / whistle. Also with the letter 't'. I feel that my crowns are a littke too long - could this be causing this issue? Why has this happened now and not immediately after having the crowns fitted? I'm worried I may need new crowns fitted - please help :(
Speech Problems After 4 Top Front Crowns?
Doctor Answers (4)
Speech can be affected after new crowns, but can be corrected.
New crowns on upper front teeth can alter pronunciation of some sounds, especially `s' sounds. Often times your mouth and tongue find ways to work with newly confined spaces. However, if it’s a major issue, your treating dentist should be able to re-contour the back side of the crowns (if there is room for adjustments) and/or length as necessary. Please talk to your dentist and have him take a look at the problem.
Speech Affected by New Crowns
New restorations on upper or lower front teeth can cause speech changes especially with "s" sounds if the amount of clearance between the upper and lower front teeth is narrowed too much. Your situation is normally alleviated very quickly by relieving the back of the crowns slightly. Saying some words beginning with S and the use of marking paper will usually show what spots are too thick and creating the problems. Excessive length can cause speech issues as well.
Long teeth/crowns on upper front teeth can cause a lisp
This is a classic case of crown edges too long. I'm assuming you had temporary crowns on while the real ones were being made. The temporaries should have been a test for this. Once the temporaries were of acceptable length for your speech and esthetics, then this information needs to be given to the lab tech who is making the crowns so he/she can make them the same length.
Go back and get them gradually adjusted until your lisp goes away. It may be as little as 1/4 or 1/2 millimiter adjustment.
Note that if the teeth look too short after adjustment, then this was poor treatment planning and the gums need to be moved up with surgery or braces so that they can be lengthened without causing a lisp again.
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Careful planning eliminates most problems
Sorry about your speech issue. You may adapt to the new position of the "Incisal Edge" in a few more weeks. If not, a slight alteration in the length or position of the incisal edge may solve the issue. The best practice is to test the speech and esthetics with precisely made prototypes (temporaries) for a few weeks or longer to verify the position and then provide that position to the ceramist with photographs and models. Good luck.