21084 Impression and custom preparation; speech aid prosthesis

Name of the Procedure:

Impression and Custom Preparation; Speech Aid Prosthesis

Summary

This procedure involves taking a detailed impression of a patient’s oral cavity to create a custom speech aid prosthesis. This prosthesis helps individuals who have difficulties with speech due to structural abnormalities or absence of certain oral structures.

Purpose

The procedure aims to improve speech clarity and communication abilities in patients with conditions like cleft palate, oral cancers, or after surgeries that affect the oral cavity. The primary goal is to create a custom-fit device that enhances the patient’s ability to articulate words effectively.

Indications

• Cleft lip and palate
• Partial glossectomy (removal of part of the tongue)
• Oral cancers that affect speech
• Velopharyngeal insufficiency (VPI)
• Structural abnormalities in the oral cavity

Preparation

• Patients may need to avoid eating or drinking for a few hours before the procedure.
• Pre-procedure assessments may include dental examinations and perhaps imaging studies.
• Patients should inform their healthcare provider about any medications they are taking.

Procedure Description

1. Initial Consultation: Evaluation of the patient’s oral cavity and speech needs.
2. Taking Impressions: Using dental putty or other impression materials, a detailed mold of the patient’s oral cavity is created.
3. Custom Fabrication: The mold is sent to a dental lab where a custom speech aid prosthesis is fabricated.
4. Fitting the Prosthesis: The patient returns for fitting, adjustments, and instructions on use.
5. Speech Therapy Referral: The patient may be referred to a speech therapist for further evaluation and training.

Tools and Equipment:

• Dental trays
• Impression materials (e.g., alginate)
• Mixing tools and containers

Anesthesia/Sedation: Typically not required, but local anesthesia may be used for patients with sensitive oral tissues.

Duration

The impression-taking process usually takes about 30 minutes to 1 hour. The entire process, including the fitting and any necessary adjustments, may span several weeks.

Setting

Outpatient clinic, dental office, or specialized medical center.

Personnel

• Prosthodontist or dentist
• Dental assistant
• Speech therapist (for follow-up care)

Risks and Complications

• Mild discomfort or gagging during the impression-taking.
• Potential need for multiple adjustments.
• Risk of irritation or sores in the mouth from the prosthesis.
• Rare risk of allergic reaction to impression materials.

Benefits

• Significantly improved speech clarity.
• Enhanced ability to communicate effectively.
• Increased confidence and social interaction.

Recovery

• Most patients can resume normal activities immediately after the impression is taken.
• Initial adaptation period to the speech aid prosthesis may take a few weeks.
• Regular follow-up appointments for adjustments and monitoring.

Alternatives

• Speech therapy alone
• Surgical intervention for structural correction
• Non-custom, over-the-counter speech aids

Each alternative varies in effectiveness and suitability depending on the patient’s condition. Custom prostheses generally offer better fit and functionality.

Patient Experience

During the impression process, the patient might feel some discomfort due to the material used but it is usually brief. After receiving the prosthesis, there may be a period of adjustment where speech may initially feel awkward. Pain management is typically unnecessary, and any minor discomfort can be managed with over-the-counter pain relievers if needed.