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Articulating the issues: speech assessment and intervention in cleft lip and palate

British Dental Journal volume 234, pages 912–917 (2023)Cite this article

Abstract

This paper describes the impact of cleft lip and palate on speech. It provides an overview for the dental clinician of the key issues affecting speech development and clarity. The paper summarises the complex speech mechanism and cleft-related factors that affect speech, including palatal, dental and occlusal anomalies. It outlines the framework for speech assessment throughout the cleft pathway and provides a description of cleft speech disorder, as well as describing treatment approaches for cleft speech and velopharyngeal dysfunction.

This is followed by a spotlight on speech prosthetics for treating nasal speech, with an emphasis on joint management by the Speech and Language Therapist and Consultant in Restorative Dentistry. This includes the core multidisciplinary approach, clinician and patient-reported outcome measures, and brief discussion of national developments in this area.

The importance of multidisciplinary cleft care is highlighted and, within this, the essential interaction between speech and dental clinicians in providing routine care, as well as in delivering a highly specialist speech prosthetics service.

Key points

  • An overview of the impact of cleft lip and palate on speech.

  • Speech is a core life skill: palatal, dental, and occlusal anomalies associated with cleft can affect speech clarity at any age.

  • Speech prosthetics is an appropriate treatment option for velopharyngeal dysfunction in selected patients and should be delivered by a specialist multidisciplinary team.

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Acknowledgements

Dr G. Phippen contributed to conceptualisation, and writing, in collaboration with Spires Cleft Centre SLT colleagues and the members of the UK Speech Prosthetics Network. Mr S. Popat and Mr M. Ashley are acknowledged for contribution to conceptualisation, review, and editing. The views expressed in this paper are those of the author and they alone are responsible for the content and writing of this article. The illustrative Figures 1, 3, 4, 5 and 6 were produced in-house and have been previously used in a textbook edited by the author.71

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  1. Lead Speech & Language Therapist, The Spires Cleft Centre, Salisbury NHS Foundation Trust/Oxford University Hospitals NHS Foundation Trust, United Kingdom

    Ginette Phippen

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Correspondence to Ginette Phippen.

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Phippen, G. Articulating the issues: speech assessment and intervention in cleft lip and palate. Br Dent J 234, 912–917 (2023). https://doi.org/10.1038/s41415-023-5954-y

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