I did some research on palatal lifts for our clinic a few months ago.  We got a list of dental prosthodontists from another SLP who works with the head & neck cancer population.  However, we have not actually had any PALS actually go through with the process.  Part of that is because there are few PALS who seem to be appropriate for them (see list of recommended patient attributes below), and part of it is because of the cost.  When I contacted the local prosthodontists, they said that Medicare will cover it, but that Medicare reimbursement is less than what it costs the prosthodontist to make the prosthesis.  That means that none of our local prosthodontists will bother billing Medicare, and the patient cannot get reimbursed if they pay out of pocket.  Our state’s version of Medicaid won’t cover palatal lifts, and private insurance coverage varies widely, as usual.  The cost is $3000-5000.

If anyone’s interested, I found this list of patient attributes favorable for benefiting from a palatal lift in Motor Speech Disorders by Joseph Duffy:

·         Slow rate of progression

·         Adequate respiratory function and articulation

·         Resonance change with occlusion

·         Evidence of lateral pharyngeal wall movement during speech

·         Pressure sounds less adequate than others

·         No hyperactive gag reflex

·         No significant spasticity

·         Adequate swallowing & saliva management

·         Adequate dentition

·         Able to insert and remove prosthesis without assistance

I would be very interested to hear the experiences of anyone who has experience working with PALS and palatal lifts.  If you recommend them at your clinic or practice, how do you determine which PALS should get them?  Are your criteria similar to those listed above?  How are PALS getting funding for these prostheses?  What kind of feedback do you get from PALS that have them?  Thanks!

I have had someone recently ask me about a lift, also.  I have asked our local SLP, and got a resource in St. Louis, but looking for someone much closer to the Bloomington area.  Does anyone know how to go about finding someone that can do this?  This is a  first for me.

Thanks Tami

Do other SLP’s regularly suggest lifts for ALS patient’s? I have been trying to find someone in my area that does them in the event that it’s appropriate.

Erin

They could be assessed for a palatal lift.