Dr Imogen Brooks still remembers the silence that followed her words. Not the comfortable quiet of a paused conversation, but the heavy, awkward pause that settled over a room when she spoke — the moment a listener’s face would shift, eyes widening slightly, the smile freezing at the corners of their mouth. They were trying to decode her. Often, they simply guessed, nodding along to a sentence she never said.
Three years after surgery stripped away most of her tongue to stop an aggressive cancer, and months of radiotherapy that shrank the reconstructed tissue until speech became an exhausting negotiation, the 29-year-old medical writer from Newham has been fitted with what clinicians believe is the NHS’s first bespoke prosthetic tongue. The device, engineered over months of trial and error by a multidisciplinary team at Guy’s and St Thomas’ NHS Foundation Trust, has not only restored her clarity — it has given her back the simple, profound ability to be understood.
The long road to a new voice
Brooks was 26 when a persistent, mild soreness on the side of her tongue sent her to her GP. She half-expected to be told she was overreacting. Instead, a biopsy confirmed squamous cell carcinoma, the most common form of head and neck cancer. The operation to remove the tumour took the bulk of her tongue. Reconstructive surgery followed, and for a while, her speech was functional. Then came the radiotherapy.
The treatment saved her life, but the fibrosis it caused tightened and shrank the new tissue. Words blurred. Phone calls became impossible without assistive technology. In the workplace, colleagues began avoiding face-to-face conversations. Strangers, she says, would look at her “in fear” when she opened her mouth.
“It was so, so common for people to just smile and even not respond and make up in their head what I had said,” she recalls. The misunderstandings bled into medical appointments and professional meetings. “I was thinking if I was just able to have that little bit of contact between the bottom of my mouth and the top of my mouth, it would be better.”
Assembling the team
Brooks did her own research. She found papers on prosthetic tongues — rare, highly specialised devices — and took the idea to her clinicians. The response, she laughs, “was like assembling the Avengers.”
At her next appointment, eight specialists crowded the room. Carolyn Doughty, an advanced specialist speech and language therapist, took the lead, pulling together experts from restorative dentistry, maxillofacial prosthetics, and the dental laboratory at Guy’s Hospital. They had never built anything like this before.
Michael Brown, the dental technician who would hand-craft the device, admits the team “loves a challenge.” The design brief was precise: a U-shaped cobalt-chrome frame that clips onto Brooks’s lower teeth, supporting a fixed silicone tongue sculpted to generate the maximum range of speech sounds. Not a replacement for eating or swallowing — purely for articulation.
Trial, error, and a breakthrough
Two prototypes came first. Each iteration meant hours in the clinic with Doughty, shaping sounds, then days at home for Brooks to test in the real world — ordering coffee, chatting with neighbours, navigating the noise of the London Underground. She returned with pages of notes. The silicone was too stiff. The tip didn’t reach the alveolar ridge cleanly. The lateral edges caught air.
“There was a lot of trial and error in finding a shape that would work,” Brown says. “Imogen would work with Carolyn on making sounds with her prototype prosthesis. Then she would take home a design, try it out and come back to us with lots of notes. It has been so satisfying to have worked with Imogen through this.”
The final version arrived last year. Within three days, Brooks noticed the shift. By two weeks, the prosthetic felt like a natural extension of her mouth. She sat her doctoral viva at King’s College London — an oral exam on skin disease therapies — and passed.
A grandmother’s voice, heard clearly
The most emotional test came at her grandmother’s kitchen table. Her nan is hard of hearing; their conversations had long been a frustrating mix of exaggerated gestures, written notes, and repeated phrases. Brooks hadn’t mentioned the new tongue. They simply talked.
Mid-conversation, she showed her the device. Her grandmother looked up, surprised. “This was the first time that I didn’t need hand gestures as much because she was able to follow me a lot better,” Brooks says. “It’s true with everyone, but perhaps especially with her.”
The physical toll has lifted, too. “It is much less effort for me to speak with it. I can speak for longer without having to take a breath in the middle of a sentence. I don’t have to think as much about what I’m saying, so it means that my speech is much more fluid and it’s much less tiring for me to speak. That in itself is massive.”
Why it Matters
Brooks’s story is a reminder that survival is not the finish line — quality of life is. The prosthetic tongue she now wears represents a rare convergence: a patient’s refusal to accept diminished communication, a clinical team willing to venture beyond standard pathways, and an NHS capable of delivering bespoke innovation at the point of care. There is no national pathway for this device, no NICE guideline, no procurement framework. It exists because clinicians listened, collaborated, and built something that had never been made on the health service before. For the thousands of head and neck cancer patients navigating speech loss each year, this quiet breakthrough in a London dental lab offers something more valuable than a medical first — it offers a precedent.
