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Zinc-containing denture adhesive: a potential source of excess zinc resulting in copper deciency myelopathy
I N B R I E F
Hyperzincaemia has been identied as a cause of copper deciency which can result in anaemia and irreversible myelopathy.
There are now a number of case reports of copper deciency myelopathy secondary to overuse of zinc-containing denture adhesive.
Even with copper supplementation, neurological damage due to copper deciency may be permanent and so early detection and patient education is vital.
PRACTICE
K. Doherty,1 M. Connor2 and R. Cruickshank3
VERIFIABLE CPD PAPER
Copper deciency in humans can result in both anaemia and neurological symptoms affecting walking and balance. Recently zinc excess due to overuse of zinc-containing denture adhesive has been recognised as a potential cause of copper deciency. Recovery from neurological symptoms with replacement therapy appears to be limited and so emphasis falls on education and early detection. Dentists are well placed to educate patients on use of denture adhesives and to detect early signs of copper deciency in patients who may be using zinc-containing denture adhesive to excess. A case of a 58-year-old man diagnosed with copper deciency myelopathy possibly due to zinc-containing denture cream overuse is presented.
INTRODUCTION
Overuse of zinc-containing denture adhesive has recently been associated with a combination of anaemia and spinal cord damage, resulting in severe neurological impairment.1,2 As this condition is preventable but largely untreatable, dentists are well placed to detect denture adhesive overuse in patients with neurological symptoms and anaemia, and prompt further investigation.
CASE REPORT
A 58-year-old man presented to his general practitioner (GP) in May2008 with a four-month history of progressive difculty with balance and walking. At presentation he was able to walk with the aid of a stick and support from his wife. His GP referred him to hospital for investigation but he discharged himself almost immediately, later admitting a dislike for hospitals and doctors.
Blood taken by his GP showed a macrocytic anaemia (haemoglobin 9.3g/dL, mean cell volume 110fL) and leucopenia
(white blood count 2.5109/L), specically a severe neutropenia (0.32109/L). Further blood tests showed low folate and high ferritin levels. Vitamin B12 was normal. The patient admitted drinking alcohol to excess since retiring in 2001and as chronic alcoholic liver damage is known to increase the...