Crown LA, May JA. Zinc toxicity: denture adhesives, bone marrow failure and polyneuropathy. Tenn Med. 2012; 105:39-42
Barton AL, Fisher RA, Smith GD. Zinc poisoning from excessive denture fixative use masquerading as myelopolyneuropathy and hypocupraemia. Ann Clin Biochem. 2011; 48:383-385 https://doi.org/10.1258/acb.2011.010282
A 52-year-old male attended a dental hospital following a referral from a royal infirmary regarding hyperzincaemia (zinc toxicity) and hypocupraemia (low copper levels). The patient had been using an excessive amount of over-the-counter zinc oxide temporary dental material for the previous 18 months owing to a phobia of dentists and misconception about amalgam fillings as caries. This resulted in acquired peripheral neuropathy, muscle weakness and the inability to walk without wheelchair aid. We present the reasons clear warnings should be in place and education is required for the general public when self-prescribing with ‘at-home’ dental kits.
CPD/Clinical Relevance: It is important to break down patient barriers to accessing dental care.
Article
We present an unusual case of a 52-year-old male who was admitted to the care of a haematology team at a royal infirmary suffering from hyperzincaemia (zinc toxicity), hypocupraemia (copper deficiency), neutropenia and anaemia with reticulocytopenia of unknown origin.
He presented with an 18-month history of the following symptoms: increasing peripheral neuropathy; bilateral wrist and foot drop; worsening hearing, which required a hearing aid; and reduced mobility, which required a wheelchair. The patient reported good health prior to the start of the symptoms.
During a 10-week inpatient stay, treatments for reversal of the hyperzincaemia and hypocupraemia were given, and a cause for both was identified. The medical team discovered he had applied an excessive amount of over-the-counter temporary dental filling, covering his entire dentition. He had used approximately four packets per week for the previous 18 months. He had mistakenly confused dark amalgam restorations for dental caries, believing he had extensive cavities.
Medical treatment included zinc chelation therapy with sodium calcium edetate and intravenous copper infusions for several weeks, as advised from a national poisons expert and clinicians at TOXBASE1 who were consulted because of the rarity of the case.
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