In recent years, there has been an increase in the availability of denture adhesives, which are used to stabilize removable dentures. A study by Okazaki and colleagues found that about 19% of denture wearers use denture adhesives.
Denture adhesives are complex products that not only affect the oral tissues but can also have an impact on overall health. They contain various ingredients such as swelling agents (karaya gum, Arabic gum, etc.) that improve denture stability, as well as antibacterial and antifungal agents (sodium borate, hexachlorophene, etc.) to maintain oral hygiene.
However, there are some negative aspects associated with denture adhesives. Certain ingredients like formaldehyde can cause allergic and toxic effects. Moreover, denture adhesives have a low pH, which can dissolve the protective layer of tooth enamel in any remaining natural teeth. Prolonged use of adhesives can also lead to excessive pressure on the denture base, causing it to wear down and potentially leading to soft tissue problems.
Additionally, preliminary studies conducted by researchers at the University of Maryland have linked the zinc content in certain denture adhesives to serious health problems, including neurological damage and blood abnormalities. These risks are particularly prevalent among individuals who frequently apply excessive amounts of denture cream in an attempt to keep their dentures securely in place.
Indeed, manufacturers recommend applying adhesive creams in small amounts, but many patients tend to use excessive quantities. This can further contribute to the potential issues mentioned earlier.
Overall, while denture adhesives can be helpful in improving denture stability, it is important to be aware of their potential risks and use them as instructed to avoid any adverse effects on oral health and general well-being.
Side effects from denture adhesives
Formaldehyde can cause allergic and toxic effects.
Formaldehyde is a chemical compound that has been used in various industries, including dentistry. But following the potential risks and symptoms associated with the presence of formaldehyde in dental adhesives, most manufacturers have stopped using them, and changed their formulations. That said, it’s still important to understand the risks associated with it, including:
- Allergic reactions: Formaldehyde can act as a sensitizing agent, meaning it can cause allergic reactions in some individuals. These reactions may manifest as skin rashes, itching, redness, or swelling in the mouth or surrounding areas.
- Irritation of oral tissues: Formaldehyde is known to be irritating to the oral mucosa, which is the lining of the mouth. Prolonged exposure to formaldehyde-containing adhesives can lead to inflammation, soreness, or discomfort in the gums, tongue, or other oral tissues.
- Cytotoxic effects: Formaldehyde has the potential to damage cells and tissues. High concentrations or prolonged exposure to formaldehyde-containing adhesives may result in cytotoxic effects, leading to cell damage or cell death.
- Carcinogenic potential: Formaldehyde has been classified as a known human carcinogen by organizations such as the International Agency for Research on Cancer (IARC). Prolonged exposure to formaldehyde has been associated with an increased risk of certain cancers, such as nasal and nasopharyngeal cancer.
To mitigate these risks, regulatory bodies and dental manufacturers have imposed limits on the concentration of formaldehyde in dental adhesives. However, it is still important for individuals to follow the instructions provided by the adhesive manufacturers and use the products in moderation to minimize any potential adverse effects.
Low pH in denture adhesives
Low pH in denture adhesives can have several side effects on oral health. Here are some potential issues associated with this:
- Tooth enamel erosion: The low pH of denture adhesives, typically around 5.5 on average, can contribute to the erosion of tooth enamel. Enamel is the protective outer layer of the teeth, and prolonged exposure to low pH substances can weaken and wear it down over time. This can increase the risk of tooth sensitivity, cavities, and other dental problems.
- Soft tissue irritation: The acidic nature of low pH adhesives can cause irritation and inflammation of the oral soft tissues, including the gums, palate, and tongue. This irritation may result in discomfort, soreness, and even the development of ulcers or sores in severe cases.
- Alteration of oral microbiome: The oral cavity has a delicate balance of microorganisms that contribute to oral health. The low pH of denture adhesives can disrupt this balance, potentially leading to changes in the oral microbiome. Imbalances in the oral microbiome can increase the risk of oral infections, such as candidiasis (oral thrush), and other oral health issues.
- Impaired taste perception: The acidic nature of low pH adhesives can affect the taste buds and impair the ability to taste food properly. This can lead to a diminished sense of taste or alterations in taste perception, affecting the overall enjoyment of eating.
To minimize the potential side effects of low pH denture adhesives, it is advisable to follow the manufacturer’s instructions for application and use. Additionally, maintaining good oral hygiene practices, such as regular brushing and rinsing with a neutral pH mouthwash, can help mitigate any negative effects on oral health.
Under normal circumstances, we can get sufficient Zinc from a balanced diet. However, vegetarians and people without proper access to zinc-rich foods such as red meat, fish, eggs, yogurt, and oysters may suffer from deficiencies that contribute to various oral problems, including gum disease, cavities, and even oral cancers. As such, zinc supplements may be necessary in such cases.
In fact, zinc is a common additive in mouth washes and toothpaste, since it reduces inflammation, bacteria, and plaque formation. It is also found in dental amalgam fillings and cements used for tooth repair. In all these cases, it is hardly a concern.
The problem with denture adhesives is that the zinc tends to leach out, and can be absorbed by the body, unlike in other applications. So the more adhesive you use, the more zinc you ingest, and the greater the risk of symptoms from denture adhesive poisoning.
While excessive zinc intake is rare, overdoses can have serious consequences. High levels of zinc in the body can displace copper, leading to copper deficiencies that result in neurological problems and blood abnormalities. Zinc interacts with over 300 enzymes in the body, affecting various bodily functions, including metabolism, immune response, and the endocrine system.
What the FDA says about Zinc poisoning
Reports of adverse health effects related to excessive use of denture adhesives containing zinc have been appearing since 2008. In fact, the U.S. Food and Drug Administration (FDA) has previously received numerous reports of symptoms consistent with zinc toxicity from denture adhesive poisoning.
In response to the concerns raised, the FDA urged manufacturers to revise their product labeling to clearly identify denture adhesives that contain zinc. Alternatively, manufacturers are encouraged to replace zinc with safer ingredients that pose fewer health risks when used excessively.
What the ADA says about Zinc poisoning
The American Dental Association (ADA), on the other hand, argues that the link between excessive denture adhesive use and health problems is not yet proven. Still, the ADA claims that some patients may be overusing denture adhesives to compensate for poorly fitting dentures. To combat the potential adverse effects, the ADA emphasizes that ill-fitting dentures should be addressed by refitting them rather than relying on adhesives.
What manufacturers say about Zinc poisoning
Over the years, various denture adhesive manufacturers have taken proactive steps to address the issue of zinc poisoning. For example, Glaxo Smith Kline, the maker of Super Poligrip, voluntarily removed zinc from their Original, Ultra Fresh, and Extra Care varieties.
These products now use a calcium, sodium, and cellulose gum-based salt instead of zinc.
Moreover, the company emphasizes that when used as directed, their products have always been safe and effective.
Should you use zinc-based denture adhesives?
Dr. Nasir Bashirelahi, a professor at the University of Maryland Dental School and co-author of a related paper, advises against using denture adhesives that contain zinc. He highlights that manufacturers are now producing zinc-free alternatives.
Similarly, Dr. Radi M. Masri, a practicing dentist and teacher at the Maryland dental school, advocates for a cautious approach.
He instructs his students to discourage long-term use of denture adhesives and recommends seeking proper denture fitting instead. He also highlights the potential risk of intra-oral fungal infections associated with adhesive use and the importance of monitoring for symptoms of neuropathy.
Importance of Diagnosis and Treatment
Quick diagnosis and immediate treatment are crucial in preventing irreversible neurological changes caused by zinc overdoses or the other side effects of using denture adhesives.
When patients who suffered from zinc toxicity discontinued using denture adhesives, their zinc and copper blood levels returned to normal.
By raising awareness of the potential risks associated with denture adhesives and promoting proper denture fitting, both dental professionals and patients can work together to minimize the likelihood of health problems arising from the misuse of these products.
If you have concerns about dental adhesives or experience any adverse reactions, it is recommended to consult with your dentist or healthcare professional for guidance. They can provide appropriate advice and suggest alternative adhesive options if necessary.