Denture cream: an unusual source of excess zinc, leading to hypocupremia and neurologic disease.
BACKGROUND
Chronic, excess zinc intake can result in copper deficiency and profound neurologic disease. However, when hyperzincemia is identified, the source often remains elusive. We identified four patients, one previously reported, with various neurologic abnormalities in the setting of hypocupremia and hyperzincemia. Each of these patients wore dentures and used very large amounts of denture cream chronically.


OBJECTIVE
To determine zinc concentration in the denture creams used by the patients as a possible source of excess zinc ingestion.


METHODS
Detailed clinical and laboratory data for each patient were compiled. Tubes of denture adhesives were analyzed for zinc content using dynamic reaction cell-inductively coupled plasma-mass spectrometry. Patients received copper supplementation. Copper and zinc levels were obtained post-treatment at varying intervals.


RESULTS
Zinc concentrations ranging from about 17,000 to 34,000 mug/g were identified in Fixodent and Poli-Grip denture creams. Serum zinc levels improved in three patients following cessation of denture cream use. Copper supplementation resulted in mild neurologic improvement in two patients who stopped using denture cream. No alternative source of excess zinc ingestion or explanation for hypocupremia was identified.


CONCLUSIONS
Denture cream contains zinc, and chronic excessive use may result in hypocupremia and serious neurologic disease.
Department of Neurology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-8897, USA. sharon.nations@utsouthwestern.edu
S P
SP
Nations
P J
PJ
Boyer
L A
LA
Love
M F
MF
Burritt
J A
JA
Butz
G I
GI
Wolfe
L S
LS
Hynan
J
J
Reisch
J R
JR
Trivedi
D000328:Adult; D002490:Central Nervous System / Q000187:drug effects / Q000378:metabolism / Q000503:physiopathology; D003300:Copper / Q000172:deficiency*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017933:Peripheral Nervous System / Q000187:drug effects / Q000378:metabolism / Q000503:physiopathology; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced* / Q000378:metabolism / Q000503:physiopathology; D013118:Spinal Cord Diseases / Q000139:chemically induced* / Q000378:metabolism / Q000503:physiopathology; D014014:Tissue Adhesives / Q000506:poisoning*; D015032:Zinc / Q000378:metabolism / Q000506:poisoning*
D014014:Tissue Adhesives; D003300:Copper; D015032:Zinc