Regulators eye link between denture cream and zinc toxicity

Regulators eye link between denture cream and zinc toxicity

Regulatory authorities and dental associations are examining reports that overuse of zinc-based denture adhesives may cause neurological damage. While a direct causal link has not yet been established, dentists are being advised to counsel denture-wearing patients to ensure they aren't using too much adhesive.

The issue has been percolating for several years, but received renewed attention this month following a segment that appeared May 5 on "Good Morning America." In addition, the U.S. FDA has received adverse event reports claiming that cases of zinc toxicity were caused by denture cream overuse, and the agency has confirmed that it has formed a working group to examine the issue.

At issue is the effect that excessive ingestion of zinc over a long period of time can have in depleting the amount of copper in the human body, as copper deficiency can lead to the impairment of various neurological processes. In fact, copper deficiency is a well-established and increasingly recognized cause of neurologic and hematologic disease, and excess zinc has been identified as a source of copper deficiency (Journal of Neurology, January 2004, Vol. 251:1, pp. 111-114).

This is where denture adhesives come in -- some, anyway. While not all denture creams contain zinc, two of the most popular are GlaxoSmithKline's (GSK) Super PoliGrip and Procter and Gamble's (P&G) Fixodent, both of which are zinc-based (GSK also offers a zinc-free version of PoliGrip). The zinc acts as a binding agent that increases the product's hold, according to Jennifer May, a spokesperson for over-the-counter products at GSK.

While zinc is an essential mineral naturally present in many protein-rich foods such as beef, chicken, and nuts, and many supplements and other over-the-counter products such as Zicam (a cold medicine), there are limits to how much a person should ingest on a daily basis, especially with long-term use. The acceptable daily intake is 8 mg for women and 11 mg for men, and more than 40 mg constitutes zinc poisoning, according to the U.S. National Academy of Sciences.

A 2.4 oz (68 gram) tube of Super PoliGrip contains 38 mg of zinc per gram of product, and GSK recommends that a single tube should last approximately six weeks. According to the company's Web site:

You should not use more than the indicated quantity of Super PoliGrip, or use it more often than once per day, to compensate for poorly fitting dentures. You should consult your dentist regularly to maintain proper-fitting dentures.

The Super PoliGrip packaging carries these same recommendations, along with the list of ingredients (topping the list is "poly(methylvinylether/maleic acid) sodium-magnesium-zinc mixed partial salt").

Language on the Fixodent packaging is less explicit; under "Helpful Hints," a highlighted section reads "Don't use too much product at first. It may take a few tries to find the right amount for you!" and "Consult your dentist regularly to ensure proper fitting dentures." There is no list of ingredients on either the Fixodent box or tube; because the FDA has classified denture cream as a Class I device, the manufacturers are not required to list the ingredients.

However, the Fixodent Web site does feature a letter from J. Leslie Winston, D.D.S., Ph.D., P&G's director of professional and scientific relations for North America, which states in part:

A small amount of zinc is used in Fixodent to provide denture hold. This helps the denture stay in place securely so our consumers can eat, chew, and talk more confidently. All Fixodent products undergo rigorous scientific evaluations and safety testing before appearing on shelf and we continue to monitor them once in market. ... The average amount of zinc an average denture adhesive user would ingest from daily usage of Fixodent is less than the amount of zinc in most daily multivitamins and comparable to 6 ounces of ground beef.

English base hyperlinks dentistry and flu

English base hyperlinks dentistry and flu

At this point, 17 activities have been registered in the U.S., according to Eric Chaffin, an lawyer with Bernstein Liebhard in New You are able to City who has so far registered five situations for five individuals, four against GSK in state judge in Chicago and one against both GSK and P&G in government judge.

"In many of these situations, the information is that the litigants use 'excessive amounts' of platter lotion," Chaffin said. "But there is no clear sign from the producers on how much is too much. 'Do not use more than once a day without talking to your dentist' is unforeseen to the guidelines and does not notify customers about prospective zinc oxide harming or birdwatcher lack of."

But in judge documents acquired by "ABC News," GSK and P&G said there is no medical evidence that platter lotion can cause zinc-related diseases. In formerly launched claims, GSK has mentioned that "the the greater part of the zinc oxide in the item continues to be in the sticky and is not launched into the oral cavity. Thus the prospective for intake of zinc oxide through the gum area is little."

At least one review in the literary works clues at a relationship between zinc oxide poisoning and platter lotion. In a research launched last year in Neurology (August 26, 2008, Vol. 71:9, pp. 639-643, initially launched online July 4, 2008), scientists from the School of Florida South west Healthcare Middle chronicled four sufferers they had seen in the division of neurology over a period of three to four decades who were being affected by neurologic irregularities and who all used veneers and revealed serious use of considerable volumes of platter lotion.

The sufferers all had unusually high stages of zinc oxide in their blood vessels, associated with unusually low stages of birdwatcher, the scientists revealed. Regular blood vessels stages of birdwatcher range from 0.75 to 1.45 mg/mL, but stages in these sufferers varied from less than 0.1 to 0.23 mg/mL. An average zinc oxide blood vessels level is 1.10 mg/mL, but these sufferers varied from 1.36 to 4.28 mg/mL.

Each individual used veneers and used two or more pipes of platter lotion weekly "for decades," the scientists revealed, and assessment of past medical, medical, and genealogy and clinical examining did not reveal any other process that could describe the neurologic irregularities. Researchers examined three types of platter lotion used by the sufferers to figure out how much zinc oxide they included (17 to 34 mg per gary of product) and determined that "no other possible description for zinc oxide unwanted or birdwatcher lack of was determined." Copper supplements led to light neurologic enhancement in two sufferers who ceased using platter lotion, the scientists mentioned.

"These sufferers had used platter lotion in considerable volumes on a regular foundation for several decades, going through two pipes per weeks time for at least two to three decades," Sharon Countries, M.D., lead writer on the research, informed DrBicuspid.com.

The reviews have persuaded oral categories to discussion whether they should think about in on the problem. On May 8, the ADA launched a declaration that flows, in part: We are not conscious of any reviews of nerve issues caused by use of a platter lotion following the company's guidelines, nor indeed of any other reviews of nerve or other wellness issues relevant to the use of platter lotion items under any circumstances. ... Patients with decrease suitable veneers should see their oral professional consistently for evaluation and appropriate care, which can decrease the need for platter sticky items.

While the ADA declaration goes on to say "To date, the FDA has not launched any advisory to the community or the career on this problem," a number of activities have been registered with the FDA's Middle for Gadgets and Radiological Health regarding zinc-based platter lotions. On May 12, in reaction to a question from DrBicuspid.com, the FDA launched this statement: FDA has lately become conscious of a research indicating a link between extreme use of zinc-containing platter sticky lotions and birdwatcher destruction, and is convening a working team to analyze the problem more carefully. And while the United states College of Prosthodontics (ACP) has not yet launched a official declaration, the company has included some knowledge content about platter lotions to its Web site.

"One of our issues is that the way this has been provided is it almost appears to be like everyone uses platter glues," said Leslie Brackett, D.D.S., a exercising prosthodontist and the ACP home of community and professional interaction. "Most veneers do not require platter sticky. We want customers to know that if veneers get decrease, the solution isn't just to heap on a lot of platter lotion."

The ACP suggests that platter users should have their veneers re-evaluated every five decades, and that they may need to be realigned, reprocessed, or modified. "The fact is, if your veneers don't fit, you use sticky," Chaffin said. "And if you have a individual come into your office with poor-fitting veneers who doesn't have the means to purchase new veneers, they need to use glues. But people have no idea this zinc oxide problem can present itself."

Computerized details backups not waste time and money

Computerized details backups not waste time and money

IT solutions company Innovative Computerized has released research results showing that dentists can meet or exceed HIPAA protection recommendations, enhance individual solutions, and reduce expenses by switching to on the internet backups for their vital individual details.

By examining the details from customers that have already switched to automated on the internet backups, Innovative Computerized determined that oral methods reduced the likelihood of large government charges, removed wasted work performing and problem solving backups, and minimized storage space expenses relevant to individual records, the company said in an argument. Offices saw immediate reductions in expenses associated with both establishing and maintaining back-up technology; the study showed a net average advantages of $2,550 yearly on storage space media and work expenses alone.

"Prior to shifting clients to the secure on the internet back-up service, over 20% of the assistance calling our help desk received were relevant to back-up verification and problem solving. Those assistance calling have been removed for on the internet back-up users. The staff can be confident that their details is safe in the event of a catastrophe, and the likelihood of breaking HIPAA back-up protection recommendations is removed," said John Moore, founder and CEO of Innovative Computerized, in the discharge. "With HIPAA charges increased to $250,000, it is practical to hire a company now. You'll preserve immediately on work and storage space while gaining satisfaction."

To encourage methods to enhance their catastrophe recovery plans, for a short while, Innovative Computerized is offering 100 GB of on the internet storage space for the price of 50 GGB, according to the news launch. The British Dental Health Base is warning that bad dental cleanliness could increase the spread of the H1N1 flu, according to the Dollars Usher in paper.

Surveying Britons about their oral routines, the basis discovered many picking their teeth with whatever they discovered lying around, including fingernails, bank cards, paperclips, screwdrivers, earrings, and screwdrivers, the paper revealed.

That's a perfect way to introduce pathogens into the body, said the foundation's us president, Nigel Jackson. "Hygiene warnings have been explained ever since the swine flu outbreak, and it is worrying that these routines have been revealed as the numbers affected by flu continuously increases," he told the Dollars Usher in.

Hailed as a leader for offering nearly universal healthcare protection, Massachusetts is mulling proposals to lessen its protection -- starting with oral advantages, according to an article in the Republican paper.

Faced with a steep fall in revenues because of the recession, the state Senate last week proposed to fall oral protection for 700,000 grownups, the paper revealed.

The cuts would include protection for 600,000 grownups getting State medicaid programs advantages for a advantages of $47 million, according to the report. Another 89,000 grownups who make too much cash to qualify for State medicaid programs but still can'