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Emergency complete dentures
Alaska, but while at home he continued to lose weight, which was attributed to the shock of the loss of his mother. Because of a continuous loss of weight, he was admitted to an Army hos pital near his home. He had an extensive workup and findings of an upper gastrointestinal series, barium enema, gallbladder study, radiographs of chest and abdomen, spine radiographs, shoulder radiographs, and an intravenous pyelogram were all normal. The patient was transferred to Chanute Air Force Base, 111., from the Army hospital on July 9, 1965, for further evaluation concerning loss of weight that was thought to be caused by a malig nancy in an undetermined location.
Report of case
Emergency complete dentures A rth u r M . LaVere, DDS, Chanute A ir Force Base, III.
The total health of a 28-year-old Caucasian man was affected adversely because of perio dontal disease and an edentulous mouth that did not permit him to chew food properly or to allow for proper absorption. In 5 years, the patient's weight went down from 210 pounds to almost 90 pounds, he had a chronic urinary tract infection and iron-deficiency anem ia. A fte r the patient received treatm ent for his physical disorders and functional complete dentures, he gained weight and returned to excellent health.
On June 16, 1965, an airman was given emer gency leave from Alaska, where he was assigned, to attend his mother’s funeral in Pennsylvania. He was in fairly good health while stationed in 1016
■ History: The patient had had usual childhood illnesses. In 1960, he weighed 210 pounds. In April, 1963, he had all his remaining teeth ex tracted because of periodontal disease and re ceived complete dentures. At that time, he weighed about 175 pounds. He had a kidney stone removed in December, 1964. He had had no accidents and no significant history of food or drug allergies. Results of a complete systems review were noncontributory. ■ Physical examination: On physical examina tion, the 28-year-old Caucasian man was emaciat ed, olive-skinned, and in no apparent distress. He was 5 feet 8 inches tall and weighed 108 pounds. The patient received a complete physical exam ination to determine if weight loss was caused by neoplasms, inflammations, trauma, or congenital abnormalities. ■ Laboratory data: Results of a complete blood count were noncontributory except for indication of hypochromic anemia (iron deficiency). The urinalysis indicated that the urine contained bac teria. ■ Hospital course: The patient was given a highprotein, high-fat, 3,000-calorie soft diet with in termittent high-energy food nourishment to help him gain weight. He was weighed daily, but he progressively lost weight until he weighed almost 90 pounds. During hospitalization, he had diar rhea for a few days which was controlled by med ication.
■ Dental treatment: On July 12, 1965, the chief of prosthodonties was called in for consultation by the chief of internal medicine. The patient was given a thorough oral examination including radio graphs. His clinical examination record and case history also were taken at the time of oral examination. The patient’s chief complaint was the inability to wear his dentures since he received them. He had to chew food without the dentures. He said that he had lost about 70 pounds during the previous 6 months and that his weight had dropped from 175 to 104 pounds after receiving his present dentures. The clinical examination revealed a healthy, edentulous mouth; however, the edentulous resid ual ridges had resorbed so that the dentures were too large. The patient also said that since 1963, “I couldn’t chew properly; food was coming out the same way I ate it; I have a lot of gas.” He had not eaten with his dentures since they were in serted. He always ate in the mess halls and al ways consumed huge quantities of food. He ate five times a day. His menu always consisted of large portions at breakfast, dinner and supper. These meals consisted of eggs, potatoes, steaks, chops, roast beef, chicken, peas, corn, beans, salads, bread, juices, and milk. He also ate two sandwiches and drank milk after supper and be fore bedtime. A comment on the nurse’s notes said, “Patient has an obsessive preoccupation with foods and liquids.” It was decided that a member of our staff would construct new dentures for the patient.* The urgency for dentures as an adjunct to mastication became evident when the patient weighed 98 pounds and became so weak that he had to be taken to the dental clinic in a wheel chair for the facebow and jaw-relation stage. It was our opinion that cusped posterior teeth were preferable. The dentures were completed as soon as pos sible. Immediately after receiving his dentures, the patient’s psychological outlook changed, and he was in excellent spirits. Seventeen days after the insertion of the den tures, the patient’s weight was 133 pounds. He was given convalescent leave 21 days after the insertion of the new dentures. Sixty days after receiving the dentures, his weight was 155 pounds. The patient was in excellent health, had been advised as to the type of diet and exercise he
should maintain, and returned to full active duty in Alaska. Discussion
A 28-year-old Caucasian man was admitted to our hospital. His chief complaint was weight loss of undetermined cause. He suffered an iron-deficiency anemia that responded to treatment, and he had a chronic urinary tract infection since the time of the manipulation for the removal of the stone. This infection also responded to treatment. When the patient received functional complete dentures, he began to gain weight and to feel bet ter physically and mentally. Since all studies had been noncontributory for a malignancy as the cause of the weight loss, psychophysiologic stress was the medical diagnosis. Sum m ary
It seems that the total health of this patient was affected adversely because of his inability to chew food properly and to allow for proper absorption. There was a large weight loss although the pa tient’s hospital diet consisted of high-protein, fat, and caloric foods. He also had lost weight the past 2 to 3 years although he consumed larger quan tities of food than normal. The patient’s weight had gone down from 210 pounds to almost 90 pounds. This variation had been partly caused by periodontal disease and an edentulous mouth, which resulted in a prolonged period of insuffi cient mastication. The patient says that the new dentures have made the difference in his health, and he feels that the dentures are an integral part of him. There seemed to be a relationship between mouth rehabilitation and the total well-being of the patient. A comprehensive review of the literature has not revealed a similar report. The opinions or assertions contained in this article a re the private ones of the w riter and are not to be con strued as o fficial or reflecting the views of the D ep art ment of the A ir Force or the A ir service a t large. Doctor L a V e re is a lieutenant colonel ih the Dental Corps, U.S. A ir Force. H e is in the Dental Services a t U S A F Hospital C h anute, C h an u te A ir Force Base, III.
61868 . *D octor Edward J . Ja c o b , cap tain in the Dental Corps, U S A F , Dental Services, U S A F Hospital C h anute, C h an u te A ir Force Base, III., constructed the new dentures for the patient. La V e re : E M E R G E N C Y C O M P L E T E D E N T U R E S
■ 1017
Report of case
Emergency complete dentures A rth u r M . LaVere, DDS, Chanute A ir Force Base, III.
The total health of a 28-year-old Caucasian man was affected adversely because of perio dontal disease and an edentulous mouth that did not permit him to chew food properly or to allow for proper absorption. In 5 years, the patient's weight went down from 210 pounds to almost 90 pounds, he had a chronic urinary tract infection and iron-deficiency anem ia. A fte r the patient received treatm ent for his physical disorders and functional complete dentures, he gained weight and returned to excellent health.
On June 16, 1965, an airman was given emer gency leave from Alaska, where he was assigned, to attend his mother’s funeral in Pennsylvania. He was in fairly good health while stationed in 1016
■ History: The patient had had usual childhood illnesses. In 1960, he weighed 210 pounds. In April, 1963, he had all his remaining teeth ex tracted because of periodontal disease and re ceived complete dentures. At that time, he weighed about 175 pounds. He had a kidney stone removed in December, 1964. He had had no accidents and no significant history of food or drug allergies. Results of a complete systems review were noncontributory. ■ Physical examination: On physical examina tion, the 28-year-old Caucasian man was emaciat ed, olive-skinned, and in no apparent distress. He was 5 feet 8 inches tall and weighed 108 pounds. The patient received a complete physical exam ination to determine if weight loss was caused by neoplasms, inflammations, trauma, or congenital abnormalities. ■ Laboratory data: Results of a complete blood count were noncontributory except for indication of hypochromic anemia (iron deficiency). The urinalysis indicated that the urine contained bac teria. ■ Hospital course: The patient was given a highprotein, high-fat, 3,000-calorie soft diet with in termittent high-energy food nourishment to help him gain weight. He was weighed daily, but he progressively lost weight until he weighed almost 90 pounds. During hospitalization, he had diar rhea for a few days which was controlled by med ication.
■ Dental treatment: On July 12, 1965, the chief of prosthodonties was called in for consultation by the chief of internal medicine. The patient was given a thorough oral examination including radio graphs. His clinical examination record and case history also were taken at the time of oral examination. The patient’s chief complaint was the inability to wear his dentures since he received them. He had to chew food without the dentures. He said that he had lost about 70 pounds during the previous 6 months and that his weight had dropped from 175 to 104 pounds after receiving his present dentures. The clinical examination revealed a healthy, edentulous mouth; however, the edentulous resid ual ridges had resorbed so that the dentures were too large. The patient also said that since 1963, “I couldn’t chew properly; food was coming out the same way I ate it; I have a lot of gas.” He had not eaten with his dentures since they were in serted. He always ate in the mess halls and al ways consumed huge quantities of food. He ate five times a day. His menu always consisted of large portions at breakfast, dinner and supper. These meals consisted of eggs, potatoes, steaks, chops, roast beef, chicken, peas, corn, beans, salads, bread, juices, and milk. He also ate two sandwiches and drank milk after supper and be fore bedtime. A comment on the nurse’s notes said, “Patient has an obsessive preoccupation with foods and liquids.” It was decided that a member of our staff would construct new dentures for the patient.* The urgency for dentures as an adjunct to mastication became evident when the patient weighed 98 pounds and became so weak that he had to be taken to the dental clinic in a wheel chair for the facebow and jaw-relation stage. It was our opinion that cusped posterior teeth were preferable. The dentures were completed as soon as pos sible. Immediately after receiving his dentures, the patient’s psychological outlook changed, and he was in excellent spirits. Seventeen days after the insertion of the den tures, the patient’s weight was 133 pounds. He was given convalescent leave 21 days after the insertion of the new dentures. Sixty days after receiving the dentures, his weight was 155 pounds. The patient was in excellent health, had been advised as to the type of diet and exercise he
should maintain, and returned to full active duty in Alaska. Discussion
A 28-year-old Caucasian man was admitted to our hospital. His chief complaint was weight loss of undetermined cause. He suffered an iron-deficiency anemia that responded to treatment, and he had a chronic urinary tract infection since the time of the manipulation for the removal of the stone. This infection also responded to treatment. When the patient received functional complete dentures, he began to gain weight and to feel bet ter physically and mentally. Since all studies had been noncontributory for a malignancy as the cause of the weight loss, psychophysiologic stress was the medical diagnosis. Sum m ary
It seems that the total health of this patient was affected adversely because of his inability to chew food properly and to allow for proper absorption. There was a large weight loss although the pa tient’s hospital diet consisted of high-protein, fat, and caloric foods. He also had lost weight the past 2 to 3 years although he consumed larger quan tities of food than normal. The patient’s weight had gone down from 210 pounds to almost 90 pounds. This variation had been partly caused by periodontal disease and an edentulous mouth, which resulted in a prolonged period of insuffi cient mastication. The patient says that the new dentures have made the difference in his health, and he feels that the dentures are an integral part of him. There seemed to be a relationship between mouth rehabilitation and the total well-being of the patient. A comprehensive review of the literature has not revealed a similar report. The opinions or assertions contained in this article a re the private ones of the w riter and are not to be con strued as o fficial or reflecting the views of the D ep art ment of the A ir Force or the A ir service a t large. Doctor L a V e re is a lieutenant colonel ih the Dental Corps, U.S. A ir Force. H e is in the Dental Services a t U S A F Hospital C h anute, C h an u te A ir Force Base, III.
61868 . *D octor Edward J . Ja c o b , cap tain in the Dental Corps, U S A F , Dental Services, U S A F Hospital C h anute, C h an u te A ir Force Base, III., constructed the new dentures for the patient. La V e re : E M E R G E N C Y C O M P L E T E D E N T U R E S
■ 1017