Oral Management Due to Denture Adjustment in a Frail Patient with Spinocerebellar Degeneration Contributed to Effective Rehabilitation

Abstract

　Background：Spinocerebellar degeneration（SCD）is a progressive and irreversible disease that affects balance, coordination and speech. Generally, patients with SCD show only a limited improvement in their activities of daily living（ADL）even after intensive rehabilitation. We report an unexpected, rapid improvement in ADL in a severely frail patient with SCD after adjustment of his dentures. We also describe the method of denture adjustment that was applied in this challenging case.

　Case presentation：An 81-year-old bedridden man with SCD required help ingesting food paste. Although he was edentulous, he was unable to use his complete dentures because they fell out easily. He did not have any conditions that affected the level of consciousness such as hydrocephalus or intracranial hypertension. Nevertheless, the initial assessment of ADL indicated that the patient was the condition of need for nursing care from secondary sarcopenia and malnutrition. We adjusted his incompatible dentures through a process involving remounting and occlusal adjustment（hereafter referred to as the remounting procedure）so as to provide bilateral balanced full occlusion. Although no effects of rehabilitation were detected before denture adjustment, the ADL of the patient（including his ability to eat）improved rapidly after the remounting procedure.

　Conclusion：Oral dysfunction can affect the ADL of older patients with frailty. In this case, oral management due to denture adjustment contributed to improvement of oral function and patientʼs motivation for rehabilitation. Denture adjustment may also be effective for a progressive disease such as SCD. Furthermore, the remounting procedure described in this report could be used for challenging cases in which chairside denture adjustment cannot be performed.