Obturators to facilitate speech and swallowing in a maxillectomy patient with dementia and cerebral infarction

Abstract

The purpose of dental treatments normally includes the recovery from the functional impairments and aesthetic problems. This case report describes the rehabilitation of a maxillectomy patient with dementia and cerebral infarction, using obturators made of different materials to facilitate speech and swallowing. The patient had difficulty inserting the original prosthesis by himself and would sometimes bite down on the obturator to position it in his mouth instead of using his hands. As a result, the obturator caused irritation and bleeding, especially in the sensitive maxillectomy area. Ultimately, a new obturator with a base made of heat-cured acrylic resin and a bulb made of silicone was delivered. In this article, we describe the case and discuss the use of the obturator to recover swallowing and speech function in this patient. (Int J Maxillofac Prosthetics 2019;1:33-35)

Prevalence of Possible Dementia in Patients with Maxillofacial Defects and Difficulty of Inserting Obturator in Maxillectomy Patients: Toward Better Provision of Supportive Care

“…Maxillofacial prosthodontics provides prosthetic rehabilitation for functions such as speech, swallowing, mastication, and esthetics and is a well-recognized subspecialty of prosthodontics [ 1 , 2 , 3 ]. In 2018, Yanagi et al conducted a study at the Clinic for Maxillofacial Prosthetics, Tokyo Medical and Dental University, and found that the average age of patients had shown an increasing trend over the previous 35 years and that almost 80% of patients had developed tumors in Japan’s now super-aging society [ 4 ], and we feel that this could be even higher now.…”

“…In addition, the structure of maxillofacial prostheses is quite unique compared with general prostheses, and the oral cavity is sensitive and prone to bleeding, especially in maxillectomy patients. Sumita et al reported a case in which a maxillectomy patient experienced difficulty inserting his maxillary obturator prosthesis after developing cerebrovascular disease and dementia [ 3 ]. However, there has been no report on the actual situation of patients who need maxillofacial prosthetic treatment from the perspective of dementia and patient-reported difficulty of inserting prostheses.…”

“…Maxillofacial prostheses are an important tool in providing continuous supportive care to patients with maxillofacial defects, including in terminal care [ 1 , 2 ]. In other words, many patients would have difficulty surviving in daily life without their maxillofacial prosthesis [ 3 ]. Thus, ongoing care to enable their continuous use of the prosthesis is important.…”