A case of restoration of masticatory function by occlusal adjustment of dentures resultied in recovery of the general condition of teminal patient

<p>This is a remarkable case, in which an 86-year-old female patient with cirrhotic ascites judged to be in the terminal stage showed no effect of albumin replacement, but improvement of general conditions after recovery of masticatory function. The patient was finally admitted to our hospital (a chronic care hospital) after being hospitalized at two hospitals: first, the patient received treatment of pressure fracture at orthopedic hospital A, then to be treated for suspected heart failure due to decreased appetite and blood pressure, emergencytransferred to acute care hospital B, where CT scan revealed liver cirrhosis, large amount of ascites, and small amount of pleural effusion in both lungs. During admission to orthopedic hospital A, anorexia, chronic diarrhea, hypoproteinemia, pleural effusion, leg edema, and thrombocytopenia were observed. The patient was transferred to Acute Care Hospital B, where he was treated with fluid replacement, albumin, and ascites puncture, but continued to suffer from anorexia. Progression of debility and obsoletism due to decreased diet was expected; however, neither the patient nor her family wanted aggressive treatment or invasive examinations, and she was transferred to a chronic care hospital for continued care. After transfer, the patient complained that she could not eat with her dentures. We remounted and adjusted her dentures with an articulator to improve her masticatory function, and encouraged oral intake in cooperation with multiple professions. As a result, the patient's food intake recovered and stabilized. The patient's general condition stabilized and FIM improved with recovery of food intake, drainage of ascites using diuretics, and improvement of liver function, and he was discharged from the facility after about 10 months. The recovery of masticatory function plays an important role in QOL, and it was strongly suggested that efforts should be made to restore masticatory function even in patients who are judged to be in the terminal stage of life. </p>