Reverse smoking and the insulated denture

Our plain-English summary of Reverse smoking and the insulated denture, by P.D. Marano (The Journal of the American Dental Association, 1976).

The study

• Author: P.D. Marano
• Journal: The Journal of the American Dental Association
• Published: 1976;92(3):599-601
• Type of article: Case report
• Read it: PubMed · Publisher

In plain English

This was a case report from a US Air Force hospital's oral surgery department. It described a 66-year-old Filipino woman who reverse smoked, holding the lit cigarette end inside her mouth. She had smoked six to eight cigarettes daily for 50 years, and for the last ten years had always worn her only complete dentures while smoking. She had a white 2 cm lesion on the middle of her hard palate. Tar and acrylic on her old denture together measured 1.9 cm thick. A biopsy showed focal hyperkeratosis with chronic inflammation, without dysplasia or neoplasm. She did not expect to stop smoking, so a new denture with a thicker palate was made. Sandwiched in its acrylic resin palate were a layer of asbestos fiber lining and a layer of aluminized asbestos cloth. The article said this material, used in fire fighters' protective clothing, reflects 90% of the heat. After one year of follow-up, the lesion had not recurred. The author concluded an insulated denture was the most feasible solution. The article did not study health effects of asbestos or name the fiber type.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient)
• Who was studied: One 66-year-old Filipino woman, a reverse smoker who had worn complete dentures (made in 1964, her only set) for ten years, referred to an oral surgery clinic (author at Maxwell USAF Regional Hospital, Maxwell AFB, Alabama); published 1976
• Exposure: Two exposures appear in the article. The first was heat and tobacco tar from reverse smoking: six to eight cigarettes daily for 50 years. For the last ten years she wore complete dentures, made in 1964, always while smoking. The second was asbestos used as a treatment material: a layer of asbestos fiber lining and a layer of aluminized asbestos cloth sandwiched in the acrylic resin of the new denture's palate. Fiber type was not named. The patient's exposure to asbestos and its health effects were not studied, and the article does not say whether fibers could be released.
• Main results:
  • The patient had a white, slightly raised lesion on the midline of the hard palate, 2 cm in diameter.
  • On the patient's old denture, the tobacco tar deposits plus the acrylic resin measured 1.9 cm thick.
  • The biopsy showed no evidence of dysplasia or neoplasm. The final diagnosis was focal hyperkeratosis with chronic inflammation.
  • The article described the aluminized asbestos cloth used in the new denture as a material from fire fighters' protective clothing that reflects 90% of the heat.
  • After one year of close follow-up with the insulated denture, the palatal lesion had not recurred.
• The authors' conclusion: The author concluded that, because the patient refused to give up reverse smoking, an insulated denture was the most feasible way to prevent further irritation to the hard palate while accommodating her habit.

Related studies

• Asbestos exposure, smoking, and neoplasia — I.J. Selikoff, E.C. Hammond, et al. (1968)
• Asbestos exposure, cigarette smoking and death rates — E.C. Hammond, I.J. Selikoff, et al. (1979)
• Asbestos and lung cancer: an analysis of the epidemiological evidence on the asbestos-smoking interaction — R. Saracci (1977)
• K-ras mutations in human adenocarcinoma of the lung: association with smoking and occupational exposure to asbestos — K. Husgafvel-Pursiainen, P. Hackman, et al. (1993)
• Combined effect of asbestos exposure and smoking on mortality from lung cancer in factory workers — G. Berry, M.L. Newhouse, et al. (1972)
• Asbestos, asbestosis, smoking, and lung cancer. New findings from the North American insulator cohort — S.B. Markowitz, S.M. Levin, et al. (2013)

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