Dentures are removable appliances that replace missing teeth and surrounding tissues, restoring the ability to speak and chew. For some wearers, the introduction of this appliance can lead to a persistent cough. While the connection between a dental appliance and a respiratory reflex may seem confusing, it is a well-documented issue. This reaction is often related to the physical fit, changes in the oral environment, or the presence of microorganisms.
The Direct Mechanical Link to Coughing
A common cause of a denture-related cough stems from the physical presence and size of the appliance. An upper denture must cover the hard palate for stability. If the posterior border extends too far back, it can impinge on the soft palate, irritating the pharynx. This intrusion directly stimulates the pharyngeal reflex, which can trigger a gag or cough response.
The initial period after receiving new dentures involves an adjustment phase where the mouth registers the appliance as a foreign object. During this time, the body is sensitive to the denture’s presence, and the gag reflex may be easily provoked. The physical bulk can also interfere with the coordinated movements of the tongue and cheek muscles necessary for proper swallowing.
A denture that restricts tongue space can lead to awkward swallowing patterns. This increases the likelihood of small amounts of food or saliva spilling into the airway. This minor aspiration irritates the throat and larynx, resulting in a reflex cough intended to clear the passage. Ill-fitting dentures are also prone to slippage during actions like speaking or chewing. A loose appliance may dislodge slightly, causing immediate physical irritation and a sudden cough.
Oral Hygiene, Infections, and Respiratory Irritation
Beyond mechanical interference, the denture environment can foster conditions that irritate the throat and respiratory tract, leading to a chronic cough. Denture wearers often experience issues related to saliva production, a natural lubricant and protective barrier. Xerostomia, or chronic dry mouth, is common due to medications or conditions prevalent in this population.
When saliva flow is reduced, the mouth and throat become dry and sticky, causing a sore or burning sensation. This lack of lubrication makes swallowing difficult (dysphagia), increasing the chance of material catching in the throat and triggering a cough. Conversely, new wearers may initially produce excessive saliva (sialorrhea) as the mouth reacts to the foreign object, which can also lead to throat clearing and an uncomfortable cough.
Poor hygiene allows microorganisms to accumulate, often leading to denture stomatitis. This fungal infection is caused by an overgrowth of Candida albicans adhering to the acrylic surface. Denture stomatitis causes inflammation and soreness in the oral mucosa, which can extend to the throat. This irritation often manifests as a persistent, low-grade cough or a constant need to clear the throat.
The microbial plaque, or biofilm, that colonizes the denture surface poses a serious respiratory risk. Dentures act as reservoirs for potential respiratory pathogens, including bacteria like Streptococcus pneumoniae and Pseudomonas aeruginosa. Aspiration of this contaminated biofilm into the lungs is a risk factor for developing aspiration pneumonia, especially in older individuals or those with difficulty swallowing. Even chronic, low-level aspiration of these irritants can cause a cough reflex as the body attempts to protect the lower airways.
When to Adjust Dentures and Seek Medical Help
When a cough is suspected to be denture-related, the first step involves reviewing the appliance’s fit and the patient’s daily hygiene routine. To mitigate biological irritation, a strict cleaning regimen is necessary. This includes daily brushing with a non-abrasive cleanser and soaking the dentures overnight in a suitable solution. It is also recommended to remove the appliance for several hours daily, ideally while sleeping, to allow oral tissues to rest and reduce the risk of yeast overgrowth.
If the cough is mechanical, characterized by gagging or slippage, a professional adjustment is needed. Contacting a dentist is necessary for a reline or modification to the denture’s posterior border or thickness. Patients should never attempt to file or alter the fit themselves, as this can cause irreparable damage and worsen the fit.
If the cough is persistent, severe, or accompanied by systemic symptoms, a consultation with a primary care physician is imperative. Symptoms such as fever, chest pain, shortness of breath, or discolored mucus may signal a respiratory tract infection, like aspiration pneumonia. This requires medical treatment and cannot be resolved by denture adjustment alone. Addressing the underlying cause often requires a comprehensive approach involving both dental and medical professionals.