Oral self‐injury. An update

Abstract

– Background: Self‐inflicted oral injuries of organic origin are particularly common in certain diseases, syndromes, and systemic disorders. In this article, we discuss the characteristics of these oral lesions and their treatment. Literature Search: The authors have reviewed the most relevant literature relating to oral self‐injury through a search in textbooks and published articles included in the Medline database for the years 1970–2010, and selected published cases from the last two decades. Results: The majority of the literature on oral self‐injury is in the form of case reports. Self‐injury is particularly prevalent in patients with Lesch–Nyhan syndrome, a heterogeneous group of neurological disorders, congenital insensitivity to pain with anhidrosis, and mental retardation. It is most common in males in the early years of life, and the sites most frequently involved are the lower lip and the tongue. Therapeutic approaches in these patients have included psychological and pharmacological treatment, intraoral devices, and surgical procedures. Clinical Implications: Intraoral devices are the best therapeutic option for self‐injury of organic origin, although this approach is not free of complications. The current lack of standardized treatment protocols for oral self‐injury means that therapy must be individualized.

Lesch-Nyhan syndrome: The saga of metabolic abnormalities and self-injurious behavior

“…SIB has also been observed in congenital insensitivity to pain with anhidrosis, mental retardation, and syndromes as Cornelia de Lange syndrome, Munchausen syndrome, Moebius syndrome, Gilles de la Tourette syndrome, and Rett syndrome (5). Since the oral cavity is the earliest primary focus and the means of interaction with environment, it falls prey to any attempt at self-injury, with sharp teeth being the preferred tool (5,6). After the eruption of the primary teeth, SIB is displayed, as was noted in the current case.…”

“…Conservative modalities such as a mouthguard, bite guard, lip bumpers, or bite planes have been tried in the past but they have not been effective (9)(10)(11). Extraction of both primary and permanent teeth may be the ultimate solution in most cases (2,5,6). In the current case, the patient's pattern of self-biting changed after a bite guard was affixed and later when the primary mandibular incisors were extracted.…”

A rare case of a myofibroma presenting on the tongue

“…This was relieved through the provision of a bite raising appliance, which provided relief of symptoms while the patient adapted progressively. 4 At the six-month follow-up review, there was no sign of recurrence and the patient no longer required her appliance following habituation to the new anatomy. Although the literature claims excellent long-term prognosis for Figure 9 Left deviation of the tongue following complete healing most solitary lesions, with no risk of metastasis, she was reviewed for two years in view of its highly infiltrative nature.…”

Oral Self-Injury: Report of a Case with Review of Literature

“…6 Limeres et al proposed that treatment for oral self-injury must be individualized as there is lack of treatment protocol. 7 Arhakis designed a maxillary intraoral appliance to prevent oral and perioral self-injury. 8 Santos et al concluded that association of different laser therapies was effective in establishing painless mastication.…”