Prevention of self‐inflicted trauma: dental intervention to prevent chronic lip chewing by a patient with a diagnosis of progressive bulbar palsy

Rover, Billy C.; Morgano, Steven M.

doi:10.1111/j.1754-4505.1988.tb00683.x

Cited by 9 publications

(3 citation statements)

References 2 publications

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“…Biological theories maintain that SIB is the expression of an underlying genetic defect that may produce alteration of neurotransmitters [2,10]. SIB in paediatric patients may be related to genetic syndromes such as Lesch‐Nyhan [2,11] Cornelia de Lange, Gilles de La Tourett [12], Munchhausen, Familial Disautonomia [13], Analgia Congenita syndrome [14,15], XXXXXY syndrome, XXY syndrome, trisomy 18 [16] and other entities such as autism [7,9], mental retardation [2], hereditary sensory neuropathies [17], encephalitis [18,19], congenital malformations, congenital infectious diseases [20], bulbar palsy [21], comatose [22], unconscious [23] and epileptic patients. Functional theories maintain that SIB is used as a means of escape or attention seeking and may arise in stressful situations [1,24,25].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the restraints must be used in accordance with the severity of SIB. Oral restraints described include fixed or removable acrylic horseshoe appliance, soft mouth guards, buccal or lingual shields, thermoplastic appliances in combination with intraoral and extraoral elastics and other accessories such as facemasks, chin‐cups, lip separators, special clothing or belts [5,2,14,17,20,22,44,45]. In severe cases, radical tooth extraction [3,44] or maxillary osteotomy may be considered necessary [3].…”

Section: Discussionmentioning

confidence: 99%

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Factitial oral lesions in an autistic paediatric patient

Medina

Sogbe

Gómez-Rey

et al. 2003

Int J Paed Dentistry

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Self Injurious Behaviour (SIB) is a deliberate harm to the body that may lead to factitial injuries. Its origin may be functional or biological and it has a higher prevalence in females and in psychologically impaired individuals. Seventy per cent of autistic patients have SIB. Seventy-five per cent of factitial injuries are located in the head and neck region. A paediatric case report concerning a 4-year-old autistic female is presented. Detailed medical history, physical examination, clinical intraoral and radiographic examination, incisional biopsy, neuropaediatrical, psychological and speech evaluation were undertaken. Diagnosis included hypochromic macrocytic anaemia, caries, coronal fracture, factitial ulcer, factitial periodontitis, self-extraction of primary teeth and permanent teeth buds, non-specific oral ulcer with inflammatory reaction, mild mental retardation, speech impairment, autistic syndrome and self injurious behaviour consisting of putting fingers and foreign objects in the gingiva, fingernail biting and hair pulling. Differential diagnosis included hystiocitosis X, prepuberal periodontitis and leukocyte adhesion deficiency. Dental preventive and restorative treatment was performed. Non-contingent reinforcement therapy was successfully used to diminish SIB. Treatment of factitial oral injuries must be interdisciplinary and requires cooperation of the patient, the parents, health care providers, and medical team.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Factitial oral lesions in an autistic paediatric patient

Medina

Sogbe

Gómez-Rey

et al. 2003

Int J Paed Dentistry

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“…Dental literature on MND is limited with only five case reports and a single case series . Management guidelines are limited and include prostheses to alleviate bulbar symptoms of dysarthria, dysphagia and traumatic biting, gagging prevention via avoidance of contact with intraoral soft tissues and avoidance of topical anaesthetic application …”

Section: Introductionmentioning

confidence: 99%

Oral health and dental treatment needs of people with motor neurone disease

2014

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Background: People with motor neurone disease (MND) may present with physical limitations impacting on oral health and access to oral health care. This study aimed to assess the oral health status and treatment needs of people with MND in Victoria, Australia. Methods: Patients with advanced MND attending a multidisciplinary MND clinic in Melbourne were recruited. Data collection included self-reporting questionnaires on previous dental experience, current oral hygiene practices and current dietary habits, a medical questionnaire, and a clinical examination charting participants' dentition, restorations, caries and periodontal status, plaque and gingival indices, and assessment of oral health. Results: Thirty-three participants took part in the study with eight self-reporting regular dental visits. No participant exhibited probing depths of more than 3 mm. Ten out of 27 dentate participants required extractions and restorations for retained roots and caries, while three presented with non-carious cavities, lost restorations and fractured cusps. Oral health status was not affected by MND presentation in these participants. Conclusions: The study found that oral health was not affected by advanced MND. Participants' and clinical teams' motivation towards oral health care may have contributed to oral health. The dental profession should be involved as part of the multidisciplinary effort towards ongoing care.

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