A Novel Approach for the Management and Prevention of Self-Induced Masticatory Lingual Trauma in the Neurologically Injured Patient

Abstract

Self-induced masticatory trauma is an unfortunate complication of a variety of neurologic disorders, including epileptic seizures, cerebral palsy, mental retardation, psychiatric disease, and brain trauma, in addition to other described etiologies. While single or occasional occurrences of tongue biting are relatively benign, recurrent self-injury can pose major issues and predispose a patient to chronic, severe complications. To prevent the complications associated with ongoing trauma to the tongue, steps must be taken to protect individuals from chronic self-injurious behavior. Often, these interventions cause significant morbidity to the patient, such as elective removal of the dentition or complications in gaining access to the oral cavity/airway associated with maxillomandibular fixation. In the neurologically impaired patient, immobilization of the jaws is frequently associated with higher rates of agitation, aspiration, or development of complicating infections of the gingival tissues. We report a case of self-induced masticatory trauma managed with the fabrication of a custom-fabricated oral appliance. This treatment modality successfully prevents the recurrence or incidence of self-induced masticatory trauma to the tongue. The benefits of this modality are that it allows access to the oral cavity, prevents immobilization of the jaws, has minimal to no morbidity, and is completely reversible.

New intraoral device for prevention of oral lesions in intubated patients

“…Appropriate mouthguards can prevent bleeding and problems associated with infection, as well as promote healing of lacerations in the oral cavity. Additionally, the cost related to the acquisition of a mouthguard would be less than that of the treatment of infections (Avashia, Bittar, Suresh & Powers, 2018).…”

Efficacy of self-designed intraoral appliances in prevention of cheek, lip and tongue bite after local anesthesia administration in pediatric patients

“…The fabrication of intraoral appliances for prevention of self-inflicted soft tissue injury has been reported in special needs patients (7-9) and in those with habitual biting of the oral mucosa (10,11). Polyethylene terephthalate has been used in the fields of medicine (12,13) and dentistry, particularly orthodontics (14).…”