Self-Mutilation of Tongue and Lip in a Patient with Simple Schizophrenia

Munerato, Maria Cristina; Moure, Sabrina Pozatti; Machado, Vivian; Gomes, Fabiano A.

doi:10.3121/cmr.2010.930

Cited by 17 publications

(7 citation statements)

References 7 publications

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“…Research has shown that mentally ill patients are more likely to have dental caries, missing teeth, xerostomia, and oral lesions [12,13]. There have been instances where patients have somatic delusions pertaining to abnormalities in the oral cavity resulting in unnecessary dental procedures [14][15][16]. Our patient's persistent concern over her gums without any physical indication of an issue illustrates a somatic delusion.…”

Section: Case Presentationmentioning

confidence: 83%

Diagnosis of Tardive Dyskinesia in an Oral Surgical Office

Prabhu¹,

Sameh²,

Kevin³

et al. 2018

Clin Med Rev Case Rep

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Tardive dyskinesia (TD) presents as uncontrolled, repetitive movements of the body, typically beginning with orofacial structures, due to antipsychotic medications. The two classes of antipsychotics, atypical and typical, are mainly distinguished by their likelihood of producing extrapyramidal side effects (EPS), with atypical producing lower rates. Our case discusses a patient who presented at our clinic for dental extractions. Pre-operative consultation presented the rapid, repetitive tongue, lip, and cheek movements characteristic of tardive dyskinesia. An extensive search through her medical history showed long-term antipsychotic usage. After a consultation revealed she had never seen a psychiatrist outside of acute care centers, we referred her to a psychiatrist to evaluate her medications as she had been taking a typical antipsychotic. During the follow-up appointment, our patient's tardive diagnosis was confirmed by a psychiatrist and she had been prescribed an atypical antipsychotic. The clinical implications of this report are to encourage dental professionals to understand the medications associated with mental illnesses, as they can significantly affect oral health and other motor functions. Although we were unable to prevent the onset of tardive dyskinesia in our patient, her case serves as a cautionary reminder of the consequences when mental illnesses go unchecked and how dental professionals can potentially prevent a life-changing condition in their patients.

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Section: Case Presentationmentioning

confidence: 83%

Diagnosis of Tardive Dyskinesia in an Oral Surgical Office

Prabhu¹,

Sameh²,

Kevin³

et al. 2018

Clin Med Rev Case Rep

View full text Add to dashboard Cite

show abstract

“…The clinical treatment of individuals with factitious ulcers is problematic because of the behavior of patients, normally very quiet and shy, reluctant in accepting the self-harm as the cause of the lesion itself [ 7 , 11 ]. In these cases, the discontinuity of the harmful habits is the target of the treatment planning, which should consider the severity, intensity, and the frequency of the self-harm actions [ 11 , 12 ]. The multidisciplinary treatment involving dentists, psychologists, and psychiatrist is essential in most severe cases [ 4 , 6 , 7 , 9 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

The Diagnosis and Treatment of Multiple Factitious Oral Ulcers in a 6-Year-Old Boy

Gonçalves

Méndez

Santos

et al. 2017

Case Reports in Dentistry

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Factitious ulcers are characterized by self-inflicted lesions with multifactorial origin. These lesions are frequently found in head, neck, and hands. This report shows a 6-year-old boy diagnosed with factitious oral ulcers that occurred after the self-biting of buccal vestibule and nail-scratching of gingival tissue. Clinically, a significant swelling was observed, hard on palpation, located at the right lower third of the face, next to the posterior area of the mandible. In the intraoral examination, ulcers at different healing stages were noted on the swelling area. During the anamnesis, the father reported a change in his familial structure that triggers psychological stress, providing the clues to the presumptive diagnosis of factitious oral ulcers. We prescribed the topical use of Gingilone® three times a day to control the local pain and inflammation. At 7-day follow-up, we noticed the reduction of extraoral swelling and the initial healing of the ulcers. The presumptive diagnosis was confirmed at 30-day follow-up, with the lasting remission of oral lesions. The treatments of factitious oral ulcers should be individually tailored for each patient, focused on a multidisciplinary approach, including psychotherapy and periodic clinical control. To the best of our knowledge, gaps of evidence lead to the lack of standardized clinical protocols on this issue.

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“…Some of these conditions could be risk factors for the occurrence of lingual abscess. We hypothesize that, at least in our case, the lingual abscess was the result of self-injury, which is a behavior commonly observed in patients with mental disorders, such as borderline personality, depression, and schizophrenia [ 10 ]. It has already been recognized that patients with schizophrenia appear to be relatively insensitive to physical pain.…”

Section: Discussionmentioning

confidence: 99%