ORAL SELF-INJURIOUS-BEHAVIOR IN THE DEVELOPMENTALLY DISABLED - REVIEWAND A CASE

Self-injurious behavior occurs in conjunction with a variety of psychi atric disorders as well as various developmental disabilities and some syndromes. The behavioral and biochemical aspects of self-injurious b ehavior are poorly understood and several etiologies have been suggest ed. Treatments for self-injurious behavior in developmentally disabled individuals fall into three main categories: pharmacological, behavio r modification and physical restraints. The dental management of self- injurious behavior is often difficult. Numerous appliances of various design have been reported in the literature. Osteotomies or extraction of the offending teeth may have to be considered if less invasive met hods are unsuccessful. A case is reported where a child engaged in ton ic lip biting secondary to a neurological and seizure disorder is trea ted using a removable lip-protruding device. No impression or lab cons truction is required. The appliance presents minimal interference with oral hygiene procedures and it can be removed and reinserted as neede d. We conclude that a removable lip-bumper may be a viable option in t reating transient and acute episodes of self-injurious behavior involv ing the lower lip and buccal mucosa.