Preventing factitious gingival injury in an autistic patient

Article Abstract:

Self-mutilation of the mouth, leading to conditions such as inflammation, may occur in people with autism or other psychological conditions. Diagnosis of self-mutilation of injuries may be suggested when the injuries occur in unusual patterns, in reachable areas, and do not suggest common diseases. Treatment of such self-mutilation injuries may require consultation with a specialist in behavior modification. A 34-year-old man with autism had an inflamed and receding gum, exposing the root of one of his teeth. The wound was self-inflicted by the man's scratching of his teeth and gums. The man became receptive to treatment and stopped the behavior after the dentist promised to reward healthy behavior with tickets to a baseball game. This behavior modification technique was suggested by the patient's psychiatrist. The patient was no longer hostile to the dentist, responded well to dental treatment, and received a gum graft. The 1994 baseball strike began just before the allotted game, the patient lost his trust in the dentist, resumed the self-mutilation, and the gum injury returned.

Injuries, Autism, Gums, Gingiva

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Treating the oral sequelae of an acoustic neuroma

Article Abstract:

Surgical removal of cranial nerve tumors can lead to complications in the mouth, such as cracking of the mucous layers and gums, tooth loss, and tumor formation, which may be teated with oral appliances. Following surgery for removal of an acoustic neuroma, a 49-year-old woman had facial paralysis, numbness of her palate, throat, and gums, and distorted speech. Identification of the areas of numbness indicated which cranial nerves were affected by surgical complications. Several months after surgery she developed mouth ulcers, tears in her gum, a fibrous oral tumor, and exposure of the roots of two teeth. Her dentist removed the exposed teeth and constructed an oral apparatus to protect the soft parts of her mouth from accidental chewing. Two months later the ulcers and tumor healed. This case illustrates how an oral exam can help diagnose nerve complications of surgery or stroke.

Acoustic neuroma, Nervous system tumors

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Oral health problems and use of dental services among HIV-infected adults

Article Abstract:

Many AIDS patients with oral complications from HIV may not be able to get dental care. A survey of 672 HIV-infected patients nationwide revealed that half had two or more oral complications of AIDS, including oral candidiasis, gingivitis, fever blisters, cold sores or ulcers. Eighty percent had AIDS and only 25% had dental insurance. Only one-third were not receiving dental care and 32% of those who were received it at public clinics. Fourteen percent had difficulty getting dental care either because they could not afford it or the dentist refused to treat them. People of color with little education and no dental insurance were least likely to receive care.

Surveys, Dental care, AIDS patients, Oral hygiene

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