Innovative appliance therapy for self injurious tongue biting habit in a child: a case report

Background: Self-injurious behaviour (SIB) is defined as deliberate harm to one’s body without suicidal intent. SIB is commonly seen in individuals with psychotic problems, character disorder, mental retardation, coma and genetic syndromes. These injuries may manifest as factitial ulcers, gingivitis, periodontitis and self extraction. Hence, the recognition and understanding of these injuries are indispensable for effective clinical management in dentistry. Method: This article presents a case of self - injurious behaviour in a 13 – year old child with ADHD having severe ulcerations on the tongue due to insistent tongue biting habit. As a part of multidisciplinary approach to deal with self-injurious behaviour, a custom tongue protective appliance was fabricated to prevent the tongue biting, hence, facilitating the healing of lesion and habit control. Result: The use of a custom tongue protective appliance facilitated complete healing of the lesions within three months. In addition to mechanotherapy; behaviour therapy, pharmacological support, and parental counselling significantly contributed to the overall success of management. Conclusion: The present case shows that although diagnosing such cases can be very challenging, but once diagnosed, via proper treatment plan, thorough knowledge and appropriate appliance, these conditions can be managed effectively.