Self-inflicted lesions of the mouth and lips in mentally retarded young subjects.
OBJECTIVE
To evaluate the type and frequency of self-mutilation lesions of the mouth and lips in a large group of institutionalized mentally retarded subjects.


METHODS
Two hundred and forty-five institutionalized mentally retarded patients were evaluated clinically by a systematic inspection of the perioral cutis, lips, tongue, oral mucosa, palate, gingivae and teeth. Moreover, the drug therapy taken by each patient was carefully reviewed.


RESULTS
Numerous lesions were found involving the tongue, lips, oral mucosa, perioral skin, gingivae and teeth, prevalently supported by a self-mutilation mechanism (such as cheek and tongue biting and nodular traumatic lesions), which were differentially expressed in patients with different degrees of mental retardation. A possible effect of anti-epileptic or neuroleptic drugs was also detected.


CONCLUSIONS
These findings indicate that inspection of the oral cavity should always and carefully be performed in all patients with mental retardation and in those with neuroleptic and anti-epileptic drug therapy, in order to avoid or even extinguish self-mutilation of the oral cavity by means of an accurate hydration of the mucosa which might counterbalance some iatrogenic undesired effects.
Unit of Dermatology.
Maddalena
M
Siragusa
Department of Neurology I.C.
Raffaele
R
Ferri
Unit of Odontostomatology, Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Via Conte Ruggero 73, 94018 Troina, Italy.
Roberto
R
Russo
Department of Human Pathology University of Messina, Messina, Italy.
Maria
M
Lentini
Unit of Dermatology.
Carmelo
C
Schepis
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003728:Dental Calculus / Q000209:etiology; D005260:Female; D005891:Gingivitis / Q000209:etiology; D006801:Humans; D008607:Intellectual Disability / Q000150:complications* / Q000188:drug therapy; D008046:Lip / Q000293:injuries; D008297:Male; D009055:Mouth / Q000293:injuries*; D009061:Mouth Mucosa / Q000293:injuries; D012652:Self Mutilation / Q000209:etiology*; D012798:Sialorrhea / Q000209:etiology; D014059:Tongue / Q000293:injuries; D014071:Tooth Abnormalities / Q000150:complications; D055815:Young Adult
D000927:Anticonvulsants; D014150:Antipsychotic Agents
Morsicatio buccarum; cheek biting; mental retardation; morsicatio labiorum; self-mutilation; tongue biting