title: The effectiveness of a mouth guard to  protect against strong occlusion caused by  modified electroconvulsive therapy.
abstract: Modified electroconvulsive therapy (m-ECT) is a treatment for mental disease such as depressive disorder. Although a muscle relaxant is used during current application, strong occlusion occurs due to the proximity of the electrode to the temporal and masseter muscles. Although a feedback mechanism to avoid excessive occlusion occurs unconsciously, the mechanism does not work under general anesthesia. Strong occlusion may cause complications such as tooth injury, pain of the jaw, lip laceration, and bleeding of the gums. Although there was a report that the insertion of shock-absorbing materials such as gauze reduces complications, there has been no study on the effectiveness of a mouth guard (MG) for alleviating the occlusal force during m-ECT. The present study investigated the effectiveness of MG for alleviation of the occlusal force and complications during m-ECT. An ethyl-vinyl-acetate (EVA) MG was used as a shock absorbing material to mitigate the strong occlusion during m-ECT to investigate the influence of MG on the occlusal force and its effectiveness. The results showed that the occlusal force was alleviated by 58 ± 22% on average using MG during m-ECT. It also helped reduce intra-oral problems such as pain and bleeding. The results suggest the effectiveness of MG for alleviating the occlusal force during m-ECT and avoiding complications due to strong occlusion.
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, Fujita Health University School of Medicine, Toyoake, Japan.
authors.forename: Saori
authors.initials: S
authors.lastname: Ogami
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, Fujita Health University School of Medicine, Toyoake, Japan.
authors.forename: Morimasa
authors.initials: M
authors.lastname: Yamada
authors.affiliation: Department of Anesthesiology, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan.
authors.forename: Mayuko
authors.initials: M
authors.lastname: Kanazawa
authors.affiliation: Department of Anesthesiology, National Hospital Organization Osaka Minami Medical Center, Kawachinagano, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Takeda
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, Fujita Health University School of Medicine, Toyoake, Japan.
authors.forename: Naoaki
authors.initials: N
authors.lastname: Kimura
authors.affiliation: Department of Oral and Maxillo-facial Surgery, Fujita Health University School of Medicine, Toyoake, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Mizutani
authors.affiliation: Anesthesiology and Clinical Physiology, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University, Bunkyo-ku, Japan.
authors.forename: Hikaru
authors.initials: H
authors.lastname: Kohase
authors.affiliation: Anesthesiology and Clinical Physiology, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University, Bunkyo-ku, Japan.
authors.forename: Haruhisa
authors.initials: H
authors.lastname: Fukayama
mesh_terms: D001732:Bite Force; D004565:Electroconvulsive Therapy; D006801:Humans; D009064:Mouth Protectors