Lip-biting in patients with profound neuro-disability

Profound neuro-disability due to severe brain damage affects approximately 1200 people per year in the UK. Approximately half of these patients exhibit exaggerated or abnormal oral reflexes. Biting, bruxism and ruminating movements may result in dental or soft tissue trauma, with severe lip or tongue lacerations. This paper describes 10 patients referred to the dental department at the Royal Hospital for Neuro-disability with lip bites and/or severe bruxism, during a 12-month period. Management options include: monitoring the lesion; smoothing teeth; providing a bite raising appliance; or extracting teeth. This paper discusses the difficulty in management of lip trauma in this group of patients and emphasizes the importance of an interdisciplinary approach.