A history of oral protection for the ECT patient: past, present, and future

Dental injuries and oral soft tissue trauma are recognized risks of electroconvulsive therapy (ECT), which continue to cause concern for patients and providers. The sudden forceful closure of the jaws that precipitates trauma is not avoidable since the pterygoid, masseter, and temporalis muscles are stimulated during treatment. Therefore, the use of a biteguard and oral protection techniques is recommended. No one biteguard has been found to be effective in protecting against all of the oral conditions that exist in the adult ECT patient population. A review of the objectives of ECT oral protection and biteguard design is detailed. The characteristics of patented, commonly used, and home-made ECT oral devices are considered, and recommended techniques for oral protection are detailed.