Tardive dyskinesia affected by occlusal treatment--a case report

The following is a case report of occlusal treatment for involuntary mandibular movement occurring in a 79-year old woman. This was diagnosed as sulpiride-induced tardive dyskinesia. The patient had been treated with sulpiride to improve gastrointestinal symptoms for five years until the onset of involuntary mandibular movement. The involuntary movement worsened even after discontinuation of the drug for 10 weeks. The dyskinesia improved in the course of treatment with an occlusal splint placed over her upper denture. After wearing the new denture with increased occlusal vertical dimension, the dyskinesia disappeared almost completely. Sirognathographic observation showed that previous denture wear evoked remarkable involuntary movement of the mandible once again. It is uncertain whether such improvement may result from discontinuation of the drug or from the occlusal treatment. However, it appears that occlusal factors played an important role in orofacial manifestation of tardive dyskinesia (TD) in this case.