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SIB and Oral Retainers


Question

My child bites his hands and arms. In your recent presentation, you made reference to retainers that can be used as an effective intervention to biting oneself. Could you provide me with more information?

Answer of our experts

The appliances I spoke about for self injurious behavior are merely Maxillary Hawley Removable retainers that have a build up of acrylic pads over the posterior (back) teeth to prevent the anterior (front) teeth from coming together to bite the hands, cheeks, tongue, etc. Sometimes this can be cemented in or bonded over the chewing surfaces of the back teeth, but hygiene and the ability to get enough control to do this may be limiting factors

The easiest appliance to make might be a simple athletic mouth guard type of retainer. It would cover the front teeth and open the bite a bit preventing the front teeth from coming together. It is easy to make and less obtrusive. It can be held in via denture adhesive powder if needed. Another thought might be to get restraints for the elbows so that the hand cannot reach the face, although these then limit the use of the hands

DM/ TK 7-13-10

SEE ALSO: Self Injury and Hair Pulling

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Recommendation(s)

Self-injurious and aggressive behaviour

R54
To identify the cause of self-injurious behaviour in individuals with CdLS, medical assessment, specifically looking for sources of pain, should be followed by behavioural assessment of self-restraint then functional analysis.
R55
Treatment of self-injurious behaviour should include both medical and behavioural strategies.

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