Extraoral management for electrical burns of the mouth

Resident: Roberts
Article title: Extraoral management for electrical burns of the mouth
Author: Josell, Stuart et al.
Journal: Journal of Dentistry for Children
Year: 1984, pages 47-51
Type of article: case review
Findings:

Electrical burns most often result from a child sucking or chewing on an electrical cord. This can result in scarring, constriction and deformity of the oral cavity. Oral splints can be fabricated to prevent or minimize tissue contracture or microstomia that often follow burn injuries. These devices can be intraoral, extraoral, removable, fixed, cemented or ligated. The dentist must decide which one to use and work to make sure the device is non traumatic, easy to insert and remove and well tolerated by the patient. Advantages and disadvantages exist to each kind of device. An intraoral device requires that an impression be taken prior to fabrication. Often times local anesthetic or means of sedation is required in order to comfortably take an accurate impression. When choosing a device that is removable it is important to remember that these devices often require more patient compliance than a fixed unit. Fixed units, though much easier for the patient to use often times can be more difficult for the dentist to adjust to the oral cavity if needed. Extraoral devices, can present difficulties at the time of eating, but require no initial impression to get started.

Case review:
A one year old sustained an electrical burn while chewing on a cord. The mother tried to treat the injuries with topical applications of hydrogen peroxide. 36 hours after the injury, the child was taken into the hospital for care. 5 days after being admitted to the hospital, pediatric dental was consulted and an intraoral splint was fabricated to assist in healing of the wound. Due to poor retention, an extraoral sling was attached to enhance retention. However, due to patient behavior (the child cont'd to try to suck his thumb) and insufficient stability an extraoral device was fabricated to replace the original intraoral splint. This time the child was able to suck his thumb improving patient tolerance, and stability was also achieved. The splint was worn between 8 and 13 hours per day. After 12 months, it was found that surgical intervention was not needed and most scar tissue that formed early on after the initial trauma disappeared over the course of the treatment.

Directions on how to fabricate these splints can be found in the article if interested.