2017 Volume 32 Issue 1 Pages 17-22
Oral dyskinesia（OD）manifests as repetitive, rapid, short, stereotypical involuntary movements that appear in the oral cavity and jaw area. OD is generally categorized as idiopathic, drug-induced or extrapyramidal, based on localized symptoms. We encountered an 82-year-old woman with a history of cerebral infarction, hypertension, chronic gastritis, osteoporosis and insomnia. In May 2014 she noticed a canker sore at the right border of the tongue, and was prescribed a steroid ointment by the referring physician. In November 2014 she was referred to our department. A well-defined, nearly round ulcer 15 mm in maximum diameter was observed on the right border of the tongue, with mild protuberance in the surrounding area, but no induration or bleeding tendency. The patient was asked to keep her tongue immobile, but was unable to do so and the tongue constantly moved in a twisting motion. The right mandibular first molar was in alignment with the position of the tongue ulcer surface. The ulcer was diagnosed as decubital ulcer accompanied by idiopathic oral dyskinesia on the right border of the tongue. An oral appliance（OA）was manufactured with the aim of protecting the tongue and for deprogramming of the oral environment, and the patient was instructed to wear it only during the daytime, and to take it out at night when she went to bed. After using the OA for 2 months, the ulcer on the tongue border had completely healed, and the OD was alleviated after 3 months. After 4 months, use of the OA was discontinued. As of 1 year after discontinuing use of the OA, the patient has had no recurrences of decubital ulcer. She continues to come for monthly examinations, and although OD has persisted, it is in a much milder form.
