Annals of Dental Specialty Vol. 3; Issue 2. Apr – June 2015 | 67 MENTAL DEPRIVATION AND ORAL MYIASIS: A SPECIAL CASE REPORT Baba IA, 1 Shah AF, 2 Yousuf A, 3 Nabi S 4 1. Registrar, Department of Oral Medicine & Radiology, GDC, Srinagar, Jammu & Kashmir. 2. Registrar, Department of Public Health Dentistry, GDC, Srinagar, Jammu & Kashmir. 3. Registrar, Department of Public Health Dentistry, GDC, Srinagar, Jammu & Kashmir. 4. Post Graduate Scholar, Department of Conservator Dentistry & Endodontics, GDC, Srinagar, Jammu & Kashmir. Introduction Body cavities of human beings have been attacked by infestations with live insects or larvae since centuries. The word Myiasis is derived from Greek “Mya” meaning fl y and “isasis” meaning disease. 1 Hope. F.W. in 1840 was the first person who coined the term “Myiasis” to describe a human disease which originated from dipterous larvae. Common etiological factor for Myiasis is dipterous larvae that breed on dead or living tissues of host, liquid body substances and ingested food. 2 The incidence of disease is higher in developing tropical and subtropical countries and less frequent in western countries. The larvae responsible for the disease prefer to grow in warm and humid environment; therefore myiasis is preferably seen in summer months. Myiasis have been classified in two categories, Primary myiasis caused by larvae feeding on living tissue and commonly seen in animals, and rarely seen in humans. Secondary myiasis which is caused by flies that feed on dead tissues, this is more common variant and seen in patients with necrotic lesions. 3 According to sites involved in the body the myiasis can be oral, ocular, cutaneous, nasopharyngeal and intestinal and urogenital. 4 Case Report A developmentally disabled 12-years-old male patient preferably of low socioeconomic status was screened at dental health camp by Department of Public Health Dentistry and was referred to Department of Oral Medicine & Radiology GDC Srinagar; patient was accompanied by his mother with chief complaint of swelling and pain in upper front region of jaw since 4 days. Patient gave history of pricking type of pain radiating to the upper part of the face which was confirmed by parent accompanying him. Complete medical history revealed that patient was mentally challenged. On examination, the patient was lean built and mal nourished with waddling gait, apprehensive and febrile. Figure 1: - Extra oral profile with diffuse swelling of upper lip and maxillary region The patient resided in a rural setting of Jharkhand, India and had shifted to Srinagar, Jammu & Kashmir for begging. Patient was from a low socioeconomic background and had a very poor oral hygiene. Extra-oral examination revealed a solitary diffuse swelling measuring 2 × 4 cm involving the upper lip and the surrounding structures. (Figure 1) Intraoral examination revealed diffuse necrosis of soft tissues as well as alveolar processes with relation to 11, 12, 21 and 22 region. (Figure 2) The swelling was soft and tender on palpation and periorbital oedema was present. Lips were incompetent and on exploration diagnosis of oral myiasis was made clinically by presence of dipterous larvae in oral cavity. Abstract Oral myiasis is a rarely reported pathology frequently seen in patients who show prolonged illness and are debilitated or unable to take care of their own wellbeing. It has a predilection for poor oral hygiene or prolonged exposure of the oral mucosa to the unhygienic environment. Inflammation, destruction and necrosis of soft as well as hard tissues are the characteristic features of disease. This paper presents a classic case of oral myiasis in a 12 year old boy with mental retardation with incompetent lips and periodontal disease. Treatment consisted of manual removal of maggots, with the help of forceps and turpentine oil, surgical debridement of wound followed by broad-spectrum antibiotics and subsequent treatment of underlying periodontal disease. Oral myiasis is a serious and debilitating condition, showing predilection amongst unhealthy patients with psychiatric disorders. The provision for basic sanitation and general cleanliness of dwelling areas and maintaining good oral and personal hygiene remains the primary preventive measure in most of the cases. Key words: Larvae, Maggots, Necrosis, Oral Myiasis, Turpentine Oil. Case Report