Secondary Logo

Journal Logo

Letter to Editor

Neurotic habit-induced disorder

Stapler pin impaction in gingiva

Shamim, Thorakkal

Author Information
Journal of Family Medicine and Primary Care: June 2022 - Volume 11 - Issue 6 - p 3372-3373
doi: 10.4103/jfmpc.jfmpc_638_21
  • Open

Dear Editor,

Neurotic habit-induced disorders are disorders originating from parafunctional activity of the soft and hard tissues of the oral cavity.[1] People who are under stress and psychogenic background may express self-mutilation by biting of the oral mucosa resulting in chronic cheek, lip, or tongue biting or biting external objects.[2] This article depicts a case of neurotic habit-induced disorder, namely, foreign body (stapler pin) impaction in the gingiva in a 12-year-old boy reported from a school to the dental outpatient department of a tertiary-care hospital in Kerala. The school authorities along with the parents presented an anxious 12-year-old boy with a chief complaint of severe pain in the gum of the upper right front teeth. From the clinical history, it was revealed that the child had the habit of playing with the stapler pin, and it got impacted in the gingiva of the right front tooth. On clinical examination and palpation, there was a swelling, and the stapler pin was evident in the gingiva in relation to the right maxillary central incisor [Figure 1], and it was confirmed radiographically using intraoral periapical radiograph [Figure 2]. The area was explored under local anesthesia, and the stapler pin was retrieved [Figures 3 and 4]. The boy was referred to the adolescent health counseling center attached to our institution for psychological intervention.

Figure 1:
Clinical photograph of stapler pin embedded in the gingiva in relation to right maxillary central incisor
Figure 2:
Intraoral periapical radiograph showing stapler pin impaction
Figure 3:
Surgical exploration of stapler pin under local anesthesia
Figure 4:
Retrieved stapler pin

Informed consent

Informed consent was obtained from the patient.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.


1. Shamim T A simple working type classification proposed for the psychosomatic disorders of the oral cavity J Coll Physicians Surg Pak 2012 22 612
2. Shamim T The psychosomatic disorders pertaining to dental practice with revised working type classification Korean J Pain 2014 27 16–22
© 2022 Journal of Family Medicine and Primary Care | Published by Wolters Kluwer – Medknow