Development of Bite Guards for Use in Electroconvulsive Therapy in Psychiatric Patients at Suanprung Psychiatric Hospital, Chiang Mai Province

Abstract

Electroconvulsive therapy (ECT) is an effective treatment modality for patients with severe psychiatric disorders or those who are refractory to other therapeutic approaches. However, muscle contractions during the procedure may lead to oral complications, including tooth fracture, tooth displacement, and tongue lacerations, particularly when the bite guard is not well adapted to the patient’s oral anatomy. The author therefore developed bite guards for use during ECT to reduce oral complications. This article outlines the conceptual framework and development process from 2017 to the present. Two models were developed: Suanprung Model 1, which was designed to be suitable for both unmodified ECT and modified ECT, and Model 2, which specifically aimed to resolve the persistent issue of tongue lacerations. Follow-up results demonstrated that the use of these bite guards significantly reduced both the incidence and severity of oral complications. Notably, no complications were observed with Suanprung Model 2. In addition, the production cost was lower compared to commercially available alternatives, resulting in reduced overall expenditure. User satisfaction was reported to be high, supporting the feasibility and appropriateness of implementation within the Suanprung Hospital context. The findings suggest that the developed bite guards have potential for broader application in other psychiatric settings and evaluate long-term outcomes.