Multiple autoextractions: oral self-mutilation reviewed.

Oral self-mutilation occurs in a variety of clinical settings. The etiology of oral self-mutilation can be divided into organic and functional categories. Organic etiologic factors include metabolic and genetic disorders. Functional self-mutilation is performed knowingly, as a response to certain stimuli, and may or may not serve a cognitive purpose. The occurrence of oral self-mutilation with a functional cause represents a diagnostic challenge to practitioners. In this article, a case of autoextraction of multiple posterior teeth in a psychotic 27-year-old white man is presented. Though a wide range of self-mutilation in a person in a psychotic state is well documented, oral self-mutilation, particularly autoextraction, is rare. Although the case reported is extreme in nature, incidence of oral self-mutilation is not uncommon and should be considered in the differential diagnosis of lesions of unknown cause.