Necrotising sialometaplasia – an unusual cause

Necrotising sialometaplasia is a rare, non‐neoplastic disease caused by the inflammation of salivary glands. Diagnosis is made by incisional biopsy, and lesions are self‐limiting and resolve spontaneously. The precise aetiology of necrotising sialometaplasia is unknown, but it is thought that necrosis of salivary glands occurs due to trauma that leads to disruption of blood supply and ischaemia of the salivary lobules. Examples of trauma include local anaesthetic administration, intubation and ill‐fitting dentures. This case demonstrates an extensive bilateral presentation of necrotising sialometaplasia as a result of traumatic autoextraction (self‐removal) of three maxillary teeth and highlights the need to consider a diagnosis of self‐mutilation when faced with atypical ulceration of the palate. Although uncommon, cases of oral self‐mutilation can present initially to dental practitioners and we must be aware of this aetiology in order to help in the prevention of further damaging behaviour.