Discussion
Dental crowding is usually a result of the discrepancy between tooth and
jaw size. In this case report, the severe dental crowding was likely a
result of constricted jaw bones rather than larger teeth since the
patient exhibited very narrow maxillary and mandibular arches. This also
demonstrates that SJS could have effects not only on general bones but
also craniofacial skeletons. Good oral hygiene helps prevent premature
loss of primary teeth that could worsen the arch length discrepancy.
Therefore, routine dental care and regular dental check-up should be
emphasized. The patient’s maxilla is constricted anteriorly and even
more so laterally. The mandible is also retrognathic. This could
illustrate the effects of myotonia on craniofacial development. Because
maxillary and mandibular hypoplasia could be a risk factor in developing
pediatric OSA.8 This could mean that patients with SJS
are at risks to develop OSA as the patient in this report. However, this
correlation has not been previously raised, possibly due to the rarity
of SJS. This is the first case report of SJS from Thailand. It is also
the first SJS report with a detailed description of craniofacial
morphology.