A school-aged female child with spinal muscular atrophy (SMA) type 1 was seen in the dental clinic prior to gene replacement therapy (Onasemnogene abeparvovec). She had seven doses of nusinersen before this. She was intermittently ventilated through tracheostomy using bilevel positive airway pressure and was fed through gastrostomy.

On examination, she had sustained open mouth with premature contacts of …