Habit breaking appliances

habit breaking appliances used in orthodontics

1. HABIT BREAKING APPLIANCES BY: SAGLOW007 1

2. CONTENTS DEFINITIONS ORAL HABITS THUMB SUCKING AND ITS MANAGEMENT TONGUE THRUSTING AND ITS MANAGEMENT LIP HABIT AND ITS MANAGEMENT BRUXISM AND ITS MANAGEMENT 2

3. DEFINITIONS HABIT: Regular tendency or practice, especially one that is hard to give up. ORAL HABITS IN ORTHODONTIC: Oral habits in infancy and early childhood considered normal but from 3-4 years and above may become symptomatic & it effects the development of the maxiofacial complex. APPLIANCES: In orthodontic appliances are devices to correct or maintain the tooth position or the occlusal relationship. 3

4. ORAL HABITS Oral habits depends on: intensity, frequency and duration. INTENSITY: Amount of force applied on the tooth. FREQUENCY: No.of times that the habits present in a day. DURATION: The amount of time spent in the habits. 4

5. ORAL HABITS CONT: Following are the oral habits: Thumb Sucking Tongue Thrusting Lip Habit Bruxism 5

6. THUMB SUCKING & ITS MANAGEMENT Placement of thumb or one or more fingers in varying depth into the mouth. Common in infants. Develops b/w birth and 3 months of age. Parents should discourage the habit after 4 years of age if not stopped. Severity depending on frequency, duration and intensity. If thumb sucking persists after the primary teeth have erupted, it can drastically change the growth pattern of the jaw, & cause significant misalignment of the teeth. 6

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8. TREATMENT Starts from 04 to 06 years. Following are the different approaches: Counselling Reminder therapy Reward system Adjunctive therapy Appliances therapy 8

9. APPLIANCES THERAPY QUAD HELIX: One of the appliances used to expand a narrow maxilla.it is evolved from the original Coffin’s W spring. it is a spring that consists of 4 helices. 2 helices in the anterior palate & 2 helices in the posterior palate near solder joint. It is capable of dentoalveolar as well as skeletal expansion. In case of thumb sucking used in pt : with posterior cross bite as a reminder. 9

10. BLUEGRASS APPLIANCES This is the least intrusive appliance & easiest for the patient to wear & tolerate. Ideal for pts: that want to qut, but need a reminder to help them. 10

11. PALATAL CRIB More aggressive than the bluegrass. It blocks the thumb, so the patient can’t suck them. Patient without cross bite. Retainer 6-12 months. 11

12. HAYRAKE Most aggressive appliance to prevent thumb sucking. Prongs are added to this appliance to make it as uncomfortable as possible when the pt: tries to suck their thumb. 12

13. REMOVABLE HABIT APPLIANCES Habit loops can be added to any removable appliance. It act as a reminder to help break the habit. Great option for pts: to wear while they sleep. 13

14. TONGUE THRUSTING & ITS MANAGEMENT Also called REVERSE SWALLOW or IMMATURE SWALLOW . Common name of OROFACIAL MUSCULAR IMBALANCE . A human behavioral pattern in which the tongue protrudes through the anterior incisors during swallowing, speech, & while the tonge is at rest. 14

15. CLINICAL FEATURES Tongue movement-irregular Malocclusion Mandble proclination Maxilla proclination, increased in overjet. Anterior open bite Short flacid upper lip No correlation b/w tongue tip & mandible Increased anterior facial height 15

16. TREATMENT TREATMENT CONSIDERATION Self correcting by age 08-09 years old TREATMENT MODALITIES Training of correct swallow & posture of tongue Speech therapy Mechanotherapy Correction of malocclusion 16

17. SPEECH THERAPY Not before 08 years To correct position of the tongue. 17

18. MECHANOTHERAPY Therapy in which fixed or removable appliance are used to correct tongue thursting FIXED APPLIANCES 18 MYOFUNCTIONAL BEAD TONGUE THRUSTING DEVICE PALATAL CRIB

19. REMOVABLE APPLIANCES Restriction of tongue thrusting habit Alignment of maxillary anterior teeth Correction of open bite Lip muscle exercises performed with ring attached in anterior part of appliance 19 HAWLEY APPLIANCE ORAL SCREEN

20. TRAINING OF CORRECT SWALLOW POSTURE OF TONGUE Use appliances as a guide. NANCE PALATAL ARCH APPLIANCE Ask the pt: to put the tongue tip in the rugae areafor 5 minutes. Whistling Count from 60-69 Hold the tongue tip against the palate using orthodontic elastics or sugerless fruit drop 20

21. LIP HABIT & ITS MANAGEMENT Habit that involves manipulation of the lips and perioral structures are termed as lip habits 21

22. TREATMENT Correction of malocclusion Treating the primary habit Appliance therapy: lip bumper/oral screen 22

23. BRUXISM AND ITS MANAGEMENT Involuntary habitual grinding of the teeth, typically dring sleep. CLINICAL FEATURES Occlusal trauma Tooth structure loss T.M.J disorder Muscular tenderness Headache 23

24. TREATMENT ADJUNCTIVE THERAPY PSYCHOTHERAPY : Aimed at loweringemotional or psychic tension. AUTO SUGGESTION & HYPNOSIS: where the pt : becomes conscious of his habit & understand the possible consequences. ELIMINATION OF ORAL PAIN & DISCOMFORT Pain associated with periodontal disease, lip and cheek should be eliminated. 24

25. TREATMENT OCCLUSAL THERAPY OCCLUSAL ADJUSTMENTS OCCLUSAL RECONSTRUCTION & PROSTHESIS BITE GUARD 25

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