March 16, 2015
The habit of thumb sucking is a cause for concern if it persists beyond the age of four. It is known to cause considerable malocclusion or poor bite, often requiring expensive treatment later on. Dentists recommend the use of habit appliances to help the child break his habit. One such appliance is the bluegrass appliance. It consists of a wire that is attached to the upper molars and extends just behind the upper front teeth. A roller which is made of acrylic is inserted in this wire. It has six sides and does not touch the upper surface of the mouth. This makes it possible for the child to easily spin it with his tongue. In a way the child is being offered a distraction from his habit and is a kind of positive reinforcement.
The bluegrass appliance is used to help the child overcome habits like thumb sucking and tongue thrusting. It was invented by Haskell and Mink in the year 1991. Though several other thumb sucking appliances are available and have been in use, this gained popularity due to several reasons.
When a habit appliance is fitted, there are two aspects to it. One, the child is unable to indulge in a habit that is pleasurable and comforting to him. Secondly, he faces discomfort whenever he tries to suck. Often, it is seen that children are unable to cope and may sometimes react negatively. The bluegrass appliance receives a favorable response from children as it offers an alternate behavior to the child that doesn’t feel like a punishment.
However, it is important to gauge the willingness of the child before this appliance is fitted. This appliance therapy is more likely to be successful with older children who wish to overcome thumb sucking. It is recommended that the appliance should be left in place for at least 6 months. This ensures that the habit is given up entirely and minimizes the chance of a relapse.
The patient needs to pay special attention to oral hygiene as food debris can get stuck between the roof of the mouth and the roller.
A variation to the original design has been introduced by Baker in 2000. Some dentists prefer to use it with the Quad helix or may make additional changes in the design. In the modified bluegrass appliance the hexagon roller may be replaced by two beads of different colors or a single bead. These are not only more appealing to children but also reduce the size of the appliance. This customized version is therefore less cumbersome.