February 21, 2015
The compliance of the child and parents is important for dental appliances to work. It is crucial that the child realizes these appliances are being fitted not as a punishment, but as a reminder to help. There are a number of intraoral appliances that have been used over the years. The dentist will select the most appropriate appliance that is likely to work.
1. Palatal cribs
Some of these are palatal cribs that may be removable or fixed. It is fixed on the mouth roof just behind the upper front teeth and is attached to the molars. This works by making it difficult for the thumb to touch the upper palate and takes away the pleasure of sucking.
2. Oral screen
The oral screen serves several purposes such as habit correction as well as treatment of proclined incisors. This is a removable device and is used while sleeping. It makes it impossible for the child to insert the thumb into his mouth.
3. Hay rake sppliance
The hay rake device is a fixed appliance and somewhat similar to the palatal crib. However, it has prongs that hurt the thumb when the child puts the thumb in his mouth. This may be needed for compulsive suckers but is essentially an aversive technique. If the child is not motivated enough, it may evoke a strong response because the comfort of thumb sucking is being replaced with discomfort.
The bluegrass appliance is used for older children in which a roller is fixed and the child can play with the roller with his tongue to distract himself whenever he has the urge to suck. The benefit with this appliance is that the child is offered an alternate behavior instead of just being restricted from sucking.
5. Modified bluegrass appliance
A modified version of this appliance has two rollers that may be of two different colors. As the rollers do not touch the roof of the mouth, the child can easily roll these beads, making it an attractive substitute to sucking.
6. Soldered W arch
This serves as a reminder appliance to the child as well as correcting posterior crossbitecaused by thumb sucking.
7. Quad helix
Used to correct open bite or a narrow upper arch, the quad helix also serves as a reminder to desist from thumb sucking.
8. Triple loop corrector
This is a somewhat newer device which consists of three loops that make it hard for the child to suck his thumb.
Recommendations
It has been seen that the child gives up digit sucking almost immediately once a dental appliance has been fixed as it takes away the pleasure the child derives from it. A fixed appliance is likely to be more successful than a removable one. Besides this, maintaining a positive attitude is important as the child should not feel that he is being punished at any stage. Special attention needs to be given to dental hygiene.
Experts agree that the appliance should be left in place for 6 months for it to be effective. This gives ample opportunity for the habit to be given up entirely and reduces the possibility of a relapse.