Habit-Breaking Appliances In Orthodontics: Types And Mechanisms
Write a short note on habit-breaking appliances.
Answer. These are also known as reminder appliances.
Ideal Requirements ofHabit-Breaking Appliances
- It should not depend on the patient’s cooperation.
- The appliance should offer no restraint to normal muscle activity.
- It should not involve the patient’s parents.
- It should not have shame attached to its use.
Mechanism of Action
- Appliance prevents the finger pressure from displacing the incisors.
- Appliance renders the habit meaningless by breaking the suction.
- Appliance re-educates the tongue to its normal posture and prevents maxillary constriction.
Removable Appliances
The removable habit retraining appliance consists of a palatal wire assembly embedded in the removable acrylic appliance. The appliance is retained by clasps on maxillary deciduous 2nd molars or first permanent molars.
- Cribs
- Rakes/spurs.
Fixed Appliances
- Consists of the maxillary lingual arch with cribs or rakes soldered or inserted in the lingual sheath in the anterior region.
- The lingual arch is soldered to the metal bands fabricated on maxillary deciduous 2nd molars or permanent first molars.
- Lingual arch with palatal crib
- Lingual arch with rakes/spurs
- Quad helix.
Blue Grass Appliance
- Teflon-made six rollers are incorporated into stainless steel wire and are soldered to the molar bands.
- The patient is instructed to turn the roller when he/she feels like sucking the finger.
- The total time for wearing an appliance is 3–6 months.
Working of Habit Breaking Appliance
- Cribs: Incorporated in removable or fixed appliances, the palatal crib acts as follows:
- Renders the habit meaningless by breaking the suction.
- Makes the habit non-pleasurable as the thumb cannot touch the palate.
- Breaks the thumb and tongue pressure applied on maxillary incisors.
- Appliance forces the tongue backward and distributes the pressure to posterior teeth as well.
- Act as a reminder not to indulge in the habit.
- Rakes/spurs: The blunt spurs projecting into the palatal vault discourage not only thumb sucking but also tongue thrusting and improper swallowing habits as well.
- Quad helix: It includes the following:
- It is the ideal appliance for correction of posterior crossbite caused due to digit sucking habit. Activation of the Quad helix causes expansion of the dental arch.
- Its anterior portion, with two helixes placed near the anterior palatal region, acts as a reminder.
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