Habit Appliances Learning Assessment

What are specific Habits

Tongue thrust

Finger Sucking

Tongue and lip sucking

What is a tongue thrust?

The habit of thrusting the tongue forwards against the teeth or in between while swallowing- Infantile pattern of swallowing, retained

People swallow 1,200 to 2,00 times every 24 hours, 4 lbs of pressure per swallow.

(constant pressure of the tongue forces teeth out of alignment)

Nervous thrusting consist of?

pushes the tongue against the teeth while it is at rest

involuntary, subconscious habit; difficult to correct

What causes a tongue thrust?

Certain types of artificial nipples used in feeding infants

Thumb sucking

Posture of the tongue

Difficult in swallowing

An abnormally large tongue

What causes tongue thrust pt2?

hereditary factors within the family, such as the angle of the jaw line.

Neurological, muscular, or other physiological abnormalities

(loose tooth, high restoration, premature tooth loss)

Short lingual frenum (tongue tied)

Hanging head

What are results of Lip Biting and Sucking?

excessive overjet and the difficulty of closing the lips properly during swallowing

uncomfortable oral conditions stimulate a child to place fingers in their mouth, leading to finger sucking or nail biting

Biting on lower lip to releasing excess energy or nervous tension

What age does a child usually exhibit a tongue thrust swallowing pattern?

from birth

needs: Emotional, Psychological, Sensual Gratification, Nutritional

age of 4 can outgrow tongue thrust pattern and developed mature swallowing

Factors to be recognized and evaluated

after age of 4 the child will need training program to develop the mature swallowing pattern

Duration, Frequency, Intensity

Type of tongue thrusting is

anterior open bite

anterior thrust

unilateral thrust

bilateral thrust

bilateral anterior open bite

closed bite thrust

Anterior open bite

common tongue trust

front lips do not close, child has mouth open with the tongue protruding beyond the lips

A large tongue usually accompanies this type of tongue thrust

Anterior thrust

upper incisor are extremely protruded and the lower incisors are pulled in by the lower lip

Accompanied by a strong mentalis (muscle of the chin)

Unilateral thrust

the bite is characteristically open on the (R/L) side (one)

Bilateral thrust

The anterior bite is closed; however the posterior teeth from the first bicuspid to the back molars may be open on both sides

most difficult thrust to correct

Bilateral anterior open bite

only teeth that touch are the molars with the bite completely open on both sides including the anterior teeth

large tongue is involved with this tongue thrust

Closed bite thrust

Typically shows a double protrusion, meaning that both the upper and lower teeth are flared and spread apart

Two ways to fabricate a habit breaker

Acrylic: maxillary anterior teeth projecting a wire

Wire: Fence located 4-5mm lingual to the linguals of the maxillary anterior teeth and 2mm past the incisal edge of the centrals

Tongue thrust appliances will accomplished two goals

eliminate the strong anterior thrust

Re-educate tongue posture

Purpose of Habit Breaking Appliances

interferes with patients habit

protect lingual of anterior from unwanted forced from tongue

prevents finger pressure from displacing maxillary incisors farther labially by preventing the ability to create a seal and suction around their fingers

forces the tongue to a more downward position during swallowing (downward/posteriorly) changes the tongue’s posture during resting position

Fixed Habit breaker

fixed appliances ideal for cooperation

the portion of the appliances that interferes with the habit is called a fence or rake.

Fence/crib: used as a tongue thrust appliance

Hayrake: used as a thumb sucking appliance