Evaluation of RURS elbow guard in the management of thumb-sucking habit in children with and without intellectual disability.

BACKGROUND: Digit sucking is a common oral habit among many children, which involves placing the thumb/finger into the mouth, which can cause malocclusion in mixed and permanent dentition. AIM: To evaluate the efficacy of the RURS elbow guard in the management of thumb-sucking habits in children with intellectual disabilities and those without in terms of the mean duration of appliance therapy. The secondary objective was to compare the RURS elbow guard with an intraoral crib in healthy children (without intellectual disabilities) to manage the habit of thumb-sucking. DESIGN: Children with intellectual disabilities and those without between the age of 4 and 16 years were included in the study and categorised into three groups, namely group I (50 normal children; intraoral crib appliance), group II (50 normal children; RURS elbow guard) and group III (50 children with intellectual disabilities; RURS elbow guard). RESULTS: The mean duration of appliance therapy for groups I, II and III were 200.20 ± 20.43 days, 204.34 ± 20.56 days, and 218.43 ± 15.66 days, respectively (p < 0.001). The differences in the mean duration between group I and group II were statistically non-significant, with statistically significant differences between group I and group III (p < 0.001) and between group II and group III (p < 0.05). CONCLUSION: The RURS elbow guard was found to be an efficient appliance in treating thumb-sucking among children who had mild to moderate intellectual disabilities. RURS elbow guard was equally efficient as an intraoral crib appliance in managing thumb-sucking habits in children without intellectual disabilities.

Avaliação da eficácia do acessório mamilo na remoção dos hábitos deletérios / Evaluation of the effectiveness of the nipple accessory in the removal of the deletery habits

Objetivo: avaliar a eficácia do acessório mamilo aplicado a aparelhos ortopédicos/ ortodônticos no tratamento de hábitos deletérios de sucção de chupeta, língua, lábio e dedo, e onicofagia em pacientes tratados nos últimos 20 anos com o aparelho. Métodos: Trata-se de um estudo clínico observacional, retrospectivo, no qual a amostra foi composta de prontuários de pacientes de ambos os gêneros, atendidos por profissionais habilitados pelo aparelho mamilo, que os utilizaram em crianças de 03 a 16 anos portadoras de hábitos deletérios. Os prontuários utilizados, correspondem a pacientes tratados entre os anos 2000 a 2020. Todas as análises foram realizadas no programa R, com nível de significância de 5%. Resultados: Foram analisados 142 prontuários, nos quais 122 foram incluídos, por estarem dentro dos critérios de inclusão propostos no estudo e 20 foram excluídos da pesquisa por apresentarem informações incompletas e/ou não preenchidas corretamente. O hábito com maior incidência foi o de sucção digital, em 71,3% dos pacientes, 91,8% dos pacientes deixaram o hábito, destacando que nos casos de sucção de chupeta e onicofagia, o sucesso na remoção do hábito foi de 100%, em ambos os casos. O tempo médio de uso do aparelho foi de 4,8 meses, variando de 0,6 a 14 meses. O tempo médio para a remoção do hábito após a instalação do aparelho foi de 1,6 meses, variando de 0 a 12 meses. Conclusão: O aparelho mamilo, mostra-se como uma alternativa de alta eficácia na remoção de hábitos deletérios de sução de chupeta, dedo, língua e onicofagia.(AU)

Objective: Evaluate the effectiveness of the nipple accessory applied to orthopedic/orthodontic appliances in the treatment of harmful pacifier, tongue, lip and finger sucking habits, and onychophagia in patients treated in the last 20 years with the device. Methods: This is an observational, retrospective clinical study, in which the sample consisted of medical records of patients of both genders, assisted by professionals qualified by the nipple device, who used them in children aged 03 to 16 years with deleterious habits. The medical records used correspond to patients treated between the years 2000 and 2020. All analyzes were performed in the R program, with a significance level of 5%. Results: 142 medical records were analyzed, in which 122 were included, as they were within the inclusion criteria proposed in the study and 20 were excluded from the research because they presented incomplete information and/or not filled in correctly. The habit with the highest incidence was digital sucking, in 71.3% of patients, 91.8% of patients quit the habit, noting that in cases of pacifier sucking and onychophagia, success in removing the habit was 100%, in both cases. The average time of use of the device was 4.8 months, ranging from 0.6 to 14 months. The mean time to remove the habit after installing the device was 1.6 months, ranging from 0 to 12 months. Conclusion: The nipple device is a highly efficient alternative for removing harmful habits of pacifier, finger, tongue and onychophagy sucking.(AU)

Adjustable tongue crib.

Thumb sucking and tongue thrusting habits are mostly counteracted and rehabilitated using a tongue crib. Most patients find the conventional crib difficult (due to its position and length) in the initial days of treatment and become uncooperative. Hence, few modifications are made to the traditional design of the tongue crib for easy adjustment of the crib height and angulation, which provides comfort to the patient.

Non-nutritive sucking habits in a child: A clinical protocol to their prevention and management.

Patients presenting with anterior open bites can be challenging to manage. This paper discusses the clinical features and aetiology of anterior open bites caused by non-nutritive sucking habits in a young child. It explores how these should be recognised and how certain interventions can be effective in their management. Whilst further high quality research is needed into the different methods and their effectiveness, the aim of the article is to provide a practical guide for general dental practitioners, orthodontists and paediatric dentists, who are involved in monitoring the developing dentitions of these patients.

Imaginería guiada para la erradicación de la succión digital en niños de 8 a 11 años / Guided imagery for the eradication of digital suction in children from 8 to 11 years old

Introducción: el hábito de succión digital en la niñez, tiene una alta prevalencia. Objetivo: determinar la utilidad de la Imaginería guiada para la erradicación del hábito de succión digital en niños de 8-11 años, la aparición de otros hábitos perjudiciales después del tratamiento sugestivo y si existe relación con el sexo y la edad. Métodos: se realizó un estudio experimental en el servicio de Estomatología del área norte del municipio de Güines. Para identificar el hábito se revisaron las historias clínicas del servicio escolar y por entrevistas. La población objeto de estudio estuvo constituida por 51 niños con succión digital entre 8 y 11 años de edad de ambos sexos. Mediante muestreo aleatorio estratificado se seleccionaron 25 niños para el grupo control (tratamiento tradicional) y 26 niños para el grupo experimental (tratamiento sugestivo). La información se recogió en planilla recolectora y encuesta. Se aplicó el X2 y la dócima de Duncan. Resultados: el 72.6 porciento de los niños eliminaron el hábito de succión digital, el 43.1 porciento del grupo experimental, el sexo no mostró diferencias. La totalidad de los niños de 8 y 9 años lo erradicaron. Tres meses después del tratamiento aparecieron otros hábitos deformantes; en el sexo femenino (19.2 porciento) y en el masculino (7.2 porciento). Conclusiones: el tratamiento de Imaginería guiada es de utilidad y con resultados superiores al tratamiento tradicional. No muestra relación con el sexo. Resulta más útil en edades de 8 y 9 años. Después del tratamiento la cuarta parte de ellos incorpora nuevos hábitos deformantes(AU)

Introduction: digital suction habit in childhood has a high prevalence. Objective: to determine the use of guided imagery for the eradication of digital suction in children from 8 to 11 years old, la the appearance of other harmful habits after the suggestive treatment and if there is a relationship between sex and age. Methods: an experimental study was carried out in the Dentistry Service of the Northern area in Güines. Clinical records from School Service were checked and interviews were performed to identify the habit. The population under study was formed by 51 children with digital suction between 8 and 11 years old of both sexes. 25 children were selected at random for the control group (traditional treatment) and 26 children for the experimental group (suggestive treatment). The information was collected by a collection form and a survey was performed. X2 and Duncan docima were applied. Results: the 72.6 per cent of the children eradicated the digital suction habit, the 43.1 per cent of the experimental group, sex did not show differences. The totality of the children of 8 and 9 years old eradicated the habit. Three months after the treatment other deforming habits appeared; in the female sex (19.2 per cent) and in male (7.2 per cent). Conclusions: the guided imagery treatment was very useful and had higher results than the traditional treatment. It shows no relation with sex. It is more useful in 8 and 9 years old. After the treatment, the fourth part of the children incorporated new deforming habits (AU)

[Hypnosis and orthodontic treatments]. / L'hypnose dans les traitements d'orthodontie.

INTRODUCTION: After being discarded from hospitals due to its lack of scientific evidence, medical hypnosis is once more in the spotlight thanks to neuroscience and medical imaging, which have proven its specificity. Medical hypnosis is currently enjoying real enthusiasm, and now the doors are opening not only to medical and surgical units but also to our orthodontic clinics. MATERIALS AND METHODS: This article defines hypnosis and its different levels of application and the required techniques. It also explores all the different fields in which it can be used in orthodontic treatment. DISCUSSION: Hypnosis can be applied from the very first contact with the patient and can be useful and therapeutic at every step of the process. It is useful to think of it in our discipline as a treatment in its own right contributing to heal parafunctions and tongue disorders more efficiently.

Habit-breaking methods employed by mothers of children with nonnutritive sucking habits resident in suburban Nigeria.

CONTEXT: Parents are often concerned about their children's nonnutritive sucking (NNS) habits and may institute mechanisms to try to break them. AIM: The study identified various methods instituted by mothers resident in a suburban Nigeria to break NNS habits of children, reasons for wanting to break the habit, and the association between instituted methods and sociodemographic profile of the mothers. MATERIALS AND METHODS: The data of 129 mothers of children aged 4 years to 12 years who had NNS habits at the time of conducting a household survey were analyzed. STATISTICAL ANALYSIS: Tests of associations were conducted to determine the association between maternal age and level of education and methods employed to break child's NNS habits. RESULTS: Eighty-four mothers (65.1%) made efforts to break the habit. Habit persisting to older age was the main concern. The most common method employed for breaking habits was punishing the child (54.8%).Only 7 (20.0%) mothers who were concerned about NNS habit(s) sought professional advice. A greater though insignificant percentage of mothers in the 25-34 years age group (57.2%; P = 0.48) and those with secondary school level of education (56.0%; P = 0.12) made efforts to break their children's NNS habits. CONCLUSIONS: The majority of mothers were concerned about their children's NNS habits. However, very few concerned mothers sought professional advice. Efforts need to be made to improve the public awareness about the availability of professional services for managing NNS habits and potential impact of employing nonprofessional methods to break habits.

Non-orthodontic intervention and non-nutritive sucking behaviours: A literature review.

Anterior open bite (AOB) is one of the most complex malocclusions to manage. AOB is caused by either by skeletal, genetic or environmental factors. Numerous treatment options are currently utilised to manage AOB. These vary from non-invasive behavioural shaping to orthodontic and surgical interventions. This paper reviews the available orthodontic and non-orthodontic interventions used in the management of AOB. The literature review was carried out using the PubMed search engine from the first of January 2000 to the first of June 2017. Two major keywords (open bite and anterior open bite) were used in addition to 23 minor keywords in the review. AOB is one of the most complex malocclusions to treat with high relapse rates. Long term outcome in treatments of patients with AOB was substantially low. Relapse rates were not taken into consideration for some of the literature reviewed. Despite limitations of the literature, it is recommended that orofacial myofunctional therapy (OMT) and non-orthodontic intervention (NOI) be used in conjunction as an effective treatment option for Anterior Open Bite.

Tratamiento ortopédico SN6 en adolescente con maloclusión clase II: reporte de caso / Orthopedic treatment SN6 in an adolescentwith class II malocclusion. case report

La maloclusión clase II tiene una prevalencia de 37.1 por ciento en México, de ahí su importancia de ser diagnosticada y tratada a tiempo. Sepresenta como resultado de la combinación de componentes dentales,esqueléticos y/o funcionales. Sus características son molares en relacióndistal, retrognatismo, protrusión maxilar o una combinación deellos. Los hábitos nocivos como la succión de labio inferior producenalteraciones dentales como retrusión de los incisivos inferiores y protrusiónde los incisivos superiores. La clase II dentoesqueletal es una desarmonía que se agrava con el tiempo, cuya prevalencia aumenta con la edad, debido a que no tiende a corregirse a edades tempranas. El reporte del caso clínico es de una paciente de 13 años, la cual tiene hábito de succión labial, clase II molar y canina bilateral, protrusión maxilar, retrognatismo, biproinclinación dental, biprotrusión labial y crecimiento horizontal. Los objetivos del tratamiento fueron eliminar el hábito de succión del labio inferior, retruir los incisivos superiores,obtener una clase I canina y molar, corregir la sobremordida vertical yhorizontal y lograr un sellado labial armónico. El tratamiento consistióen colocar ortopedia funcional removible SN6 en dos etapas debido aque la sobremordida era de 9 mm. La aparatología ortopédica funcionalremovible puede considerarse una terapia efectiva para los problemasde maloclusión clase II y sobremordida horizontal y vertical.

Class II malocclusions have a 37.1% prevalence in Mexico; their timelydiagnose and treatment is therefore relevant. They appear as a result ofa combination of dental, skeletal and/or functional components. Amongthe intraoral characteristics, there are the distal molar relationship,retrognathism, maxillary protrusion, or a combination of all of them.Harmful habits, such as the suction of the lower lip they cause dentalalterations like the retrusion of the incisor teeth and the protrusion ofthe upper incisor teeth. Skeletal class II malocclusion is a misalignmentwhich steadily worsens; its prevalence increases as the person gets olderbecause it is not likely to be corrected at an early age. The clinicalcase report is that of a 13-year-old female patient, who has the habitof lip suction, class II molar and canine, and class II occlusion in bothcanines, maxillary protrusion, mandibular retrognathism, bimaxilarydental proclination, biprotrusive lips and horizontal growth. Thetreatment aimed at eliminating the lower lip suction habit, retractingthe upper incisor teeth, getting a canine and molar occlusion class I,correcting both overjet and overbite, achieving an adequate, lip seal.The treatment comprised SN6 removable functional orthopedics in twostages due to the 9 mm overbite. The removable functional orthopedic apparatus may be deemed an eff ective therapy for class II malocclusion problems, and both overjet and overbite.

Severe Anterior Open Bite during Mixed Dentition Treated with Palatal Spurs.

Deleterious oral habits, such as non-nutritive sucking or tongue thrusting, if not intercepted at an early stage can cause complex malocclusions. This manuscript describes a clinical case report of a successful interception of a severe anterior dental open bite caused by thumb sucking and tongue thrusting habits. The case involved a six-year-old female patient treated with the use of palatal spurs and maxillary removable crib followed by monitoring the development of dental occlusion. At the end of the interceptive phase acceptable results were achieved, showing the efficacy of the treatment undertaken as well the importance of an early intervention to remove harmful oral habits.

New electronic habit reminder for the management of thumb-sucking habit.

Methods for intervention of nonnutritive sucking habits include counseling, positive reinforcement, calendar with rewards, adhesive bandage, bitter nail polish, long sleeves, and appliance therapy. All these methods have been reported in the literature with variable success rates. We present a case of an 8-year-old child with thumb-sucking habit successfully managed in a short period of 5 months by a new electronic habit reminder, an extraoral appliance which was designed to overcome the disadvantages associated with intraoral appliances.

Evidence-Based Psychosocial Treatments for Pediatric Body-Focused Repetitive Behavior Disorders.

Habits, such as hair pulling and thumb sucking, have recently been grouped into a category of clinical conditions called body-focused repetitive behavior disorders (BFRBDs). These behaviors are common in children and, at extreme levels, can cause physical and psychological damage. This article reviews the evidence base for psychosocial treatment of pediatric BFRBDs. A review of academic databases and published reviews revealed 60 studies on psychosocial treatments for pediatric BFRBDs, 23 of which were deemed suitable for review. Based on stringent methodological and evidence base criteria, we provided recommendations for each specific BFRBD. Individual behavior therapy proved probably efficacious for thumb sucking, possibly efficacious for several conditions, and experimental for nail biting. Individual and multicomponent cognitive-behavioral therapy was named experimental for trichotillomania and nail biting, respectively. No treatment met criteria for well-established status in the treatment of any BFRBD. Recommendations for clinicians are discussed. Reasons for the limitations of existing research in children and adolescents are explored. Several recommendations are presented for future pediatric treatment research on BFRBDs.

Timetable for oral prevention in childhood--developing dentition and oral habits: a current opinion.

As most of the etiologic factors of malocclusion are of genetic origin and thus cannot be prevented, environmental causative factors have become the focus for correction. Early interception of oral habits may be an important step in order to prevent occlusal disturbances in children. The identification of an abnormal habit and the assessment of its potential immediate and long-term effects on the dentition and potentially on the craniofacial complex should be made at an early stage. This paper focuses on the most common oral habits influencing dentofacial growth in childhood and management of these habits in the developing dentition.

Influence of non-orthodontic intervention on digit sucking and consequent anterior open bite: a preliminary study.

OBJECTIVES: This study aimed to assess behavioural and occlusal outcomes of non-orthodontic intervention (NOI) in a sample of children, 4-12 years of age, in Australia, in order to establish clinical relevance. MATERIALS AND METHODS: Data from 91 patient records of 4- to 12-year-old children reporting a habit of digit sucking, from two clinics in north-eastern Australia, were de-identified and used. Each patient had been examined at two visits, separated by an interval of 4 months, using standard clinical procedures. RESULTS: Of the 77 children who received a 4-month NOI, 69 (89.6%) had ceased their digit sucking habit by the end of the NOI period [χ2=67.0, degrees of freedom (d.f.)=1, P<0.001]. Of the 72 subjects who had front teeth, the number with anterior open bite decreased from 37 (51.4%) to 12 (16.7%) upon completion of NOI (χ2=21.3, d.f.=1, P<0.001). Among the 32 patients with a measurable overjet, the mean overjet was found to decrease from 4.2±2.4 mm to 3.1±1.9 mm after implementation of NOI (t=5.8, d.f.=31, P<0.001). Children who received NOI were more likely to quit the digit sucking habit in the 4-month period (P<0.001, OR=51.8, 95% CI: 9.8-273.9) and were more likely to appear without anterior open bite at a 4-month recall (P<0.001, OR=30.0, 95% CI: 5.9-151.6). CONCLUSIONS: This study demonstrated clinical relevance of NOI on the cessation of a digit sucking habit, closure of anterior open bite and reduction of overjet. Further investigations are indicated.

Counseling on Early Childhood Concerns: Sleep Issues, Thumb-Sucking, Picky Eating, School Readiness, and Oral Health.

Family physicians are often a source of information and advice on early childhood concerns regarding sleep, thumb-sucking/pacifier use, picky eating, school readiness, and oral health. Evidence indicates that family variables are important in the genesis of sleep difficulties, and that traditional behavioral methods are not as effective as previously thought. Attention to family psychosocial well-being, especially maternal functioning, is important in addressing childhood sleep difficulties. Thumb-sucking and pacifier use may be associated with negative consequences if they persist, and referral is recommended after four years of age if appropriate behavioral interventions are ineffective. Picky eating is heavily influenced by environmental factors, and food neophobia is a normal stage of development. The main approaches to childhood eating problems include social modeling of normal eating behaviors, repeated exposures to new foods, and positive mealtime experiences. School readiness focuses on supporting the psychosocial variables that are associated with school success. Reading with the child enhances literacy skills. Quality early childhood education programs are also effective in enhancing school success. Delaying school entry is not beneficial and may be detrimental. School readiness includes the schools' role in supporting the learning needs of all children regardless of their abilities and skills. Oral health is increasingly recognized as an important contributor to overall health. Oral health should be incorporated into well-child visits beginning at the eruption of the first tooth.

Anterior open bite treated with myofunctional therapy and palatal crib.

This case report demonstrates the treatment effects of palatal crib combined with the myofunctional therapy in a child with anterior open bite (AOB) due to thumb sucking and habitual anterior and low tongue position. The patient, an 11-year-old boy, had an anterior open bite and flared and spaced upper and lower incisors. Palatal cribs in conjunction with myofunctional therapy were used to discourage sucking habit and to adapt normal tongue position. Successful correction of the AOB with adequate overjet and overbite were achieved with total treatment time of 7 months. The importance of myofunctional therapy in adopting normal tongue position and in maintaining the stability of open bite correction is emphasized.

Follow-up problems with fixed appliances in pediatric dentistry.

Fixed appliances are commonly used in managing early orthodontic problems. Despite their widespread use, they have the potential to impinge on the soft tissues, interfere with the eruption of adjacent teeth and become dislodged or broken. These two case reports present the poor outcomes of fixed appliance treatments if the patient fails to attend follow-up appointments. A successful outcome of treatment with fixed appliances depends upon proper patient selection and the communication skills of the dentist to help patients/parents understand the importance of regular checkups.

Hipnoterapia en niños de 7-12 años con succión digital / Hypnotherapy in 7-12 years children with digital suction

Se realizó un estudio de intervención terapéutica en 13 niños con hábito de succión digital, atendidos en la consulta de Ortodoncia del Hospital General Docente Dr Juan Bruno Zayas Alfonso de Santiago de Cuba, desde enero hasta diciembre del 2013, a fin de valorar las ventajas de la hipnoterapia en la eliminación de este hábito. La información se procesó mediante el paquete estadístico SPSS/PC y se empleó el porcentaje como medida de resumen para variables cualitativas. En la casuística predominó el sexo femenino, la maloclusión clase II y el hábito de succión intermitente. La mayoría de los afectados necesitaron entre 4 y 6 sesiones de hipnoterapia. A los 6 meses de tratamiento se observó que el mayor porcentaje de los afectados había erradicado esta práctica(AU)

A study of therapeutic intervention in 13 children with habit of digital suction, assisted in the Orthodontics department belonging to Dr Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba was carried out from January to December, 2013, in order to evaluate the advantages of hypnotherapy in the elimination of this habit. The information was processed by means of the statistical package SPSS/PC and the percentage was used as summary measure for qualitative variables. The female sex, the malocclusion class II and the habit of intermittent suction prevailed in the case material. Most of the affected patients needed between 4 and 6 hypnotherapy sessions. After 6 months of treatment, it was observed that the highest percentage of those affected had eradicated this practice(AU)