Inhibition Therapy for Oral Habits


Part of Tongue Thrust Therapy is the elimination of oral habits such as:

  • Grinding and Clenching Teeth
  • Fingernail biting
  • Thumb / Finger sucking
  • Chewing hard substances like ice cubes
  • Chewing pens and pencils
  • Cheek and/or lip biting
  • Continually holding objects with the teeth like keys, glasses, toothpicks, etc.

Depending on the willingness of the child to stop the habit, three different approaches to treatment have been advocated. They are:

  • Reminder Therapy
  • Reward Therapy
  • Appliance Therapy

The most important thing to remember about any intervention is that the child must want to discontinue the habit for treatment to be successful!  Timing of treatment is also critical.  The child should be given every opportunity to stop the habit spontaneously before the eruption of the permanent teeth.

Reminder Therapy

Reminder therapy is important for those who want to stop the habit, but need some help to stop completely.  One idea is to have an adhesive bandage taped to the offending finger to serve as a constant reminder not to place the finger / digit in the mouth.  Another suggestion is to put bitter paste on the digit for digit sucking habit.  Keep in mind that the reminder must be neutral and not perceived as any form of punishment.

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Reward Therapy

With regards to Reward Therapy, a contract is agreed upon between the child and parent or between the child and therapist.  The contract simply states that the child will discontinue the habit for a specified period of time, and in return he/she will receive a reward if requirements of the contract are met.  The reward does not have to be extravagant, but special enough to motivate the child.  The more involvement the child can take in this project, the more likely the project is to succeed.

Appliance Therapy

Appliance Therapy is provided by an orthodontist, and can be used when Reminder Therapy and Reward Therapy have failed.  The dentist should have already explained to the child and parent that the appliance is not a punishment, but rather a permanent reminder.  The parent and the child should be informed that certain side effects may temporarily appear after the delivery of an appliance.  These include: eating difficulties, speaking/speech problems, and/or disturbed sleeping patterns.

Some examples are:

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Fixed Palatal Crib
This is a type of brace that sits full-time on the upper teeth and the roof of the mouth.  It takes away the digit sucking gratification. Crib wires prevent the thumb or finger from touching the gums behind the front teeth and on the palate (roof of the mouth), turning a pleasant experience into an unpleasant one.



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Tongue Crib
The Tongue Crib is used to inhibit the tongue from “pushing” the anterior teeth when speaking. It is used to “retrain” the tongue posture in conjunction with speech therapy to aid in permanent correction.  It also helps to break the thumb sucking habit.



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Bluegrass Appliance
The Bluegrass appliance is used to stop thumb sucking and or tongue thrusting by rolling / spinning the wheel instead of performing the “habit” (sucking the finger). The Bluegrass Appliance provides both the reminder and diversion with comfort.  It also functions as a "tongue toy" to help develop better swallowing function.


References


Johns Dental. (1999). Ortho Habit Appliances. Retrieved from http://www.johnsdental.com/articles/ortho/fixed/habit.htm


Orthotech. (n.d.). Fixed Appliances. Retrieved from http://www.orthotechohio.com/fixed.php

Plioz. (2010). Break the Habit: Thumb Guard and Finger Guard. Retrieved from http://www.plioz.com/search/Thumbguard

Ravi, L. (2009). Oral Habits and Inhibition Therapy. Retrieved from http://www.slideshare.net/stgdc/oral-habits