Habits
Oral habits when present beyond 2 years of age can result in malocclusions that can only be treated after cessation of the
habit. The most common habits are thumb and finger sucking, sucking of objects such as blanket and tongue thrusting. The types of malocclusion that can result from these habits
are crossbites and openbites. The longer the habit persists, the more severe is the problem. The earlier the habit is broken, the greater is the success rate. Cessation of the
habit before the eruption of the permanent teeth usually can result in spontaneous correction of the bite. After that, a habit appliance can be cemented to the teeth as a
‘reminder’ to the patient. Usually after 6 months, the habit will be broken and braces can be placed to correct the malocclusion. Habits that persist into adulthood usually
would require jaw surgery to correct bite, but will only be recommended after cessation of the habit through the use of the same habit appliance.
Problem:
Class I open bite with lower crowding and an active thumb habit in a 13y 7m old boy.
Treatment:
Habit appliance for 2 months followed by full braces for 29 months.
Problem: Class I malocclusion with upper and lower dental
crowding and an open bite due to an active thumb habit in a 13 year old teenage boy.
Treatment:
Four bicuspid teeth were extracted and a
thumb appliance was cemented to the upper first molars. The thumb
appliance was left in place for 19 months and during that time period, the teeth have aligned themselves, the open bite closed on its own, (because the thumb habit was broken)
and the extraction spaces closed 75%. Patient was very happy with the result and did not want to have braces placed to closed the residual extraction space.
Problem:
Class I malocclusion in a 7y
10 m old girl with an active thumb habit. The habit has created a 3mm anterior open bite, 5mm overjet and a narrow maxilla.
Treatment:
2 Phase treatment. Phase I treatment involved palatal expansion with a
quadrihelix appliance for 3 months, followed by a
habit appliance for 6 months. Upper partial braces were worn for 4 months to close dental spacings. She wore an upper retainer
and had a lower space maintainer until all her permanent teeth have erupted and she is ready for Phase II treatment. Phase II treatment involved full braces for 12 months.
Problem:
Class I open bite with upper dental spacing and an active thumb habit in a 13y 3m old boy.
Treatment:
Habit appliance for 6 months followed by upper braces only for 7
months. No treatment was needed in the lower arch because the teeth were well aligned.
Problem:
Class II malocclusion with very crowded teeth, 5mm overjet and a slightly narrow upper jaw due to an active thumb habit in a 11y 9m old teenage girl.
Treatment: Extraction of four first bicuspid teeth followed by full braces for 29 months. Patient stopped her habit on her own and a habit appliance was not needed.
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