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 Table of Contents  
CASE REPORT
Year : 2017  |  Volume : 7  |  Issue : 2  |  Page : 149-151

A new innovative light-emitting diode habit-breaking appliance


1 Department of Orthodontics and Dentofacial Orthopedics, Hitkarini Dental College and Hospital, Jabalpur, Madhya Pradesh, India
2 Department of Orthodontics and Dentofacial Orthopedics, College of Dentistry-Female Section, Majmaah University, Al Zulfi, Saudi Arabia

Date of Web Publication28-Dec-2017

Correspondence Address:
Dr. Tarulatha Revanappa Shyagali
College of Dentistry-Female Section, Majmaah University, Al Zulfi
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmd.ijmd_49_17

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  Abstract 


The aim of the present case report is to introduce a modified and innovative design for effective habit breaking with minimal patient discomfort. Abnormal oral habits are one of the major etiological factors in malocclusion. The harmful, unbalanced pressure bears upon the immature, highly malleable alveolar ridges and brings about potential changes in the position of teeth and occlusion. These habits can also cause behavioral problems and are socially unacceptable. Various methods and appliances are used to break the abnormal oral habits, as a part of treatment of malocclusion. The traditional habit-breaking appliances used so far can cause irritation to the tongue, subsequently leading to ulceration and in addition can also cause mastication and speech problems. The appliance is a regular Hawley's appliance with the addition of the light-emitting diode bulb and the switch. When the child's tongue or the finger touches the appliance, the light bulb gets illuminated, thus reminding the child to quit the habit. The said appliance utilizes easily available electrical gadgets that will function by disturbing the subconsciously built vicious cycle. The reminders send by its activation will break the pleasure perception obtained during the habit. Habit breaking through this appliance is effective as it is superior to other appliances in the mode of action as well as the design itself is attractive to the children.

Keywords: Habit-breaking appliances; Hawley's appliance light-emitting diode light; thumb sucking; tongue thrusting


How to cite this article:
Sahu A, Shyagali TR. A new innovative light-emitting diode habit-breaking appliance. Indian J Multidiscip Dent 2017;7:149-51

How to cite this URL:
Sahu A, Shyagali TR. A new innovative light-emitting diode habit-breaking appliance. Indian J Multidiscip Dent [serial online] 2017 [cited 2019 Jul 21];7:149-51. Available from: http://www.ijmdent.com/text.asp?2017/7/2/149/221770




  Introduction Top


Dental malocclusions are the product of multiple etiological factors, and one among them is oral habits. The most common oral habits, which are tagged as the etiological factors, are tongue thrusting and thumb sucking.[1],[2] The management of these habits includes removing the etiology behind the habits, countering the habit using the active restraining appliances, and/or training the individual through proper exercises.[3],[4],[5],[6] The habit-restraining appliances routinely used have spikes or spurs, which can be irritating to the tongue and may produce speech and mastication problems. Apart from this, the available appliances for the management of the habit are effective but are not modified according to the current trends. The present case report is aimed to introduce a new, innovative habit-breaking appliance made according to the trends of the tech-savvy society of ours using the electrical items readily available in the market.


  Case Report Top


A 12-year-old female patient came to the Department of Orthodontics with the chief complaint of forwardly placed upper front teeth. On examination, it was revealed that she had a thumb-sucking habit. It was decided to correct her thumb-sucking habit using the new innovative habit-breaking appliance.

Technique – appliance design and the construction

A good-quality alginate impression of the patient's maxillary arch was made, and the models were prepared. A regular Hawley's retainer is fabricated with a short labial bow and Adam's clasp on the first molars. The palatal acrylic part of this Hawley's retainer is thinned as much as possible. A coat button-sized battery, a very small colored light-emitting diode (LED) bulb, and a small piece of plastic-coated copper wire are used with an on–off switch or feather touch switch to form an electric circuit. The circuit is made with the help of a local electrician.

This circuit is then placed on the already fabricated Hawley's appliance and acrylized with cold-cured acrylic resin. Acrylization is done in such a manner that the whole assembly of this circuit gets embedded in the acrylic except the LED bulb and the on–off switch. While doing acrylization, the LED bulb is placed just behind the upper central incisors. The on–off switch is placed at a point, which is most likely to be touched by the thumb/digit/tongue of the patient while executing the habit. Caution should be executed while doing the acrylization, so that no part of the battery or wire is exposed to the oral environment. This appliance is then finished and polished as regular acrylic appliance taking care of LED bulb and the switch [Figure 1] and [Figure 2].
Figure 1: Constructed habit-breaking appliance

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Figure 2: Activated appliance in the patient having tongue thrust

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The appliance can be inserted in patient's mouth and checked for proper fitting. The wear time of the appliance should be kept the same as any other conventional habit-breaking appliance.


  Discussion Top


Patients with nonnutritive sucking, who wants to quit the habit, are primarily treated using strategies such as psychological counseling, reminder therapy or reminder appliance (habit-breaking appliance), and reward.

As is generally agreed upon, the aim of treating thumb-sucking habit must be physiologic and not mechanical. To eliminate the habit, a clinician must focus on altering the afferent arm of the neuromuscular response. As per the pain–pleasure theory, a habit is acquired either to avoid pain or to seek pleasure.[7] In most of the cases, pain is psychological and oral structures have to pay for it (as the child is in the oral phase: oral cavity being the most sensitive zone).

The said appliance works by breaking the pleasure perception of this vicious cycle. The “gentle” and “light” reminders sent by the appliance lead to subconscious de-rooting of the problem [Figure 2] and [Figure 3]. This appliance is less mechanical and more psychological. Conventional habit-breaking appliances will remind the patient to withdraw from the habit, but the patient might adopt his or her tongue or thumb in a different position to receive the pleasure from the habit. However, when the patient touches the switch of the current appliance, the light is emitted automatically which serves two purposes. First, it reminds the patient to withdraw from the habit and second, it exposes him/her in front of the peer group, friends, or the people surrounding, who after noticing the light emitting from the mouth can pose questions related to it, thus creating an embarrassing situation, which makes him/her conscious and aids in immediate withdrawal from the habit.
Figure 3: Activated appliance in the patient having thumb sucking

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Considering the mechanism of action of the present appliance, it can be said that this appliance acts by psychological re-rooting of the patient's action.

Advantages

  1. Easy to prepare and maintain
  2. Inexpensive
  3. Does not hurt patients like the conventional appliances
  4. Effective in reminding the patient about the habit, as the button can emit the light by mere touch of the tongue or the thumb.


Disadvantages

  1. Compliance of the patient is required
  2. Battery shelf-life might be a problem.



  Conclusion Top


The present appliance is easy to make and more effective than the conventional appliance due to its unique mechanism of action. As whole of the light-emitting assembly is inside the acrylic coverage except for the switch, the appliance is biocompatible too. Further, the appliance can be refined according to the current trends in technology.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given her consent for her images and other clinical information to be reported in the journal. The patient understood that her name and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Kharbanda OP, Sidhu SS, Sundaram K, Shukla DK. Oral habits in school going children of Delhi: A prevalence study. J Indian Soc Pedod Prev Dent 2003;21:120-4.  Back to cited text no. 1
[PUBMED]    
2.
Miremadi SA, Khoshkhounejad AA, Mahdavi E. The prevalence of tongue thrusting in patients with periodontal disease. J Dent 2005;2:50-3.  Back to cited text no. 2
    
3.
Ritto AK, Leitão P. The lingual pearl. J Clin Orthod 1998;32:318-27.  Back to cited text no. 3
    
4.
Baker C. The modified bluegrass appliance. J Clin Orthod 2000;34:535-7.  Back to cited text no. 4
    
5.
Haskell BS, Mink JR. An aid to stop thumb sucking: The “Bluegrass” appliance. Pediatr Dent 1991;13:83-5.  Back to cited text no. 5
    
6.
Ritto AK. The micro-implant pearl. J Clin Orthod 2010;44:385-8.  Back to cited text no. 6
    
7.
Esch T, Stefano GB. The neurobiology of pleasure, reward processes, addiction and their health implications. Neuro Endocrinol Lett 2004;25:235-51.  Back to cited text no. 7
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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Abstract
Introduction
Case Report
Discussion
Conclusion
References
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