Pr

event
ionofdi
gitsucki
ng

Amal
AboseadaEbr
ahi
m El
sawy
61710897
ACU,
Oral
&Dent
alMedi
cine
DNT328
Cousedi
rect
or/Dr
.Dal
i
aKhaf
agy
.
Sect
ionD
Def
ini
ti
onofdi
gi
tsuck
ing:
I
t’
sputti
ngthet
humbormor
efi
nger
satv
ary
ing
dept
hinsi
dethemout
h.
Pr
eval
enceofdi
gi
tsuck
ing:
Commoni
ninf
ant
s.
Mor
epr
eval
entbet
weenboy
s.
Hi
ghl
ypr
eval
entbet
ween3-
6year
s.
I
ttakest
hemaj
ori
tybet
weenot
heror
alhabi
ts.
Sev
eri
tydependsonf
requency
,dur
ati
on,
int
ensi
ty.

Si
deef
fect
sofdi
gi
tsuck
ing:
Ant
eri
oropenbi
te.
I
ncr
easedov
er-
jet
.
Decr
easedov
er-
bit
e.
Post
eri
orcr
ossbi
te,
spaci
ng&cr
owdi
ng.
Labi
ali
ncli
nat
ionofupperinci
sor
s&l
i
ngual
i
ncli
nat
ionofl
owerinci
sors.
Hi
ghpal
atal
vaul
t&t
endencyf
ort
onguet
hrusthabi
t
al
so.
Speechdef
ect
s&f
ingerdef
ect
s.
cr
owdi
ng&spaci
ng

f
ingerdef
ect
.
pr
event
ion&management
:
 Thechi
l
dshouldtakeeachoppor
tuni
tytostopthehabi
tspont
aneousl
y
bef
oret
heerupt
ionofpermanent
s(beforeageof6).
 Tr
eat
mentbegi
nsbyageof6y
.
 Tot
reatt
hechi
l
dweshoul
dtodi
agnoset
hecasebef
oreso;
weshoul
d
1.Taki
ngt
hehi
stor
yofdi
gitsucki
ngact
ivi
tyf
rom par s(
ent askabout
f
requency
,int
ensi
ty,
dir
ect
ion,
type&dur
ati
on)
2.Ev
aluat
etheemot
ional
stat
eoft
hechi
l
d.
3.Ext
raor
alexami
nat
ion.
4.I
ntr
aor
alexami
nat
ion.
 Thet
reatmentt
akes4appr
oaches:
1.Counsel
li
ng
2.Remi
ndert
her
apy
3.Rewar
dsy
stem
4.Adj
ust
iveandAppl
i
ancet
her
apy
(Taket
hepsy
chol
ogi
calst
ate,age,
mat
uri
ty,
andpat
ient
cooper
ati
oni
nconsi
der
ati
on.)
1.
couns
ell
i
ng
Usingapositi
vereinf
orcementbyadvi
singt
hechi
l
dandl ear
ninghi
m howtostopt
he
habit
.
Usingachartdesignedwithdaysoft
heweekandblankspaces(i
tact
salsoasa
remindersy
stem).
2.
remi
ndert
her
apy
Byusi
ng:
1.Bit
terorpast
e,pepper
,cast
eroi
l
,orant
ithumbsol
uti
ons(
ast
humb-
up/ant
ithumb)on
thedigi
t
2.Anadhesiv
ebandagewrappedar
oundt
hef
ingerorgl
ovescanser
veaconst
antr
emi
nder
(ACEbandageappr
oach)
3.
Rewar
dsy
stem
 Chi
l
dshoul
dber
ewar
dedf
ornotdoi
ngt
hehabi
t.
 Rewar
dsy
stem i
scont
ractbet
weent
hechi
l
dandhi
spar
ent
s/dent
ist
.

4.
appl
i
ancesy
stem
I
tusedaf
tert
her
emi
nder
&rewr
ardsy
stemsar
efai
l
ed
I
t’
sdi
vi
dedi
nto2t
ypes:
1.
Fixedappl
iances:
 Hay r
akesappli
ance(
mostaggr
essi
veappl
i
ancef
ort
hechi
l
dduet
oit
spr
ongs)
 Pal
atalcr
ib(
incaseofnopost
eri
orcr
ossbi
te)
 Modi
fi
edpal
atalcr
ib(
palat
alcri
b+maxill
aryexpansi
onappl
i
anceasquadhel
i
xor
smet
oadaptthepost
eri
orcrossbi
tecases)
 Quadhel
ix(
forpost
eri
orcr
ossbi
tecor
rect
ion&expansi
onofmaxi
l
la)
 Bluegrassappliance(cal
l
edTeflonrol
lerappl
iance_hasahi
ghsuccessr
ate
_indi
catedforearl
y/l
atemixeddenti
ti
on_ t
oler
atedbythechi
l
d&giveaposi
ti
ve
reinf
orcement)
 Modi
fi
edbl
uegr
ass(
bluegr
ass+quadhel
i
x)
 Tongueconnect
orappl
iance.
 Tr
ipl
eloopact
ivat
or.
 Gr
aberappl
iance.
2.
Remov
abl
eappl
i
ances:
 Or
alscr
een(
funct
ional
appl
i
ance)
.
 Modi
fi
edHawl
ey.
(Al
lofthem actal
soasremi
ndersandr
emovedaft
er6mont
hsofhabi
t
cessat
ion_parent
sshoul
dn’
tconsi
deri
tasapuni
shment
)

Ref
erences:
 Textbookofpedodont
ics- andon2ndedi
shobhat ti
on,
pg:
492-
526
 Thumbsucki
ng(
jour
nalofappl
iedbehav
iouranal
ysi
sis2000,
33,
4-52,
Eli
ngsonetal
)
 Pr
inci
plesandpr
act
iceofpedi
atr
icdent
ist
ry,
Arat
hiRao,
pg:
147-
162