Patients often have underlying habits that are not apparent until orthodontic treatment begins. Often these habits are not fully expressed until the tongue has room to move and new appliances to investigate. With new appliances in the mouth patients can also have a heightened awareness of the new braces or aligners and develop habits with the lips and tongue playing with the appliances and placing unwanted forces on the teeth. Some of these habits include thrusts and general tongue habits.
While tongue habits are common in young children, these habits typically subside in older children, teens, and young adults. When a patient begins wearing clear aligners it creates a new environment and sensations and some teen and adult patient will develop the habit of playing with their aligners with their tongue and thrusting the tongue against the lingual surface of the anterior teeth. This can cause unwanted movement and protrusion of the incisors.
There are many appliances that can be used in traditional bracket and wire orthodontics to stop a tongue habit. Many of these appliances look barbaric with metal spikes and poking wires to prevent the tongue from contacting the teeth. Clear Aligners create a unique situation that they cover the teeth and make placing any type of tongue deterrent a challenge. Bonding of tongue tamers or buttons attachments to clear aligners is difficult since the surfaces of the aligners create a weak bond strength, and the attachment must then be duplicated and replaced on every aligner.
There are many appliances that can be used in traditional bracket and wire orthodontics to stop a tongue habit, however, many of these appliances are often viewed as barbaric as they contain metal spikes and poking wires to prevent the tongue from contacting the teeth. Clear aligners create a unique situation that they cover the teeth and make placing any type of tongue deterrent a challenge. Bonding of tongue tamers or buttons attachments to clear aligners is difficult since the surfaces of the aligners create a weak bond strength, and the attachment must then be duplicated and replaced on every aligner.
A quick and easy solution that I have identified in my practice is the use of the Hu-Friedy Tear Drop Plier or Five-Star Orthodontic Slit-Plier to create an opening on the lingual surface of the aligner at the aligner trimline as a tongue deterrent. The teardrop shape creates a pointed end and small constriction to the slit that is unpleasant to the tongue. Several small slits can be placed in the area of need on the aligner in a matter of seconds, with no polishing or finishing required. This aligner modification can be done chairside quickly and efficiently to as many aligners as needed during an office visit. Pliers for modifying aligners provides me with a quick and easy chairside solution for treating habits as soon as they are identified in a patient.
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