Treatment of a class II malocclusion complicated by digit-sucking

The prevalence of digit-sucking varies between 12–34% in 9-year-olds.^1,2,3 There is little published literature on the prevalence of digit-sucking habits in the UK. A relatively recent study undertaken in Kettering reported that 23.6% of children reported a history of a habit and 12.1% reported a prolonged habit past the age of 7 years old.4

Management of a digit-sucking habit is initially conservative and can include the following:

If intercepted early, the anterior open bite caused by the digit-sucking habit can resolve, but this can take several years. Management of a patient with this particular habit is complicated because, prior to starting any orthodontic treatment, the digit-sucking habit has to have been discontinued because any treatment undertaken without this will relapse.

A Class II malocclusion in a growing individual can be managed by growth modification with functional appliances. Functional appliances can be defined as fixed or removable orthodontic appliances, which use the forces generated by the stretching of muscles, fascia or periodontium to bring about change to the existing skeletal or dental relationship.5 There is strong evidence to suggest that the large amount of correction achieved is dento-alveolar.^{6,7,8,9,10,11}