بررسي تاثير و مقايسه استفاده از وسايل داخل دهاني (پالاتال كريب) و نيز رفتار درماني (مزه بد طعم و تقويت مثبت) در كنترل عادت مكيدن انگشت در كودكان 12 ـ 6 ساله

Evaluation and compare the use of intraoral appliance (Palatal crib) and behavior therapy (aversive taste and positive reinforcement) in Digit-sucking management in 6-12 years old children

Introduction: The aim of this study was to evaluate the efficacy of intraoral appliance (palatal crib) and behavior therapy (aversive taste and positive reinforcement) in digit-sucking management in 6-12 years old children. Material and Methods: In this clinical trial study, 29 children attended for treatment of digit-sucking habit. After underlying data collection and oral- dental examinations, the children were randomly assigned into two groups. Group A: Appliance therapy (palatal crib) for 4 months and 1 month follow up; group B: Behavior therapy included aversive taste on nails and positive reinforcement; and for breaking night digit- sucking habit; use of hand wraps or gloves. Data was analyzed by Mann Whitney and Wilcoxon tests in the 0.05 confidence rate. Results: 4 months follow-up revealed that appliance therapy was relatively effective in ceasing daytime habit (about 50%) and even more effective in ceasing nighttime habit (about 79%). The effectiveness of palatal crib decreased with time. Aversive taste and positive reinforcement had higher efficacy in daytime thumb- sucking control (about 87%), but were relatively effective in nighttime digit- sucking control (about 50%). Comparing the treatment results during 1, 2, 3 and 4 months, separately in day and night time habit between two groups, no significant difference was seen; whereas it was significant between sum of the means of 4 months results for day habit (p value = 0.047). Conclusion: Aversive taste and positive reinforcement are low- cost, easy, effective and high success alternatives in digit- sucking habits control and they were more effective in daytime habit control than nighttime. Use of intra- oral appliances especially palatal crib is more effective in control of nighttime habits than daytime. Behavior- therapy had significant difference in daytime habit control related to appliance- therapy in the four months.