Managing Low Tongue Posture in Open bite: Composite Habit Breaking Appliance

Abstract

Tongue dysfunction in form of altered tongue rest posture and tongue tip protrusion during swallowing, go along with anterior open bite malocclusion in majority of cases.Once the etiology of open bite has been identified and ascribed to an abnormal posture of the tongue, orthodontists should classify tongue posture through an analysis of the morphological features of the malocclusion. Vertical orientation of tongue at any given posture deserves equal consideration to that of its forward thrusting potential. In cases with low tongue rest posture, only blocking mechanism such as cribs may not solely be effective as upward elevation of tongue is also needed to achieve normal rest posture. Contrarily, tongue stimulator appliances namely blue grass appliances and tongue practice beads as well as myo-functional therapy require a great deal of patient engagements to become clinically effective in modifying tongue behaviour. We endeavour to find therapeutic potential of hybrid approach; that combines forward tongue restriction and vertical elevation via a composite habit breaking appliance (CHBA), in patients having low forward resting posture of tongue. A case report has been presented to exemplify the idea.