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 (palatalcrib) and behavior therapy (aversive taste and positive reinforcement) in digit-suckingmanagement in 6- 12 years old children.Material and Methods: In this clinical trial study, 29 children attended for treatment of digitsuckinghabit. After underlying data collection and oral- dental examinations, the children wererandomly assigned into two groups. Group A: Appliance therapy (palatal crib) for 4 months and 1month follow up; group B: Behavior therapy included aversive taste on nails and positivereinforcement; and for breaking night digit- sucking habit, use of hand wraps or gloves. Data wasanalyzed 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 ceasingdaytime habit (about 50%) and even more effective in ceasing nighttime habit (about 79%). Theeffectiveness of palatal crib decreased with time. Aversive taste and positive reinforcement hadhigher efficacy in daytime thumb- sucking control (about 87%), but were relatively effective innighttime digit- sucking control (about 50%). Comparing the treatment results during 1, 2, 3 and 4months, separately in day and night time habit between two groups, no significant difference wasseen; whereas it was significant between sum of the means of 4 months results for day habit (pvalue = 0.047).Conclusion: Aversive taste and positive reinforcement are low- cost, easy, effective and highsuccess alternatives in digit- sucking habits control and they were more effective in daytime habitcontrol than nighttime. Use of intra- oral appliances especially palatal crib is more effective incontrol of nighttime habits than daytime. Behavior- therapy had significant difference in daytimehabit control related to appliance- therapy in the four months.Key words: digit-sucking habit, intraoral appliance, palatal crib, behavior therapy, aversive taste,positive reinforcement