Clinical Tip

Management of Lip Biting Using Clear Journal of Indian Orthodontic Society

55(1) 94–95, 2021

Aligner/Clear Retainer © 2020 The Author(s)

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DOI: 10.1177/0301574220964897
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Supriya Gopalakrishnan1, Tojan Chacko1, and Jose Jacob1

Abstract
Orthodontists play an important role in the management of deleterious oral habits. Lip biting has a multitude of adverse
effects on the stomatognathic system. A new appliance has been suggested to manage this habit. It is efficient and has got high
patient acceptability.

Keywords
Lip biting, clear aligner, orthodontic treatment

Introduction
Lips play an important role in deglutition, speech, and
maintenance of normal occlusion. Lip biting and lip sucking
most often involve the lower lip. It can result in proclination
of upper anteriors, flattening and crowding of lower anteriors,
increase in over jet, and cracking of lips. When the habit
becomes pernicious, the lip itself shows the effects of this
abnormal habit.
Lip biting has been traditionally treated with lip bumper,
Figure 1. Preparation of cast
oral screen, or bonding of brackets to palatal surface of upper
anteriors.1,2 A simple and efficient alternative is demonstrated
with a clear aligner/retainer. This particular appliance helps
to treat lip biting with minimum discomfort to the patient and
is esthetically appealing. This can be done as a part of an
aligner/retainer or as an individual appliance.

Procedure
The cast is fabricated using patient’s upper impressions.
Button-shaped elevations of around 1 mm to 2 mm diameter
Figure 2. Clear retainer with elevations
and 2.5 mm height are made on the palatal surface of incisors.
They could be of smooth round edge or sharp depending on
the intensity of habit/need of the individual case (Figures
1–3). Angulation of spikes should be set at 45 to 65 degrees 1
 epartment of Orthodontics and Dentofacial Orthopaedics, Sree Anjaneya
D
to the long axis of incisors. The clear retainer/aligner is
Institute of Dental Sciences, Calicut, Kerala, India
fabricated over this. Advice the appliance full time except
during meals and brushing. The spikes make the habit of Corresponding author:
Supriya Gopalakrishnan, Department of Orthodontics and Dentofacial
lip biting uncomfortable for the patient (Figures 4–7). The Orthopaedics, Sree Anjaneya Institute of Dental Sciences, Calicut, Kerala
sharpness of the spikes can vary depending on the need of 673315, India.
the case. E-mail: supriyagirish31@gmail.com

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Gopalakrishnan et al. 95

Figure 7. Post treatment

Figure 3. Clear retainer with elevations

Discussion
The success of any habit breaking treatment depends on
patient conviction and faithful wearing of the appliance. Even
though this is a removable appliance, it is clear, invisible, and
transparent. It is much more comfortable than traditional
appliances and easily removable and does not affect eating
habits. Better oral hygiene maintenance is feasible, and issue
of breakage is virtually free compared to other techniques.
Patient acceptance is better due to the aesthetic advantage.
Even though bonding of brackets to the palatal aspect of
upper incisors is also used as a reminder appliance in lip
Figure 4. Lip biting habit biting, it may require bite raising, which is not encountered
in this particular appliance. If required, habit control can be
carried out simultaneously with aligner therapy or as a part of
retainer phase.

Conclusion
This appliance is not only efficient but also esthetically
pleasing and better accepted by the patient.

Declaration of Conflicting Interests

Figure 5. Clear retainer with elevations in patients mouth The authors declared no potential conflicts of interest with respect to
the research, authorship, and/or publication of this article.

Funding
The authors received no financial support for the research, author-
ship, and/or publication of this article.

References
1. Durgekar SG, Naik V. Lingual buttons to intercept lip-sucking
habits. J Clinic Orthodont. 2009;43(4):272.
2. Germec D, Taner TU. Lower lip sucking habit treated with a lip
Figure 6. Clear retainer with elevations in patients mouth bumper appliance. Angle Orthod. 2005;75(6):1071-1076.