Short Communication

Simplified Appliance for Lip Journal of Indian Orthodontic Society

1­–5
Biting Habit—A Case Report © The Author(s) 2023
Article reuse guidelines:
in.sagepub.com/journals-permissions-india
DOI: 10.1177/03015742231214378
journals.sagepub.com/home/jio

Rakesh Mohode1, Aayushi Chauhan1 and Rajan Mahindra1

Abstract
Lip biting habit can cause severe malocclusions and should be intercepted early in age. The lip bumper device is a helpful
treatment as it can stop the habit and prevent the resulting malocclusion. Lip biting habit is intercepted by removable or fixed
lip bumper. A simplified appliance for lip biting habit that is easy to fabricate and is more accepted and comfortable for the
patient was designed. It consists of a thermoplastic sheet with a labial acrylic pad as in a conventional lip bumper appliance.
Improved patient compliance was noted with added advantage of ability to maintain better oral hygiene.

Keywords
Lip biting, lip bumper, lip sucking

Received 7 June 2023; accepted 16 October 2023

Introduction 2. Add modeling wax between deciduous canine and

The extraoral muscles and tongue are usually in equilibrium
which helps to stabilize the dentition. Any deleterious habit can
alter the normal development of the orofacial structures by
hampering this equilibrium.1 Lip sucking is commonly seen
during 6 to 9 years of age. According to the severity and fre-
quency the malocclusion it may produce varies, but it is essen-
tial for normal development that the habit be eliminated. The
lip bumper device is a helpful treatment as it can stop the habit
and prevent the resulting malocclusion. Lip biting habit is
intercepted by removable or fixed lip bumper.2 Patient compli-
ance is not favorable with removable lip bumper because of its
rigidity, irritation to lingual mucosa, and excess salivation. For
fixed lip bumper, child may not be cooperative for banding
procedure and maintaining oral hygiene will be a difficult task.
Since appliance is fixed, it will be difficult for child to eat with
appliance or to have it in school. To overcome above difficul-
ties, we fabricated a simple appliance to eliminate lip biting
which has proven to show good compliance from patient.
deciduous first molar on occlusal surface. Wax will
act as a spacer to insert molar tubes (Figure 1).
3. Over the cast make a 1.5-mm thermoplastic plate1
from vacuum press machine (Figure 2).
4. Take the plate out from the cast and remove the wax
remnant.
5. Heat the round molar tube2 and pierce through the
thermoplastic plate to place it between deciduous
canine and first molar. Molar tube will prevent plate
from tearing when patient will start wearing the appli-
ance after fabrication (Figure 3).
6. Pass 0.8-mm stainless steel wire in molar tube from
labial to lingual and adapt the wire over thermoplastic
plate on lingual side over the thermoplastic sheet fol-
lowing gingival contour. Extend the wire on occlusal
surface to adapt it on the buccal side (Figure 4).
7. Add wax spacer in the anterior sulcus region and
adapt the wire slightly away from it (Figure 5).

1Department of Orthodontics and Dentofacial Orthopedics, Government

Technique for Fabrication Dental College, Aurangabad, Maharashtra, India

Corresponding author:
1. Take an accurate well-extended Alginate impression Aayushi Chauhan, Department of Orthodontics and Dentofacial Orthopedics,
of mandibular arch. Disinfect the impression and pour Government Dental College, Ghati, Aurangabad, Maharashtra 431001, India.
the working cast in dental stone. E-mail: aayushichauhan95@gmail.com

Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-
NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-Commercial use, reproduction and
distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://
us.sagepub.com/en-us/nam/open-access-at-sage).
2 Journal of Indian Orthodontic Society

8. Engage the wire into acrylic forming a lip bumper 2. The contoured wire on labial and lingual side pro-
(Figure 6). vides added retention.
9. After acrylic is set, remove the wax and polish the lip 3. The appliance can be worn and removed easily.
bumper (Figure 7). 4. Patient will not have difficulty in eating as appliance
can be removed during meals.
5. No soft tissue laceration or impingement since ther-
Advantage of the Appliance moplastic sheet is well adapted to the teeth.

1. This appliance fits snugly on the teeth.

Figure 1. Wax as Spacer.

Figure 2. Thermoplastic Sheet Adapted to Cast Using Vacuum Forming Machine.

Mohode et al. 3

Figure 3. Insertion of Heated Molar Tube Through Thermoplastic Sheet.

Figure 4. Adapted Stainless Steel wire.

6. Patient compliance is good without obstructing oral for treatment to be successful. Therefore, if you can deliver a
hygiene or increasing caries susceptibility (as with comfortable appliance, it will be more effective.
banding of lip bumper).

The most important thing to remember about any intervention

is that the child must themselves want to discontinue the habit
4 Journal of Indian Orthodontic Society

Figure 5. Wax Spacer in Anterior Region.

Figure 6. Acrylic Lip Bumper in Anterior Region over Spacer.

Mohode et al. 5

Figure 7. Finished and Polished Appliance Intraorally.

Declaration of Conflicting Interests ORCID iDs

The authors declared no potential conflicts of interest with Aayushi Chauhan https://orcid.org/0009-0009-5562-0331
respect to the research, authorship and/or publication of this
article.
References
Funding
The authors received no financial support for the research, 1. Graber TM. The “three m’s”: Muscles, malformation, and maloc-
authorship and/or publication of this article. clusion. Am J Orthodont. 1963;49(6):418–450.
2. Graber TM. Orthodontics; principles and practice. Saunders; 1972.
Note
1. Raintree Essix.
2. TP Orthodontics, Inc.