Patient co-operation and motivation
The Dentist should build up a very good relationship of trust and assure co-operation with a child. Only after this conversation with the child the particular problem and their consequences for permanent dentition and the need and benefits of doing the early treatments and the expected favorable results be discussed with the parents. This is best done using a hand mirror, models of other patients upper and lower jaw and related pictures and brouchers with the appliances. With the appliance practice the child the action of putting in and removing the appliances and doing the lip exercises. In this way the unforced closing of the mouth is achieved and nasal breathing assured. Parents must also be made aware of the need for any more comprehensive orthodontic treatment which may be necessary at a later stage. Survey shows that the children aged 5 and above can give up their habits in 2 to 3 weeks time and get favorable dental alignment. This is most successful when parents, brothers and sisters and even grand parents support the dentists, treatment and effort. Appliance must be worn every night and also for a few hours during the day (Eg. While doing homework, watching television or playing computer). Night use is very essential and should be started only when the child is accustomed to day time use, usually done after 1 to 2 weeks. If it falls out while sleeping dont panic. This is a training programme and once it stays in all night that is a major success. Some retentive straps or some towel can be used initially to hold the mandible firmly in position to prevent the appliance from falling out while sleeping. However this can be stopped once the child is fully trained.