Finger sucking digital deformities

Pernicious Effects of Toe Sucking Habit in Children

Digit sucking is common nonnutritive sucking habit in childhood. However it is unusual to find toe sucking habit in children. We report a case of a seven-year-old child sucking great toe of the left foot. The child was referred by her paediatrician for dental evaluation due to her complaint of recurrent episodes of pyrexia. A dental evaluation was warranted as no particular system contributed to such recurrent episodes of fever in this child. Although dental examination did not reveal any cause for recurrent episodes of pyrexia, as a part of routine history taking we discovered that this child indulges frequently in sucking the great toe of her left foot since infancy. Any nonnutritive sucking habit is considered deleterious; this habit also caused significant effect on the child's dentofacial structures, sucked toe, and her general health. Hence the treatment plan was formulated for immediate cessation of habit. Appropriate interception of habit and timely orthodontic intervention led to not only early interception of cross-bite but also decrease in pyrexial episodes. This case report describes the pernicious effects of toe sucking habit and its relevance to recurrent pyrexia in children.

Influence of non-orthodontic intervention on digit sucking and consequent anterior open bite: a preliminary study

OBJECTIVES

This study aimed to assess behavioural and occlusal outcomes of non-orthodontic intervention (NOI) in a sample of children, 4-12 years of age, in Australia, in order to establish clinical relevance.

MATERIALS AND METHODS

Data from 91 patient records of 4- to 12-year-old children reporting a habit of digit sucking, from two clinics in north-eastern Australia, were de-identified and used. Each patient had been examined at two visits, separated by an interval of 4 months, using standard clinical procedures.

RESULTS

Of the 77 children who received a 4-month NOI, 69 (89.6%) had ceased their digit sucking habit by the end of the NOI period [χ2=67.0, degrees of freedom (d.f.)=1, P<0.001]. Of the 72 subjects who had front teeth, the number with anterior open bite decreased from 37 (51.4%) to 12 (16.7%) upon completion of NOI (χ2=21.3, d.f.=1, P<0.001). Among the 32 patients with a measurable overjet, the mean overjet was found to decrease from 4.2±2.4 mm to 3.1±1.9 mm after implementation of NOI (t=5.8, d.f.=31, P<0.001). Children who received NOI were more likely to quit the digit sucking habit in the 4-month period (P<0.001, OR=51.8, 95% CI: 9.8-273.9) and were more likely to appear without anterior open bite at a 4-month recall (P<0.001, OR=30.0, 95% CI: 5.9-151.6).

CONCLUSIONS

This study demonstrated clinical relevance of NOI on the cessation of a digit sucking habit, closure of anterior open bite and reduction of overjet. Further investigations are indicated.

Metacarpal osteotomy for correction of acquired phalangeal rotational deformity

Symptomatic phalangeal rotation deformities require corrective osteotomy. Surgery at the phalangeal level is technically demanding and has a higher complication rate. We describe the surgical technique of metacarpal base osteotomy for rotation correction of the digit. This technique is simple, allows early rehabilitation, and has a lower complication rate.