International Handbook of Clinical Hypnosis - E-Lib FK UWKS

294 INTERNATIONAL HANDBOOK OF CLINICAL HYPNOSIS
one of the most useful modalities in the management of oral habits that no longer
serve a useful purpose is clinical hypnosis.
HABIT MANAGEMENT
General techniques for decreasing undesirable oral habits are extinction, ignoring
a previously reinforced behavior, temporarily denying privileges, punishment,
direct negative action, reasoning, provision of alternatives, and positive reinforcement
in the absence of the behavior Peterson & Schneider, 1991). The
general dental practitioner does not have the facility or training to apply these
relatively time-consuming methods. He or she can utilize some hypnotic
strategies that may yield dramatic result with an investment of just a few
minutes of chairtime.
PACIFIER, FINGER AND THUMB SUCKING
According to the authors of `Oral Habits: A Behavioral Approach' Peterson &
Schneider, 1991): `Some 13% to 45% of children are reported to suck their
digits. Practically all children who eventually take up the habit do so during
their ®rst few months. By 3.5to 4 years of age, most children have discontinued
the habit spontaneously. The severity and even presence of deleterious effects of
®nger sucking depends on the habit's frequency, duration, intensity, and position
of the ®nger in the mouth. Dentoalveolar changes associated with thumbsucking
include anterior open bite accompanied by decreased alveolar bone
growth. If the habit continues beyond puberty, these problems do not usually
self-correct.'
Cessation of ®nger sucking may be approached in a number of ways. Finger
sucking is frequently accompanied by possession and manipulation of a favored
object, such as a doll or blanket. Removal of the object has been shown to eliminate
the ®nger sucking as well. Explaining to the child the association between the habit
and the object and subsequent con®scation of the object may aid in elimination of
the ®nger sucking.
The application of a bitter solution to the thumb has empirically absolved ®nger
suckers of the habit. A `hayrake' attached to a palatal bar ®xed to the molars that
does not interfere with occlusion reminds the child of the habit, and has shown to
be quite effective even for an intense habit. Lingual spurs attached to the maxillary
incisor bands also act as a reminder appliance.
The effectiveness of psychotherapeutic counseling has also been shown to be
high. Intellectual/emotional/hypnotic approaches are of particular interest here.
The use of age regression/progression has been shown by Crasilneck & Hall 1985,
1990) to be very effective. The authors suggest that the child's feelings for personal