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Case Reports in Dentistry
Volume 2013, Article ID 537120, 4 pages
Case Report

Modified Bluegrass Appliance: A Nonpunitive Therapy for Thumb Sucking in Pediatric Patients—A Case Report with Review of the Literature

1Department of Pedodontics and Preventive Dentistry, Faculty of Dental Science, Nadiad, Gujarat, India
2Department of Prosthodontics, Pacific Dental College, Udaipur, India
3Department of Orthodontics and Dentofacial Orthopedics, Darshan Dental College, Udaipur, India
4Department of Oral Medicine and Radiology, Karnavati School of Dentistry, Gandhinagar, Gujarat, India

Received 12 March 2013; Accepted 2 May 2013

Academic Editors: P. G. Arduino and D. Ram

Copyright © 2013 Amish Diwanji et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Oral habits in form of digit/thumb sucking are common phenomenon and part of childhood behavior. They are normally associated with oral pleasure, hunger, anxiety, and sometimes psychological disturbances. Chronic practice can cause major orthopedic alterations to the skeletal structures of the oral cavity and lower face. Aversive approaches in form of punitive therapy have been moderately effective. Modified bluegrass appliance is nonpunitive therapy to treat sucking habits. It acts as a habit reversal technique and installs positive reinforcement in children. Modified blue grass appliance proved to be very comfortable to patients and encourages neuromuscular stimulations.