Soft Bite Appliance for Teething Infants

ABSTRACT

Mother’s milk is a biological secretion that provides the best nutritional source with numerous benefits to the infant, which include somatic growth, modulation of post-natal intestinal function, brain development, and immune ontogeny. As per WHO, exclusive breastfeeding is recommended for the first six months and continuation up to two years of age as both mother and the infant are mutually benefitted. Breast milk contains more nutritional, hormonal, and growth factors which are mandatory for the baby to attain the highest standards of health. Many mothers encounter bite injuries in their nipples and areola while feeding due to the teething process, which usually starts six months after birth. This may cause injury to the mother’s skin causing inconvenience in feeding. This can be avoided by fabricating a “soft bite appliance” for the infant, which prevents bite injuries and makes both the baby and mother feel comfortable during feeding. This device can be used as a temporary device during the teething process, thereby enhancing nursing mothers to continue the feeding process without anxiety.

INTRODUCTION

Every mother takes that pleasure in giving birth and nursing her child. Breastfeeding by the mother will give a number of short- and long-term health benefits to herself as well as the baby.[1] Exclusive breastfeeding the baby releases oxytocin in the mother, thereby decreasing the uterus to pre-pregnancy size and also reducing post-partum bleeding. There is a benefit of reduced risks of breast and ovarian cancer for the mother.[2] A baby who is fed with breast milk receives many benefits as it contains many hormones, neuropeptides, and growth factors that help in growth, development, and self-regulation of food intake.[3] Babies who are not breastfed sufficiently, or who are breastfed for short periods or at low intensity, have a higher chance to get infection and illness than those who are breastfed optimally and sufficiently.[4]

Every mother takes pleasure in nursing her child and so does the child. Nature in its best way teaches an infant to suck and swallow while also allowing them to breathe comfortably within a few minutes after birth. Breastfeeding is often mentioned as a facilitator of mother-infant bonding and creating an unbreakable relationships with each other in a comfortable environment.[5,6]

Bite during the initial days of nursing commonly happens due to improper latching, which is slowly learned by both of them. However, from 6 months’ time during teething, the child tends to actually bite the nipple while feeding. This is done either because of teething or the child may be hungry or when the demand is more than the supply. Some babies bite in frustration, boredom, and also to seek attention. This becomes a very painful course for the mother and becomes difficult to make the child understand. Diversion, explanation, and training the child is time-consuming as well as doesn’t always turn out successful. Most of the time this results in anxiety in the mother and leads to discontinuity in nursing. A confident mother will be able to nurse her child more comfortably.

Infants in their first few years of life will undergo exclusive breastfeeding, partial breastfeeding, and later spoon feeding, and then be moved to semi-solid and solid food. During this process, exclusive and partial breastfeeding will have a greater impact on the development and eruption of both primary and permanent dentition teeth.[5,7]

WHO strongly recommends breastfeeding exclusively for the first six months and its continuation up to at least two years of age for all new-borns.[8,9] So far, no proper direction was carried out to prevent biting injuries during breastfeeding by using any appliance. To help the mother from pain and also feed comfortably, a device that covers the maxillary arch of the child without disruption in feeding activity is innovated. The impression is taken using either putty followed with special trays or by using the intraoral scanner for optical impression. A confident mother will be able to nurse her child more comfortably which is aided by using this device enabling convenience and comfort.

CASE REPORT

The mother of one-year-old child who was breastfeeding was selected to observe the difference between comfort and anxiety levels with and without using the soft bite appliance during feeding. Impression of the upper arch of the child was taken using Putty A silicon, (Zetaplus, Zhermack) [Figure 1]. The cast was poured on the impression and the soft bite appliance was fabricated using a polyvinyl sheet of 1.0 mm thickness [Figure 2]. The appliance covers only the arch and does not extend to the palate as the baby may lose the euphoric feel of feeding and stops to receive the feed. A temporary elastic strap was attached for retention purposes. The mother was asked to use the appliance on the child during breastfeeding to avoid a bite.

Figure 1.

Recording impression of upper arch

Figure 2.

Soft bite appliance

Device fabrication

This device will cover the maxillary arch of the child without disruption in feeding activity for which, the impression is taken using suitable biocompatible material like putty followed by special trays or by using the intraoral scanner for optical impression. The appliance is custom-made according to the baby’s arch using thermoplastic elastomer or food-grade silicon material which is more bio-friendly and commonly used in the medical and dental fraternity. It has properties enabling proper cleaning with water or vinegar. It was found to be non–choking and non-Interrupting. It covers only the alveolar ridge area. The material is recyclable and used only while feeding particularly while the eruption of upper anterior teeth between 8-12 months.

Parts and their functions

This device has two parts: a soft bite appliance (1) and an elastic head strap (2), each of which can be connected to one other. The intraoral soft bite appliance is attached to the elastic head strap with buttons and helps the baby to suckle without hurting the mother’s skin. It is removable and can be attached at the time of wearing the appliance. The head strap is attached in the deciduous upper canine to the molar region in the buccal aspect of the soft bite appliance and helps the retention of the appliance [Figure 3].

Figure 3.

Soft bite appliance with temporary head strap front view

Advantages

The appliance helps as a barrier in avoiding direct contact of the baby’s erupting tooth with the mother’s skin, thereby preventing a sharp bite. Therefore, it eases the mother’s anxiety during feeding. This will be a temporary device till the baby learns, the duration of which may differ for each child. The same may not be necessary for the lower arch as the tongue overlies on the lower anterior region to enable sucking during which the lower teeth or gum is covered by the tongue, therefore it does not directly come in contact with the mother’s skin.[10] For retention purposes, soft head straps are used.

The child was hesitant and refused to suckle during the first few attempts wearing the soft bite appliance. However, the child and mother felt comfortable after a few days. The appliance was used for a minimum period after which the mother complained of improper latching by the child.

Further improvisation with better retention straps is required for consistent usage.

CONCLUSION

The “Soft Bite Appliance” described here prevents bite injuries, decreases anxiety level, and increases comfort during feeding. Further, it aids in creating better bonding between mother and baby, helps the baby to get the benefits of breast milk, and can be recommended by pediatricians and pediatric dentists.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.