Assessment of Bond Failure of Tongue Tamers in an Orthodontic Population: A One-Year Audit

Abstract

Abstract Background: Tongue tamers are small, bonded metal spurs used in orthodontics to help eliminate deleterious oral habits such as tongue thrusting and thumb sucking by creating a physical reminder that discourages the habit. They are commonly used with fixed appliances and are valued for being minimally obtrusive. However, their success depends on secure bonding to the teeth, and detachment can compromise treatment efficacy. This study is an audit of the bond failure rate of tongue tamers and examines the associated demographic and clinical factors in a Nigerian clinical setting. Materials and Methods: A retrospective cross-sectional review was conducted using records from a private clinic in Lagos State, Nigeria. Data were extracted from the orthodontic patients’ records who had tongue tamers bonded within one year. Variables collected included patient age, gender, oral habit, malocclusion classification, arch and teeth bonded, appliance type and time to bond failure. Statistical analysis was performed using R, with significance set at P < 0.05. Results: A total of 28 patients with 192 bonded tongue tamers were recruited into the study. The prevalence of bond failure was 68/192 (35.4%). Approximately 25/28 (89.3%) of patients experienced failure of at least one tongue tamer. Most failures, 41/68 (60.3%), occurred within the first four to six weeks of placement. Bond failure was significantly more frequent in the upper arch 42/100 (42.0%), compared with the lower, 26/92 (28.3%; χ 2 = 3.95, df = 1, P = 0.047), and amongst patients with tongue thrusting and thumb sucking ( P = 0.043, Fisher’s exact). Class III malocclusion 17/28 (60.7%) and reduced/incomplete overbite 23/44 (52.3%) were significantly associated with higher failure rates compared with class I 36/124 (29.0%) and anterior open bite 45/148 (30.4%) (χ 2 = 10.12, df = 2, P = 0.006; χ 2 = 7.09, df = 1, P = 0.008, respectively). No significant associations were found with gender ( P = 0.110), age ( P = 0.200) or appliance type ( P = 0.800). Conclusion: Tongue tamers are prone to early bond failure, particularly in the upper arch, with most failures occurring within the first six weeks of placement. Early follow-up and rebonding or alternative habit-breaking appliance choices may improve treatment outcomes in high-risk cases.