Galella Tongue Habit Appliance

Original designer: Dr. Steve Galella, Collierville, TN

Description: 
   This appliance is used to correct tongue habits through retraining the tongue to function properly. It is effective for anterior tongue thrust, lateral tongue thrust, improper swallowing patterns, training of the tongue post ankyloglossa surgery and aberrant tongue function. It is also used to deter thumb sucking. It is comprised of a combination of a Fixed-Removable Lingual Arch, a transpalatal wire with a coffin spring directed posteriorly (8-10 mm below the palate) and a 3 mm “spinable” bead positioned over the posterior 1/3 of the incisive papilla. This appliance is designed to be physiologically harmonious with normal tongue function.

Indications for use of Galella Tongue Habit Appliance:                

• Aberrant Tongue Function
• Tongue Thrust
• Thumb Sucking
• Anterior Open bite from tongue habit
• Posterior Open bite from tongue habit
• Patients with TMD.

Contraindications for use of Galella Tongue Habit Appliance:                  

• None

Alternate Appliances:

• Tongue Fence Appliance
• Transpalatal
• Appliance with tongue bead

1.        One-week prior to impressions, separate the Mx 6-year molars.  (Separators need not always be placed before impressions, but makes it easier for the laboratory to fabricate appliance.)  

2.        Complete Maxillary Alginate Impression.

3.        Pour models with lab stone.

4.        Complete laboratory prescription form.

5.        Ask for molar bands as your band prescription dictates with lingual horizontal sheaths.

6.        One week prior to delivery, patient must be seen for placement of separators mesial and distal of Mx 6-year molars

7.        The appliance is delivered and adjusted for best fit.

8.        Instructions are given to patient on wear and care and adjustment procedures.   

Adjustment suggestions:

                When the Galella Tongue Habit Appliance is seated make sure the anterior bead is positioned over the posterior 1/3 of the incisive papilla. The Posterior coffin spring should be 8-10 mm inferior to the palatal tissue. The appliance is designed to retrain the tongue by having the patient constantly “pulling” the bead towards the back of the mouth. When the patient swallows he or she is instructed to “wedge” their tongue between the bead and the roof of the mouth. The coffin spring serves as a gentle reminder of aberrant swallows.  

Length of time of treatment, and results expected:

                Since this appliance is a habit correction appliance, it usually is not “active”, but rather a passive appliance.  It may safely remain in place for 6-12 months.  

Hard tissue and soft tissue response to wear of the Galella Tongue Habit Appliance:

                There are few negative responses to this appliance, other than the occasional loosening of one of the bands.  However, with use of the new glass ionomer cements, this is less of a problem than in previous decades.  

Stabilization of teeth and bone following removal of the Galella Tongue Habit Appliance:

                Usually teeth remain in a stable relationship following the removal of this appliance.  It adds to the inherent stability if the appliance is left in place longer than a 12-month period.  

PRECAUTIONS:

                The use of this appliance is dependent on the tolerance of the patient. If this appliance frustrates the patient for more than one month, one should consider another less invasive appliance.

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