This patient was 8 years 6 months old and was a chronic thumbsucker.
This resulted in lack of vertical overlap of the front teeth and some mild crowding of the lower front teeth.
With vigorous thumb sucking normally we would also see narrowing of the upper back teeth possibly resulting in a crossbite.
The thumb sucking in this case is relatively passive as no posterior crossbites are evident.
A TSDA (thumb sucking deterrent appliance) was used for 6 month to act as a reminder to stop thumb sucking.