commonly occuring oral habits in children
TRANSCRIPT
COMMONLY OCCURING ORAL HABITS IN
CHIlDREN
DEFINITIONSDorland:
Habit can be defined as a fixed or constant
practice established by frequent repetition.
Mathewson:
Oral habits are learned patterns of muscular
Contraction.
Buttersworth:
Defined a habit as a frequent or constant
practice or acquired tendency,which has
been fixed by frequent repetition.
DEVELOPMENT OF HABIT
First,infant makes an effort by frequent
learning and practice.
Later, muscles start responding more
readily.
BASIC ETIOLOGY OF HABIT
OverprotectionLonelinessIsolationPain and discomfortAbnormal physical size of partsImitation or imposition of others
BASIC EFFECT OF HABIT
Brings unbalanced pressure on immature, highly malleable alveolar ridges.
All the clinical features are consequences of this effect
CLASSIFICATION
OBSESSIVE:
Intentional:
Nail biting
Digit sucking
Lip biting
Masochistic:
Gingival stripping
NON-OBSESSIVE
Unintentional:
Abnormalpillowing
Chin propping
Functional habits:
Mouth breathing
Tongue thrusting
Bruxism
Habits significant to dental surgeon
Thumb suckingTongue thrustingMouth breathingBruxismNail bitingLip biting
THUMB SUCKING
Definition:
Thumb sucking can be defined as
placement of the thumb at various depths
into the mouth.
Other names:
Finger sucking
Digit sucking
SUCKING REFLEX
One of baby’s inherent reflex
Natural normal infant habit which gives the baby a feeling of security, pleasure and nutritional satisfaction.
Babies restricted from sucking,adapt to sucking a available object,mostly thumb.
CLASSIFICATION
Normal:
During 1st and 2nd yrs
Disappears as child
matures
Abnormal:
Persist beyond
preschool age or 3yrs
Divided into:
Psychological:
Habitual
Sucking habits can also classified as
Nutritive sucking habit
Breast-feeding
Bottle-feeding
Non-nutritive sucking habit
Thumb sucking
Subtelny classification of thumb sucking
Type A: More common
Whole digit is placed inside the mouth with
the pad of the thumb pressing over the
palate and thumb contact with max. and
man. Anteriors is maintained.
Type B:
Thumb is placed into the oral cavity without touching the vault of the palate and thumb contact with max. and man. Anteriors is maintained.
Type C:
Thumb is placed into the mouth just beyond
the first joint,contacting the hard palate and
thumb contact is maintained with only
max.anteriors.
Type D:
Little portion of the thumb is placed into the
mouth
Etiology of thumb suking
Parents from high socioeconomic statusWorking motherIncreased number of siblingsLater order of birth of childSocial adjustment and stress-scolding
parentsFeeding practicesAge of child
Clinical findings Maxillary anterior proclination and mandibular
retroclination. The anterior open bite Constriction of maxillary arches Posterior cross bite Increased maxillary arch length Increased trauma to maxillary central incisors Increased mandibular intermolar distance Increased overjet Decreased overbite
TONGUE THRUSTING
Definition:
Brauer:
A tongue thrust is said to be present if the
tongue is observed thrusting between, and
the teeth do not close in centric occlusion
during deglutition.
Tulley:
States tongue thrust as the forward
movement of the tongue tip between the
teeth to meet the lower lip during deglutition
and in sounds of speech, so that the tongue
becomes interdental.
ClassificationPhysiologic:
Due to retained infantile swallow
Habitual:
Present as a habit even after the correction of malocclusion.
Functional:
Adaptive behaviour developed to achieve an oral seal.
Anatomic:
Persons having enlarged tongue.
Etiology of tongue thrust
Retained infantile swallowUpper respiratory tract infectionsNeurological disturbancesFunctional adaptability to transient change
in anatomyFeeding practicesOther oral habitsHereditaryTongue size
Clinical manifestations
Extra oral findings:Seperated lipsNo corelation between the movements of
tongue tip and mandible.Mandibular movement is upward and
backward with tongue moving forwardProblems in articulation of
/s/,/n/,/t/,/d/,/i/,/th/,/z/,/v/ soundsIncrease in anterior facial height
Intraoral findings Tongue movements are irregular Swallowing sequences are seen to be jerky and
inconsistent Lowered tongue tip at rest Malocclusion:
maxilla:Proclination of anteriors
Generalized spacing
Maxillary constriction
mandible:Retroclination or proclination
intermaxillary relationships:
Anterior or posterior open bite
Posterior cross bite
MOUTH BREATHING
Definition:
sassouni:
Defined mouth breathing as habitual
respiration through the mouth instead of
nose,.
Merle:
Suggested the term oronasal breathing
instead of mouth breathing.
Classification(Finn)Anatomic:
In persons whose short upper lip does not permit complete closure.
Obstructive:
Children who have increased resistance to or complete obstruction of,normal flow of air through the nasal passages.
Habitual:
Child who continually breathes through his mouth by force of habit.
Etiology Nasal insufficiency in most of the children Allergies,physical obstructions and chronic
infections Airway obstruction due to
-Enlarged turbinates
-Deviated septum
-Obstruction in bronchial tree or
larynx
-Obstructive sleep apnea
syndrome
-Ectomorphic children
Clinical featuresGeneral effects:No purification of inspired airPoor pulmonary compliance and pigeon chest
appearanceEsophagitisLow % of oxygen in air inhaled through mouth
Effects on dentofacial structures:Increased facial height,retrognathic maxilla
and mandibleAdenoid facies
Retroclined upper and lower incisors and posterior cross bite
Nasal tone in voice is seenLip apart posture,short thick incompetent
upper lip and a voluminous curled over lower lip
Slit like external nares with a narrow noseHyperplastic gingiva and classic rolled
margin in gingiva Enlarged interdental papillaOtitis media
BRUXISMDefinition:
Ramfjord:
Habitual grinding of teeth when the
individual is not chewing or swallowing.
Vanderas:
Nonfunctional movement of the mandible
with or without an audible sound occuring
during the day or night.
Types of bruxism
Day time bruxism/Diurnal bruxism:
Night time bruxism/Nocturnal bruxism:
EtiologyCNS-cortical lesions,children with cerebral
palsy and mental retardationPsychological factors-feelings of anger
and aggressionImproper interdigitation of teethGeneticsMg++ deficiency and other systemic
factorsAllergies Overenthusiastic student or compulsive
overachievers
ManifestationsOcclusal trauma-tooth mobilityIncreased tooth sensitivity from an
excessive abrasion of the enamelFracture of the tooth crown or restorationsMuscular tenderness,muscular fatigueTMJ disturbances and painChronic headacheSoft tissue trauma Small ulcerations on the buccal muosa
opposite the molar teeth
Lip habitDefinition:
Habits that involve manipulation of the lips
and perioral structures are termed as lip
Habits
Classification:
-Wetting the lips with the tongue
-Pulling the lips into the mouth between the teeth
Etiology Angle’s class II division 1 malocclusion with
large overbite and overjet Other habits-thumb sucking Emotional stress
Manifestations: Protrusion of max.incisors and retrusion of man.
Incisors Interdental spacing in max.incisors Crowding in man.incisors Dislocated vermilion border Malocclusion
Cheek bitingDefinition:
Abnormal habit of keeping or biting the
cheek muscles in between the upper and
lower posterior teeth
Clinical features:Ulcer at the level of occlusionOpen biteTooth malposition in the buccal segment
Nail bitingEtiology-Internal tension
Effects:
-Crowding,rotation and attrition of incisal edges of man.teeth
-Inflammation of nail and nail beds
Self injurious habitsDefinition:
In these habits, the patient enjoys inflicting
damage to himself.
Etiology:
Organic-Lesch nyhan disease
-De Lange’s syndrome
Functional-Superimposed on pre existing
lesion
-Secondary to an habit
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