commonly occuring oral habits in children

43
COMMONLY OCCURING ORAL HABITS IN CHIlDREN

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Page 1: Commonly occuring oral habits in children

COMMONLY OCCURING ORAL HABITS IN

CHIlDREN

Page 2: 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.

Page 3: Commonly occuring oral habits in children

DEVELOPMENT OF HABIT

First,infant makes an effort by frequent

learning and practice.

Later, muscles start responding more

readily.

Page 4: Commonly occuring oral habits in children

BASIC ETIOLOGY OF HABIT

OverprotectionLonelinessIsolationPain and discomfortAbnormal physical size of partsImitation or imposition of others

Page 5: Commonly occuring oral habits in children

BASIC EFFECT OF HABIT

Brings unbalanced pressure on immature, highly malleable alveolar ridges.

All the clinical features are consequences of this effect

Page 6: Commonly occuring oral habits in children

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

Page 7: Commonly occuring oral habits in children

Habits significant to dental surgeon

Thumb suckingTongue thrustingMouth breathingBruxismNail bitingLip biting

Page 8: Commonly occuring oral habits in children

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

Page 9: Commonly occuring oral habits in children
Page 10: Commonly occuring oral habits in children

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.

Page 11: Commonly occuring oral habits in children

CLASSIFICATION

Normal:

During 1st and 2nd yrs

Disappears as child

matures

Abnormal:

Persist beyond

preschool age or 3yrs

Divided into:

Psychological:

Habitual

Page 12: Commonly occuring oral habits in children

Sucking habits can also classified as

Nutritive sucking habit

Breast-feeding

Bottle-feeding

Non-nutritive sucking habit

Thumb sucking

Page 13: Commonly occuring oral habits in children

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.

Page 14: Commonly occuring oral habits in children

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

Page 15: Commonly occuring oral habits in children

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

Page 16: Commonly occuring oral habits in children

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

Page 17: Commonly occuring oral habits in children
Page 18: Commonly occuring oral habits in children

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.

Page 19: Commonly occuring oral habits in children

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.

Page 20: Commonly occuring oral habits in children

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.

Page 21: Commonly occuring oral habits in children

Etiology of tongue thrust

Retained infantile swallowUpper respiratory tract infectionsNeurological disturbancesFunctional adaptability to transient change

in anatomyFeeding practicesOther oral habitsHereditaryTongue size

Page 22: Commonly occuring oral habits in children

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

Page 23: Commonly occuring oral habits in children

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

Page 24: Commonly occuring oral habits in children
Page 25: Commonly occuring oral habits in children
Page 26: Commonly occuring oral habits in children

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.

Page 27: Commonly occuring oral habits in children

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.

Page 28: Commonly occuring oral habits in children

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

Page 29: Commonly occuring oral habits in 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

Page 30: Commonly occuring oral habits in children
Page 31: Commonly occuring oral habits in children

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

Page 32: Commonly occuring oral habits in children

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.

Page 33: Commonly occuring oral habits in children

Types of bruxism

Day time bruxism/Diurnal bruxism:

Night time bruxism/Nocturnal bruxism:

Page 34: Commonly occuring oral habits in children

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

Page 35: Commonly occuring oral habits in children

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

Page 36: Commonly occuring oral habits in children

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

Page 37: Commonly occuring oral habits in children
Page 38: Commonly occuring oral habits in children

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

Page 39: Commonly occuring oral habits in children

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

Page 40: Commonly occuring oral habits in children

Nail bitingEtiology-Internal tension

Effects:

-Crowding,rotation and attrition of incisal edges of man.teeth

-Inflammation of nail and nail beds

Page 41: Commonly occuring oral habits in children

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

Page 42: Commonly occuring oral habits in children
Page 43: Commonly occuring oral habits in children

THANK YOU

PRESENTED BY MANTHRU