Commonly occuring oral habits in children


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Commonly occuring oral habits in children

  2. 2. DEFINITIONS Dorland: 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.
  3. 3. DEVELOPMENT OF HABIT First,infant makes an effort by frequent learning and practice. Later, muscles start responding more readily.
  4. 4. BASIC ETIOLOGY OF HABIT Overprotection Loneliness Isolation Pain and discomfort Abnormal physical size of parts Imitation or imposition of others
  5. 5. BASIC EFFECT OF HABIT Brings unbalanced pressure on immature, highly malleable alveolar ridges. All the clinical features are consequences of this effect
  6. 6. 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
  7. 7. Habits significant to dental surgeon Thumb sucking Tongue thrusting Mouth breathing Bruxism Nail biting Lip biting
  8. 8. 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
  9. 9. 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.
  10. 10. CLASSIFICATION Normal: During 1st and 2nd yrs Disappears as child matures Abnormal: Persist beyond preschool age or 3yrs Divided into: Psychological: Habitual
  11. 11. Sucking habits can also classified as Nutritive sucking habit Breast-feeding Bottle-feeding Non-nutritive sucking habit Thumb sucking
  12. 12. 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.
  13. 13. 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
  14. 14. Etiology of thumb suking Parents from high socioeconomic status Working mother Increased number of siblings Later order of birth of child Social adjustment and stress-scolding parents Feeding practices Age of child
  15. 15. 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
  16. 16. 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.
  17. 17. 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.
  18. 18. Classification Physiologic: 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.
  19. 19. Etiology of tongue thrust Retained infantile swallow Upper respiratory tract infections Neurological disturbances Functional adaptability to transient change in anatomy Feeding practices Other oral habits Hereditary Tongue size
  20. 20. Clinical manifestations Extra oral findings: Seperated lips No corelation between the movements of tongue tip and mandible. Mandibular movement is upward and backward with tongue moving forward Problems in articulation of /s/,/n/,/t/,/d/,/i/,/th/,/z/,/v/ sounds Increase in anterior facial height
  21. 21. 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
  22. 22. 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.
  23. 23. 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.
  24. 24. 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
  25. 25. Clinical features General effects: No purification of inspired air Poor pulmonary compliance and pigeon chest appearance Esophagitis Low % of oxygen in air inhaled through mouth Effects on dentofacial structures: Increased facial height,retrognathic maxilla and mandible Adenoid facies
  26. 26. Retroclined upper and lower incisors and posterior cross bite Nasal tone in voice is seen Lip apart posture,short thick incompetent upper lip and a voluminous curled over lower lip Slit like external nares with a narrow nose Hyperplastic gingiva and classic rolled margin in gingiva Enlarged interdental papilla Otitis media
  27. 27. BRUXISM Definition: 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.
  28. 28. Types of bruxism Day time bruxism/Diurnal bruxism: Night time bruxism/Nocturnal bruxism:
  29. 29. Etiology CNS-cortical lesions,children with cerebral palsy and mental retardation Psychological factors-feelings of anger and aggression Improper interdigitation of teeth Genetics Mg++ deficiency and other systemic factors Allergies Overenthusiastic student or compulsive overachievers
  30. 30. Manifestations Occlusal trauma-tooth mobility Increased tooth sensitivity from an excessive abrasion of the enamel Fracture of the tooth crown or restorations Muscular tenderness,muscular fatigue TMJ disturbances and pain Chronic headache Soft tissue trauma Small ulcerations on the buccal muosa opposite the molar teeth
  31. 31. Lip habit Definition: 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
  32. 32. 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
  33. 33. Cheek biting Definition: Abnormal habit of keeping or biting the cheek muscles in between the upper and lower posterior teeth Clinical features: Ulcer at the level of occlusion Open bite Tooth malposition in the buccal segment
  34. 34. Nail biting Etiology-Internal tension Effects: -Crowding,rotation and attrition of incisal edges of man.teeth -Inflammation of nail and nail beds
  35. 35. Self injurious habits Definition: 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