by Dr faryal haider

1. Dr.Faryal Haider
TMO
ORTHODONTIC

2. ORAL HABBITS AND
ORTHODONTICS

3. LECTURE OUTLINE
 What are habits?
 What are oral habits?
 Classification of oral habits.
 Prevalence of oral habits.
 Various oral habits
 Thumb sucking/finger sucking
 Mouth breathing
 Tongue thrusting
 Nail biting
 Bruxism
 Lip bitting

4. HABITS
 WHAT ARE HABITS??
 Habits can be defined as fixed or constant
practice established by frequent establishment.
Dorland 1957

6. ORAL HABITS
 DEFINITION
 Oral habits are habits that frequently children
acquire that may be either temporarily or
permanently be harmful to dental occlusion for
and to the supporting structures.
 Harmful effects of any oral habit depends on
three factors.
1. Intensity of force.
2. Frequency of habit.
3. Duration of habit.

8. CLASSIFICATION OF ORAL
HABBITS ACCORDING TO CAUSE
BY WILLIAM JAMES
• USEFUL HABBITS E.g nasal breathing
• HARMFUL HABBITS E.g mouth breathing, thumb sucking
BY MORRIS AND BOHANNA
PRESURE HABIT E.g tongue thrusting, thumb sucking.
NON-PRESSURE HABIT E,g mouth breathing.
BITING HABIT E.g nail biting, lip biting
BY FINN
• COMPULSIVE
• NON-COMPULSIVE
BY KLEIN
EMPTY/UNINTENTIONAL HABITS
MEANINGFUL/INTENTIONAL HABITS

9. PREVALANCE

10. VARIOUS ORAL HABBITS ARE
 THUMB SUCKING
 TONGUE THRUSTING
 NAIL BITING
 MOUTH BREATHING
 BRUXISM
 LIP BITING

11. THUMB SUCKING
 DEFINITION
ACCORDING TO GELIN 1978
“ it’s the placement of one or more
fingers in varying depths of mouth”

12. THUMB SUCKING
 It is observed that most children
below three year suck their finger
and thumb.
 Thumb sucking in infants is common and is
meant to meet both psychological and nutritional
needs.
 Most children discontinue at 3-4 years of age.

13. If thumb sucking is normal
in
children then what makes it
BAD??

15. CAUSITIVE FACTORS
 SOCIOECONOMIC STATUS

16.  WORKING WOMAN

17.  NO. OF SIBLINGS

18.  ORDER OF BIRTH OF CHILD

19.  AGE OF CHILD
1. In neonates: insecurities in demand to primative
needs e.g feeding
2. During first few week: related to feeding
problems
3. During erruption of primary molars:it may be
used as a teething device,

20. HOW TO MAKE DIAGNOSIS??
1. HISTORY TAKING
 Determine the psychological component
involved.
 Question regarding duration, intensity and
frequency of habit
 Enquire feeding patterns, parental care of child.
 The presence of other habits shoud be
evaluated.

22. II. Lips:-
 Hypotonic upper lip
 Lower lip is hyperactive

23. INTRAORAL
EXAMINATION

24. 1. LABIAL FLARING OF MAXILLARY
INCISORS.

25. 2. LINGUAL COLLAPSE OF MANDIBULAR
INCISORS

26. 3. INCREASED OVERJET

27. 4. HIGH PALATAL VAULT

28. 5.POSTERIOR CROSBITE

29. MANAGMENT

30. PSYCHOLOGICAL THERAPY
 Screen patient for underlying psychological
disturbance that sustained the habit and refer for
counceling
 Children between 4-8 years need reasurance,
positive reinforcement and friendly
reminders.

31.  DUNLOP HYPOTHESIS.
 Patient is made to sit in front of the mirror and ask to
suck his thumb this will make him realize how
awkward he looks and will want to stop his habit.

32. REWARD THERAPY
 When habit is discontinued the child is rewarded
with a favorite toy or candy etc

33. REMINDER THERAPY
A. EXTRAORAL APPROACH.
 Bandage around the thumb or finger
 Distasteful agents applied on thumb or finger
such as quinine, pepper etc
 ACE bandage approach.
 Use of long sleeve night gown

34. APPLIANCE THERAPY
 INTRAORAL APPLIANCES
1. Quad helix.

35.  2. BLUE GRASS APPLIANCE.

36. 3. TONGUE CRIB/PALATAL CRIB

37. CASE 1

39. TREATMENT
 PHASE 1
Palatal crib with plates
 PHASE 2
Fixed appliance
(brackets)

40. CASE 2