This document defines and classifies common oral habits in children, including thumb sucking, tongue thrusting, mouth breathing, bruxism, lip biting, nail biting, and self-injurious habits. It discusses the development, etiology, effects, and clinical findings associated with each habit. Key points include that oral habits are learned patterns that develop from frequent repetition, can be caused by overprotection, isolation, or pain/discomfort, and result in unbalanced pressure on developing dental structures. The document classifies habits as obsessive or non-obsessive and provides diagnostic criteria for common habits significant to dental surgeons.

1. COMMONLY OCCURING
ORAL HABITS IN CHIlDREN

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. DEVELOPMENT OF HABIT
First,infant makes an effort by frequent
learning and practice.
Later, muscles start responding more
readily.

4. BASIC ETIOLOGY OF HABIT
Overprotection
Loneliness
Isolation
Pain and discomfort
Abnormal physical size of parts
Imitation or imposition of others

5. BASIC EFFECT OF HABIT
Brings unbalanced pressure on immature,
highly malleable alveolar ridges.
All the clinical features are consequences
of this effect

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. Habits significant to dental surgeon
Thumb sucking
Tongue thrusting
Mouth breathing
Bruxism
Nail biting
Lip biting

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

10. 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.

11. CLASSIFICATION
Normal:
During 1st and 2nd yrs
Disappears as child
matures
Abnormal:
Persist beyond
preschool age or 3yrs
Divided into:
Psychological:
Habitual

12. Sucking habits can also classified as
Nutritive sucking habit
Breast-feeding
Bottle-feeding
Non-nutritive sucking habit
Thumb sucking

13. 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.

14. 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

15. 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

16. 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

18. 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.

19. 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.

20. 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.

21. 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

22. 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

23. 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

26. 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.

27. 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.

28. 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

29. 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

31. 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

32. 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.

33. Types of bruxism
Day time bruxism/Diurnal bruxism:
Night time bruxism/Nocturnal bruxism:

34. 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

35. 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

36. 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

38. 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

39. 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

40. Nail biting
Etiology-Internal tension
Effects:
-Crowding,rotation and attrition of incisal
edges of man.teeth
-Inflammation of nail and nail beds

41. 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

43. THANK YOU
PRESENTED BY MANTHRU