1) Habits can be classified in various ways such as oral habits, oral hygiene habits, adverse habits, and dietary habits. Common oral habits include thumb sucking, tongue thrusting, mouth breathing, bruxism, lip biting, nail biting, and cheek biting. 2) Maintaining good oral hygiene through proper brushing, flossing, using mouthwashes and rinses, and a balanced diet can help prevent dental caries, gingivitis, and periodontitis. Adverse habits like smoking and tobacco chewing increase the risk of oral cancer and periodontal disease. 3) A balanced diet with a variety of nutrients is important for overall health. Dietary habits like the

1. P R E S E N T E D B Y : J H U R R Y A . H A D I
3 R D Y E A R B . D . S
B A T C H : 2 0 1 4 - 1 5
HABITS

2. Definition
 A habit can be defined as tendency towards an act that has
become a repeated performance, relatively fixed, consistent
and easy to perform by an individual. (Boucher O.C)
 Habit includes: 1) oral habits
2) oral hygiene habits
3) adverse habits
4) dietary habits

3. 1) Oral habits
 Various oral habits are :
1) Thumb and digit sucking
2) Tongue thrust sucking
3) Mouth breathing habit
4) Lip biting
5) Nail biting

4. Classification of oral habits
1) Useful and harmful habits
2) Empty and meaningful habits
3) Pressure, nonpressure & biting habits
4) Compulsive and
non compulsive habits

5. 1 i)Thumb and digit sucking
Digit sucking is defined as the placement of thumb or 1
or more fingers in varying depths in the mouth.
 Commonly seen in children.
 Normal till the age of 3-4 years
 Persistence of habit beyond this age leads to
malocclusion.

6. Effects of thumb sucking
Effects are :
 Labial tipping of maxillary anterior
 Overjet increases due to proclination of maxillary
anterior.
 Anterior open biting occurs as restriction of incisor
eruption and supraeruption of buccal teeth
 Tongue thrust habit may develop due to open bite

7. 1 ii) Tongue thrust habit
Defined as a condition in which tongue makes contact
with teeth anterior to molars during swallowing.
Clinical features
 Tongue movement: swallowing sequences are seen to be
jerky and inconsistent. Movements also are irregular from 1
swallow to another. Chin point is found to be posterior
 Tongue posture : tongue tip at rest is lower.

8.  Malocclusion :
Features of maxilla:
 Proclination of maxillary anteriors resulting in increase
in overjet.
 Generalized spacing between the teeth
 Maxillary constriction
Features of mandible :
 Retroclination of mandibular teeth
Intermaxillary relationship:
 Anterior or posterior open bite based on the posture of
tongue
 Posterior teeth crossbite

9. 1 iii) Mouth breathing
Defined mouth breathing as habitual respiration through the
mouth instead of the nose ( Sassouni)
Clinical features
 Facial form: an increased facial height, increased mandibular
plane angle, retrognathic maxilla and mandible.
 Adenoid facies: characterized by a long , narrow face with an
accompanying narrow nose and nasal passages ,flaccid lips with
the upper lip being short .

10.  Dental effects: upper and lower incisor are
retroclined, posterior crossbites are present and there is
a tendency towards an open bite .
 Speech defects: nasal tone in voice
 Lip: gummy smile revealing large amount of gingiva
 Gingiva: inflamed and irritated gingival tissue in the
anterior maxillary arch due to continuous exposure of
the tissues to air drying.

11. How to diagnose mouth breathing
The following tests can be performed to diagnose mouth
breathing:
1) Mirror test
2) Water test
Mirror test
A double sided mirror is held between the nose and the
mouth. Fogging on the oral side indicates oral breathing
and vice versa.
Water test
Patient is asked to fill his mouth with waterand retain it for
a period of time.
Mouth breathers find the task difficult compared to nasal
breathers.

12. 1 iv) Bruxism
Bruxism is the habitual grinding of the teeth when the
individual is not chewing or swallowing. (Ramfiord)
Manifestation
1) occlusal trauma
 can result in tooth mobility
2) tooth structure
 non functional patterns of occlusal wear
 increased tooth sensitivity from an excessive abrasion of
enamel
 pulpal sensitivity to cold can be observed

13. 3) muscular tenderness
 tenderness of jaw muscles, especially to palpation of lateral
pterygoid and masseter muscle
 muscular fatigue on waking up
 hypertrophy of masseter muscle unilaterally/bilaterally.
4) TMJ disorders
 TMJ disturbances and pain present
 Clicking within the joint , restriction of mandibular
movements and jaw deviations

14. 1 v) Lip habit
 Habits that involve manipulation of the lips and perioral
structures.
Clinical features
1) Protrusion of maxillary incisors and retrusion of
mandibular incisors
 Wedging the lip between the upper and lower incisors
creates a muscular imbalance
2) Lip
 Lip sucking can be recognized by reddening, irritated area
below the vermillion border.
 Vermillion border may be relocated further outside from
the mouth due to constant wetting of the lips. Most
commonly seen in lower lips.

15. 1 vi) Cheek biting
 This is an abnormal habit of keeping or biting the
cheek muscles in between the upper and lower
posterior teeth.
 May cause injury to soft tissues and cause an open
bite.
Clinical features
 Ulcers at level of occlusion
 Open bite
 Tooth malposition in buccal segment

16. 1 vii) Nail biting
 Nail biting is one of the most common habits in
children and adults. It is a sign of internal tension.
Effects
 Most common effects of nail biting on the teeth are
crowding, rotation and attrition of incisal edges
 Inflammation of the nail and nail beds

17. 2) Oral hygiene habit
• Oral hygiene is the practice which enables to keep
the oral cavity clean in order to prevent the onset
and progression of common dental problems.
• By maintaining good oral hygiene we can prevent :
1)Dental caries
2)Gingivitis
3)Periodontitis
4)Halitosis

18. Basic steps for maintaining oral hygiene:
1.Brushing your teeth (at least twice a day )
2.Floss your teeth regularly
3.Proper diet
4.Other interdental cleaning
5.Rinsing
6.Regular dental checkups

20. 2 i) Brushing:
• Many methods have been described to be efficient
and effective for brushing the teeth namely Fones
technique , Leonard technique etc.
• Most recomended technique is the Bass technique
because it emphasizes sulcular placement of the
bristle.

21. Bass technique
1) Place the head of a soft brush parallel to the
occlusal plane, beginning at the most distal tooth in
the arch.
2) Place the bristles at the gingival margin, pointing at
a 45 degree angle at the long axis of the teeth.
3) Exert gentle vibratory pressure, using short, back
and forth motions without dislodging the tips of the
bristles. The latter must end into the gingival
sulcus area and the embrasures area.
4) Complete several strokes in the same position.

22. 5) Lift the brush and move it adjacent teeth and repeat
the process
6) Continue around the arch. Use same method to
brush the lingual surfaces.
7) Mandibular are also brushed in the same organised
manner to reach all teeth.
8) Brush the occlusal surfaces of 3-4 teeth at a time by
pressing the bristles firmly into the pits and brushing
with several back and forth strokes

24. 2 ii) Flossing:
 A dental floss is a tool used to remove interdental
plaque
 Available as multifilament nylon that can be twisted
or non twisted, bonded or non bonded, waxed or non
waxed.
 Factors influencing the choice of dental floss include
tightness of tooth contacts, roughness of proximal
surfaces.

25. METHOD OF FLOSSING:
METHOD:
1. Use an arms length (18 inches) of floss. Wrap around both forefingers.
2. Pass it gently through each contact area with a firm back and forth
motion.
3. Once the floss is apical to the contact area between the teeth, wrap the
floss around the proximal surface and slip it under the marginal gingiva.
4. Move the floss firmly along the tooth up to the contact area and gently
down the sulcus again repeating it 2-3 times.
5. When the working portion of floss becomes dirty move to a fresh
portion of floss.

26. 2 iii) Proper Diet:
1. Avoid foods that are high in sugar content.
2.Carbonated drinks are more acidic than non carbonated drinks; hence
more dangerous.
3.Avoid sticky food which tend to stick in the grooves; stay for an
extended period and cause decay.
4.Avoid excessive intake of fruit juices (can be very acidic). They can be
diluted with water.

27. 2 iv ) Other interdental cleaning:
1.Single tufted brushes:
• one large bristle for cleaning spaces between teeth.
 to carry medicated gel into pockets.
2.Interdental brushes:
 for cleaning spaces between teeth.
 for cleaning pontics.
3.Interdental woodsticks:
 Specially shaped ‘tooth picks’ made from either wood or plastic.
 used for interdental cleaning.
4.Super floss:
 Special type of floss designed to clean beneath pontics

28. 2 v) Rinsing:
• A mouth rinse may be defined as a substance that is
swished around the oral cavity and then
expectorated in order to freshen the mouth and
breath.

29.  Basic ingredients include water, alcohol, cleansing
agents, flavoring ingredients and coloring agents.
1) Antimicrobial agents ( chlorhexidine 0.2%) act directly
on oral bacteria to help reduce plaque, decrease the
severity of gingivitis and control bad breath.
2) Fluoride helps reduce tiny lesions (tooth decay) on tooth
enamel and make teeth more resistant to decay.
3) Astringent salts can serve as temporary deodorizers that
mask bad breath.
4) Odor neutralizers act by chemically inactivating odor
causing compounds.

30. 3) Adverse habits
Adverse habits include:
 Smoking
 Tobacco chewing
 Alcohol consumption

31. SMOKING AND ORAL HEALTH
 Tobacco use in all forms, especially cigarette smoking, is the
number one risk factor for oral cancer.
 Possible mechanisms are:
 Irritants and toxic substances in tobacco
 Change in Ph
 Dryness due to heat produced while smoking
• The most common form of cancer is Squamous cell
carcinoma.
• The most common sites of the oral cancer is the tongue and
the floor of the mouth.
• The other common sites are buccal vestibule, buccal mucosa,
gingiva and rarely hard and soft palate.

32. 3 i) Smoking
Cigarette Smoking and Gingival Bleeding
 Smokers expressed less gingival bleeding than non-smokers
 This may be due to vasoconstrictive effect of nicotine
Effect of Smoking on Gingival Blood Flow
 In smokers, gingival blood flow was significantly increased by cigarette
smoking.
Smoking and gingival inflammation
 Smokers may present with lower levels of gingival inflammation than
nonsmokers.

33. Periodontitis due to Smoking in young
adults
Young adult smokers aged 19-30 years had a higher prevalence and
severity of periodontitis compared to non-smokers despite similar or
lower plaque levels.
The prevalence of periodontitis, defined as having a site with attachment
loss of ≥2 mm and probing depths of ≥4 mm, was 3 -4 times higher in
young smokers compared to non-smokers.

34. Smoking and Periodontitis in Adults
 Current smokers have deeper probing depths, greater attachment loss,
more bone loss, and fewer teeth.
 Smokers also exhibit more supragingival calculus deposits.
 There is a strong dose-response relationship between the amount
smoked and the severity of periodontal destruction which further
supports the role of smoking as a risk factor for periodontitis.

35. Disease associated with smoking:
 Leukoplakia
 SMOKER’S PALATE
 SMOKER’S MELANOSIS
 HAIRY TONGUE
 COATED TONGUE
 STAINING OF TEETH
 DELAYED WOUND HEALING
 SMOKER’S FACE

36. 3 ii) Tobacco chewing
 It involves chewing a quid that includes betel leaf,
lime, areca nut, and tobacco.
 Tobacco use may significantly increase bleeding on
probing and periodontal attachment loss.
 Areca nut extracts have also been shown to inhibit
the growth, attachment, and matrix protein
synthesis of cultured human gingival fibroblasts.

37. 3 iii) Alcohol
 Alcohol and smoking gives synergistic effect affecting
the integrity of oral tissues causing oral submucous
fibrosis, leukoplakia and oral cancer.

38. 4 ) Dietary habits
 Diet is the total intake of substances that provide
nutrition and energy.
 A balanced diet is when various nutrients are present
in proper proportion and in sufficient amount to
meet all the needs of the body.

39. Components of a balanced diet :
1) Carbohydrate
2) Protein
3) Fats
4) Vitamins
5) Minerals
6) Water

40. Dietary history and evaluation
Information for a dietary history is collected from
a 24 hour or a 7 days ( including 1 weekend day )
recall record of food intake.
• Information consists of amount of food ingested and
patient’s eating habits and attitude about food.
• Patient is asked to record everything consumed from
morning to before going to sleep in a note book.

42. Dietary recommendations:
1) Eat a variety of food
2) Maintain a healthy weight
3) Choose a diet low in fat, saturated fat and
cholesterol
4) Have plenty of vegetables, fruits and grain products
5) Consume sugars in moderation
6) Consume salt and sodium in moderation
7) If you drink alcoholic beverages, do so in
moderation.

43. Source of water in diet
 Through the food ingested.
 Some of the water is made during the process of
metabolism. But drinking water is the main, and best
source of water.
 Also through liquid foods and beverages, such as
soup, milk, and juices.

44. Classification of sugars
The different classification of sugar is as follows:
1) Monosaccharide, disaccharide and polysaccharide
2) Intrinsic and extrinsic sugar
3) Milk and non milk extrinsic sugars
4) Fermentable and non fermentable sugars

45. Factors affecting cariogenicity of a diet
 Dental caries is caused mainly by fermentable sugars
particularly sucrose.
 Cariogenicity of a diet depends on :
1) Ability of food particle to be retained by teeth
2) Ability to form acids
3) Ability to dissolve enamel
4) Buffer the acids

46. Important dietary habit that merit attention
 1) frequency of sugar consumption
 2) physical form and retentiveness of sugars
 3) amount of sugar added to food or beverages for
sweetening.

47. Cariogenicity of sucrose-containing meal
depends on:
On a decreasing order , it is grouped as :
1) Adherent and eaten frequently between meals.
2) Adherent and eaten during meals.
3) Non retentive beverages consumed frequently
between meals.
4) Liquid beverages consumed during meals.

48. Preventive dietary programme
1) exclude fermentable sugars from diet
2) If child is fond of sweets, give them all at meal time
and not in between meals.
3) Include vegetables and fruits , nuts and cheese as
basic diet( increases salivation )
4) Avoid solid and sticky sugary food
5) Decrease number of sugar exposures

49. Caries protective effects of food
 Consumption of the following food help in protection
against tooth decay:
1) fibrous food
2) buffering agent (cheese)
3) sugar alcohol ( xylitol).
On chewing they increase salivary flow. Stimulated
saliva :
a) Increases pH of oral cavity
b) Increases buffering capacity of saliva
c) Increases calcium and phosphorus which helps in
remineralisation of the tooth.

50. Thank you