Habits / oral surgery courses

Habit:
The concise oxford English dictionary defined
a habit as a ‘settled regular tendency or practice’
and a ‘practice that is hard to give up’.
Habits in relation to malocclusion can be
classified as :
 Useful habits
 Harmful habits
www.indiandentalacademy.com

Common harmful or deleterious habits seen in
children which affect the dento-facial complex
and which in turn leads to malocclusion are:
 Improper bottle feeding
 Thumb sucking
 Mouth breathing
 Tongue thrusting
 Lip biting
 Bruxism

Effect of bottle feeding on dentofacial development
varies according to the type of nipple used.
Nipples differ in –
Length
Form of nipple
Location of holes
Rate of liquid flow
Flexibilitywww.indiandentalacademy.com

Use of non-physiological & physiological nipple
Non-Physiological nipple
• End is almost against pharyngeal wall
• Liquid released directly into digestive tract
• Muscles involved in breast feeding are either
- Immobilized (Orbicularis Oris , Masseter)
- Over active (Chin muscles)
- Malpositioned (Tongue is pushed backwards)
This may produce an abnormal dentofacial development
in child if continued for long period

Physiological
nipple
Management
» Use of physiological nipple
» Education of mother about proper feeding

It is placement of thumb into various depths
in the mouth

Etiology:
 Psychological implementation
 Related to hunger
 Satisfying of sucking instinct
 Insecurity
 Even a desire to attract attention

Clinical features
Maxillary anteriors flared & proclined
Mandibular anteriors retroclined
Anterior open bite ( may or may not be present )
Narrowing of maxillary arch
Posterior cross bite
Callus formation on the digitwww.indiandentalacademy.com

1. Parent and Patient education
2. Chemical approach
Use of bitter tasting or foul smelling
preparations placed on the thumb
3. Mechanical aids
Removable habit breakers
e.g. Reminder appliance ( simple acrylic plate )
Appliance with tongue spikes
Oral screen
Management
Fixed habit breakers
Rakes
Sharpened fork
Upper palatal arch

It is intermittent and more common at night
It can result in altered jaw and tongue posture which
could alter the orofacial equilibrium thereby leading to
malocclusion

Anatomic: Lip morphology does not permit complete
closure of mouth
E.g. Short upper lip
Obstructive: Complete or Partial nasal obstruction
may be due to –
* Deviated nasal septum
* Narrow nasal passage associated with
narrow maxilla
* Inflammatory reaction of nasal mucosa or
edema
* Allergic reaction to nasal mucosa
* Obstructive adenoids
* Nasal polyps
Habitual: It becomes deep rooted habit
Etiology

Clinical features
Long narrow face
Narrow nose and nasal passage
Short & flaccid upper lip
Anterior marginal gingivitis
Anterior open bite can occurwww.indiandentalacademy.com

Elimination of underlying pathology
Appliance like oral screen for interruption of habit
and restore normal breathing
Management

It is a condition in which tongue makes contact with
any teeth anterior to the molars during swallowing

 Hereditary factor
 Learned behavior
- Predisposing factors that can lead to
tongue thrusting
• Improper bottle feeding
• Prolonged thumb sucking
• Prolonged tonsillar infection or
Upper respiratory tract infection
 Mechanical restriction
 Deviated nasal septum
 Psychological factor
Etiology

Clinical features
 Proclination and spacing of anterior teeth
 Anterior open bite / incomplete over bite
 Bimaxillary protrusion
 Posterior open bite in lateral tongue thrust

· Patient and parent education
· Removal of etiologic factor
· Habit interception with habit breaking appliance
· Treatment of malocclusion
Management

It may appear by itself or with thumb sucking
Most common presentation is lower lip tucked
behind maxillary incisorswww.indiandentalacademy.com

Clinical features
Proclined upper anteriors
Retroclined lower anteriors
Increased overjet
Hypertrophic & redundant lower lip
Cracking of lips & ulceration

· Parent & patient education
· Use of lip bumper or oral screen

Management

It is a non functional grinding or gnashing of teeth
Usually reported to occur while child is sleeping
Local theory suggest bruxism is a reaction to an
occlusal interference , high restoration or some
irritating dental condition
Psychological theory – increased stress
Can result in attrition of primary and permanent teeth
Reduction in vertical height
TMJ problems later on

Occlusal interferences should be identified and
equilibrated if necessary
Rule out systemic problem
Psychological counseling
Mouth guard like appliance fabricated of soft plastic
to protect teeth
Management

Habits are most important local etiological factor
for malocclusion
The severity of the malocclusion depends on:
Early intervention can help reduce the severity
of the developing malocclusion
INTENSITY
FREQUENCY
DURATION

Habits / oral surgery courses

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