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Questions and Answers
What is the primary reason behind non-nutritive sucking in infants?
What is the effect of digit sucking on the offending digit?
What is the most common intra oral effect of digit sucking?
What is the primary factor that determines the severity of malocclusion caused by digit sucking?
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What is the first step in diagnosing digit sucking?
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What is the simplest approach to habit therapy for digit sucking?
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What is the most effective age group for the 'adult' approach to habit therapy?
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What is the purpose of reminder therapy in digit sucking treatment?
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What is the primary indicator of an endogenous tongue thrust?
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At what age is a lisp a normal occurrence?
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What is the primary cause of an endogenous tongue thrust?
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What is the percentage of the population that suffers from an endogenous tongue thrust?
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What is the primary goal of myofunctional therapy for tongue thrust?
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What is the most common cause of mouth breathing habit?
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What type of tongue thrust is associated with an anterior lisp during speech?
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What is a characteristic of 'Adenoid Facies' appearance?
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What is the result of a simple tongue thrust according to Moyer classification?
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What is a consequence of mouth breathing habit on the mandible?
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What is the characteristic of an anterior tongue thrust according to Backlund classification?
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What is the effect of an endogenous tongue thrust on the developing teeth?
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What is a consequence of mouth breathing habit on posterior teeth?
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What is the term for the persistence of infantile swallowing reflex even after permanent teeth appear?
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What is the expected outcome of treating an endogenous tongue thrust?
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What is the effect of an endogenous tongue thrust on the upper and lower incisors?
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What is a characteristic of a patient with a mouth breathing habit?
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What is the purpose of the mirror test in diagnosing mouth breathing habit?
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What is the cotton test used to determine?
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What is the primary reason for ENT referral in managing mouth breathing habit?
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What is bruxism?
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What is a common cause of bruxism?
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What is a treatment option for bruxism?
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What is a common effect of bruxism?
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What is the most common lip involved in sucking and biting habits?
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What can be a result of repeatedly holding the lower lip beneath the maxillary anterior teeth?
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What is the purpose of a lip bumper?
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What is nail biting habit often due to?
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What is a clinical feature of nail biting habit?
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How can nail biting habit be managed?
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What is an essential feature of normal swallowing of solid food and saliva?
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What is another essential feature of normal swallowing of solid food and saliva?
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Study Notes
Non-Nutritive Sucking
- Non-nutritive sucking is a habit adopted by infants in response to frustration and to satisfy their need for contact.
- Children who do not receive breast feeding or have access to a pacifier may satisfy their need with habits like thumb sucking, which can be harmful to their dentofacial development.
Effects of Digit Sucking
- Extra oral effects:
- Offending digit may be exceptionally clean, reddened, or sometimes deformed.
- Fibrous roughened callus may be present on the digit.
- Viral or fungal infection may occur.
- Intra oral effects:
- Proclination and spacing of upper incisors.
- Retroclination of lower incisors.
- Anterior open bite (usually asymmetrical).
- Narrow maxillary arch (posterior cross bite).
- The severity of malocclusion caused by digit sucking depends on:
- Frequency: number of times the habit is practiced per day.
- Duration: amount of time spent on the habit.
- Intensity: amount of force applied to the teeth during sucking.
Diagnosis of Digit Sucking
- History.
- Extra oral examination.
- Intra oral examination.
Treatment of Digit Sucking
- Discussion: a straightforward discussion between the child and the dentist to express concern and explain the habit.
- Reminder therapy: for patients who desire to stop the habit but need assistance.
- Other options may include habit breaking appliances.
Tongue Thrusting
- Endogenous tongue thrust: a neuromuscular mechanism.
- Anatomic tongue thrust: due to macroglossia (enlarged tongue).
- Backlund classification:
- Anterior tongue thrust: forceful anterior thrust leading to anterior open bite.
- Posterior tongue thrust: lateral thrusting in case of missing posterior teeth leading to posterior open bite.
- Moyer classification:
- Simple tongue thrust (teeth are together): buccal teeth are together with a forward positioning of the tongue between the anterior teeth during swallowing, resulting in production of an incomplete overbite or anterior open bite.
- Complex tongue thrust (teeth are apart): buccal teeth are apart during swallowing, the tongue is positioned between them, and does not fill the upper jaw, leading to buccal crossbite usually unilateral.
- Retained infantile thrust (endogenous tongue thrust): persistence of infantile swallowing reflex even after permanent teeth appear.
Management of Tongue Thrusting
- 3-11 years: normal occurrence, reassure parents, and observe the child.
- 11 years or older: treatment options may include correction of malocclusion, myofunctional therapy, muscle exercises, oral screen, and habit breaking appliances.
- Note: treatment of endogenous tongue thrust has poor stability.
Mouth Breathing Habit
- It is the habitual respiration through the mouth instead of the nose.
- Main causes: nasal obstruction, hypertrophy of pharyngeal lymphoid tissue (adenoids), defects in the nasal septum, polyps, allergic rhinitis, etc.
Effects of Mouth Breathing Habit
- 'Adenoid Facies' appearance: long narrow face, underdeveloped paranasal area, and small nostrils.
- Increased facial height.
- Mandible would rotate down and back.
- Posterior teeth would overerupt.
- Anterior open bite and increased overjet.
- Posterior crossbite, constricted maxilla with narrow shaped palate.
- Incompetent, dry, and fissured lips.
- Gingival hypertrophy.
Diagnosis of Mouth Breathing Habit
- Ask the patient to take a deep breath.
- Mirror test: a double-sided mirror is held between the nose and mouth.
- Cotton test/Massler's butterfly test: a butterfly-shaped cotton strand is placed over the upper lip below nostrils.
- Water test: the patient is asked to fill the mouth with water and retain it for a period of time.
Management of Mouth Breathing Habit
- ENT referral for management of nasopharyngeal obstruction.
- Myofunctional therapy and oral screen can also be used for treatment.
Bruxism
- It is the term used to indicate the non-functional contact of the teeth, including clenching, grinding, and tapping of the teeth.
- Main etiological factors: occlusion defects and psychological factors.
- Effects: occlusal wear, sensitivity, teeth mobility, fracture, and TMJ problems.
Management of Bruxism
- Determine the underlying cause and eliminate it.
- Occlusal adjustment including restoration and occlusal splints/bite guards.
- Psychotherapy like relaxation exercises.
- Drugs like local anesthetic injections into TMJ for muscles, sedatives, and muscle relaxants.
Lip-Sucking and Lip-Biting
- Lip-sucking may appear by itself or with thumb-sucking or as a compensatory activity.
- In almost all instances, it is the lower lip that is involved in sucking and biting.
- Effects: proclination of maxillary anterior teeth, often an open bite, and sometimes retroclination of mandibular incisors.
- Sometimes, there may be an eczematous appearance of the skin below the lower lip.
Management of Lip-Sucking and Lip-Biting
- Lip over lip exercises.
- Lip bumper: fixed or removable with labial acrylic pads.
- Oral screen.
Nail Biting Habit
- It is one of the most common habits in children and adults.
- Causes: emotional and social problems.
- Clinical features:
- Crowding.
- Rotation.
- Attrition of lower or upper incisors.
- Effect on nails: inflammation of nailbeds and heavily cut nails.
Management of Nail Biting Habit
- No treatment in mild cases.
- Treat the basic emotional factor causing the habit.
- Encourage outdoor activities.
- Reminders like nail polish.
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Description
Learn about non-nutritive sucking habits in infants, including thumb sucking, and their effects on dentofacial development.
