Oral Habits in Pediatric Dentistry PDF

Oral Habits in Pediatric Dentistry Dr. Rabab M. Abd El Hakam Researcher at the National Research Centre, Orthodontics and Pediatric Dentistry Department Lecturer at Ahram Canadian University Member of the Egyptian Society for Pediatric Dentistry and Children with Special...

Oral Habits in Pediatric Dentistry Dr. Rabab M. Abd El Hakam Researcher at the National Research Centre, Orthodontics and Pediatric Dentistry Department Lecturer at Ahram Canadian University Member of the Egyptian Society for Pediatric Dentistry and Children with Special Needs (ESPSN) Member of Center for Oral Dental and Health Promotion (CODE HP) What is a habit ? A fixed practice established by frequent repetition of same act  COMMON ORAL HABITS Thumb Mouth sucking breathing Lip biting Bruxism Tongue thrusting Etiological factors in the development of oral habits  I- Digit Sucking  One of the most common oral activities of infants and young children.  Thumb and finger sucking which generally termed digit sucking.  Thumb sucking is more prevalent than finger sucking.  Digit Sucking (Thumb Sucking) Etiology: 1. Physiological 2. Imitation of other children 3. Feeding problem 4. Emotional disturbances or social problems Classification: Phase 1: Extends from birth to 2 years normal activity which may be ignored in infancy Phase 2: In the preschool child extends from 2-5 years. This results in temporary malformations of the jaws or displacement of the teeth. It is necessary to manage or correct the habit at this stage Phase 3: In the school child extends from 6-12 years. It's more serious as it may results in malocclusion Clinical features: 1. Proclination and protrusion of the upper incisor teeth 2. The lower incisors may or may not be displaced lingually by the abnormal sucking habit 3. Anterior open-bite 4. Posterior cross-bite due to over-activity of buccinator compressing the maxilla 5. Tongue thrust The severity of malocclusion caused by digit sucking depend on  A. Psychological Means  Direct conversation with child (discussion between the child and dentist that express concern and explanation  Reward system  B. Chemical Means bitter-flavoured preparations or distasteful agents that are applied to the fingers or thumbs  C. Mechanical  Application of adhesive tape to the thumb or finger  Hawely appliances with palatal bar may be fitted as a habit reminder  Active oral screen corrects the habit and corrects the protruded incisors  II- Mouth breathing Mouth breathing is defined as habitual breathing through mouth instead of nose Etiology:  Respiratory obstruction  Deviated nasal septum , nasal polyps  Enlarged adenoids, tonsils  Habitual: Who continually breathes through his mouth by force of habit, although abnormal obstruction has been removed Clinical features: 1. Protrusion of upper incisors 2. High arched palate 3. Chronic gingivitis 4. Increased incidence of caries. The front upper teeth are affected the most  Management  Treatment of the cause  Passive oral screen in case of habitual type  Active oral screen in case of protruded incisors for correction of resultant malocclusion  III- Lip biting and sucking habit Etiology : 1. Malocclusion : Class II division I 2. Habits : associated with other habits such as thumb sucking and digit sucking habit 3. Emotional stress and psychological disturbances Clinical manifestation Dental: a. Protrusion of maxillary incisors and b. Retrusion of mandibular incisor c. Increased overjet d. Anterior open bite. Soft tissues: Lip: reddened, irritated in addition to probability of scarring.  Management 1. Emotional therapy: involves self-discipline, not to perform the habit again in the near future 2. Lip moisteners 3. Correction of malocclusion—class II division I 4. Treating the primary habits 5. Oral shield (screen) helps to stop habit and also the incisal alignment 6. Habit breaking appliance (Lip Bumper)  IV- Bruxism. Definition Etiology  Emotional problems e.g. psychological Non-functional movement of the mandible with or without an audible sound occurring nervousness, tension during day or night  Occlusal interference due to faulty restoration, malocclusion, etc  Systemic factors like intestinal parasites, epilepsy, cerebral palsy, and GI disturbances  Clinical Features 1.Occlusal wear of teeth and there will be a chance of pulp exposure and decrease in vertical dimension 2.Teeth sensitivity 3.Unexpected fracture of teeth or restorations 4.TMJ pain and headache 5.Trauma to the periodontium  Management 1. Treatment of the cause 2. Psychotherapy and Tranquilizers 3. Occlusal adjustment 4. Stainless steel crowns may be used in posterior teeth to prevent further destruction of teeth and correct vertical dimension. 5. Night guard Mariam Mohsen  V- Tongue thrusting Etiology 1.Persistence of infantile type of swallowing 2.Associated with thumb sucking 3.Respiratory obstruction 4.Macroglossia 5.Muscular imbalance as in cerebral palsy Mariam Mohsen  Clinical Features  Protrusion of maxillary incisors  Increased overjet and open bite  Lisping and speech problems Mariam Mohsen  Management  Learning of the new reflex  Tongue guard  Correction of malocclusion  Treatment of open bite after age of 10 years