10 Oct 2017 - 11:38
Harmful oral habits - All we need to know
Prof Dr. Jacob John
Oral habits in children bring about harmful unbalanced pressures to the immature soft gum ridges and these changes the position of teeth and occlusions, which may become abnormal if these habits are continued for a long time. The cause, age of onset, self-correction and treatment modalities for the various habits differ greatly. Hence for a successful management of the habits, an understanding of the dental complications and manifestations of the habit should be pursued.
Harmful oral habits
Pressure habits like thumb sucking, lip sucking and tongue thrusting, non-pressure habits like mouth breathing and biting habits such as nail biting, lip biting, bruxism and cheek biting have an adverse effect on the teeth and their supporting structure.
Thumb and digit sucking habit (finger sucking)
Thumb and digit sucking, placement of the thumb or one or more fingers into the mouth, is one of the most commonly seen habits that most children indulge in.
Thump sucking could cause forward placement of upper front teeth (protruded front teeth), backwardly placed lower teeth (retruded lower teeth), increased over jet, front teeth open bite, narrow upper arch (constricted maxillary arch) and back teeth cross bite (posterior cross bite).
Orthodontic treatment for thumb sucking
Treatment for thumb sucking is decided after considering factors like frequency, duration, intensity of the habit and the history of feeding pattern (bottle feeding) along with clinical examination of mouth and finger of the child.
Orthodontic treatment appliances plays the role reminding appliances that will assist the child who is willing to quit the habit but is not able to do so as the habit has entered the child’s subconscious level. The common appliances used are removable appliance like roller, palatal crib, spur/ rackes etc. In fixed category triple loop corrector, blue grass, teflon roller, quad helix and hay rakes can be used.
Tongue thrusting habit
Tongue thrusting is said to be present if the tongue is observed thrusting between and the teeth did not close in centre occlusion during swallowing and it is also a condition in which the tongue makes contact with any teeth front to the molar during swallowing.
Causative factors effecting tongue thrusting are Genetic factor which are specific anatomic or neuromuscular variations in the oro-facial region that can initiate tongue thrusting. Learned behavior habit is a predisposing factor that can lead to tongue thrusting which is caused due to improper bottle feeding, prolonged thumb sucking, prolonged tonsillar and upper respiratory tract infection, constricted dental arches, enlarged adenoids and large size tongue.
Orthodontic treatment for tongue thrust
The treatment of tongue thrust involves interception of the habit followed by treatment to correct the malocclusion. Pre-orthodontic myofunctional trainer, fixed orthodontic treatment with braces, fixed or removable tongue crib and frankel IV appliance are the treatment options.
Mouth breathing is the habitual breathing through mouth instead of nose. The mode of breathing influences the posture of the jaw, the tongue and to a lesser extend the head. Mouth breathing can result in altered jaw and tongue positions, which could alter the oro-facial equilibrium thereby leading to malocclusion.
Causative factors of mouth breathing habits are developmental and morphological anomalies influencing nasal breathing, partial obstructions due to deviated nasal septum, due to allergic conditions, abnormal nasal polyps, enlarged adenoids or tonsils and obstructive sleep apnoea syndrome.
Clinical features of mouth breathings are large size prominent gums, protrusion with spacing of upper front teeth, open bite, increased over jet, short and incompetent lips, long narrow face, constricted maxillary arch, back teeth cross bite and narrow nose passage.
Orthodontic treatment for mouth breathing
Habitual causes can be treated by using myofunctional appliances like oral screen, head gear and maxillary splint therapy, maxillathorax myotherapy along with various lip exercises and by correcting the malocclusion.
Lip biting most often involves the lower lip which is turned inwards and pressure is exerted on the inner surfaces of the upper front teeth. Clinical features of lip biting are retruded lower teeth with irregularly placed teeth (crowding), forwardly placed upper front teeth with spacing and open bite.
Orthodontic treatment for lip biting
Treatment of lip biting and lip sucking can be done by using oral shield appliance therapy and lip bumper.
Prof Dr Jacob John is a Consultant Specialist Orthodontist at Aster Medical Centre and will be visiting Aster Medical Centre from October 20-29.