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Bad oral habits
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- 2. These habits canalter the normal muscle balance in the face, resulting in an orofacial myofunctional disorder, which can have a negative impact on facial growth.
- 3. Thumb sucking Thumb suckingis the most recognized oral habit that is widely understood to negatively affect the growth of the jaws and the teeth. Causative factors:- (1) Socioeconomic status:- In high socioeconomic status the mother is in better position to feed baby, where as mo (2) No. of sibling:- The development of habit can be indirectly related to number of sibling. As number increases the attention meted out by the parents to child gets divided associated with oral pleasure, hunger, anxiety, and sometimes psychological disturbances.
- 4. Thumb sucking (3) Ageof child:- The time of appearance of digit sucking habit has significance ▪ In neonates ▪ During first few week ▪ During eruption of primary molar (4) The order of birth of the child It has been observed that the later the rank of brothers in the family, the greater the change in oral habits.
- 6. -:Clinical Features Intraoral ❇️Increased overjet due to incisor flaring ❇️Anterior open bite ❇️Interdental spacing ❇️Posterior crossbite ❇️Mandibular incisor crowding ❇️Lingual tipping of mandibular incisors ❇️Under eruption of maxillary incisors ❇️ Overeruption of posterior teeth ❇️ Class II molar relationships ❇️ Narrow (V-shaped) anterior maxillary arch
- 7. -:Extra oral Fungal infectionon thumb ❇️ Thumb nail exhibit dish pan appearance ❇️ Lips:- ❇️ Upper lip may be short and hypotonic ❇️. Lower lip is hyperactive Facial form analysis:- ❇️. Check for mandibular retrusion ❇️. Maxillary protusion ❇️ High mandible plane angle
- 9. Treatment planning Psychoanalytic❇️ methods Behavioralmodification techniques (reminder and reward therapy)❇️ Orthodontic appliances❇️ Combination method❇️
- 10. Appliances Removable habit breaker; Hawley appliance with a piece of wire embedded in acrylic resin Fixed Habit Breaker : Palatal Bar with Reminder
- 11. Bluegrass habitbre . Modifiedblue grass appliance proved to be very comfortable to patients and encourages neuromuscular stimulations Quad Helix with Habit Controller ( Specially When the Patient Needs Pala
- 12. Tongue thrusting States tonguethrust as forward movement of tongue tip between the teeth to mee Classification:- (1) Physiologic:-This comprises the normal tongue thrust swallow of infancy (2) Habitual:- The tongue thrust swallow is present as a habit even after the correction of the malocclusion (3)Functional:- When the tongue thrust mechanism is an adaptive behaviour developed to achieve an oral seal, it can be grouped as functional
- 13. (4) Anatomic:- Persons havingenlarged tongue can have an anterior tongue posture Clinical features:- Extra oral (1) Lip Posture:- Lip separation is more both at rest & in function (2) Mandibular movement :- Path of mandible movement is upward & backward with tongue movement forward (3) Speech Lipsing problem in articulation of s/n/t/d/ 1/th/z/v/ sounds
- 14. (2) Intraoral (1) Tongueposture:-Tongue tip at rest is lower because of anterior open bite present (2) Tongue movement :- Movement is irregular from one swallow to another (3) Malocclusion:- In maxilla Proclination of maxillary anterior ❇️ An increase over jet ❇️ Maxillary constriction ❇️ Generalized spacing between teeth In Mandible :- Retroclination of mandible
- 15. Management:- 1) Patient isinstructed to put the tip of tongue at correct positions 2) Training to correct swallow and posture of tongue 3) Flat sugarless fruit drop can be placed on back of the tongue & it is held against the palate in the correct position until it is completely dissolve twice a day 5) Appliance therapy is initiated for child above 9year appliances used can be either fixed with band palatal rake or removable with adam's clasp 6) Nance Palatal Arch Appliance - in this acrylic button can be used as to guide the tongue in right position
- 16. 7) Removable appliancetherapy A variety of modifications of Hawley's - appliance is used to treat it (8) Fixed Habit breaking Appliance - Crowns and bands are given on the first permanent molar
- 17. Hawley's - appliance NancePalatal Arch Appliance Fixed Habit breaking Appliance
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- 19. Mouth breathing Nasal respirationand its capsular matrix, the nasomaxillary complex, have an important role in and effect on normal maxillofacial morphology and growth and therefore on occlusion. Normal respiration requires adequate airway space through the nasal and nasopharyngeal areas. If the structures within this passage, such as the adenoids, tonsils, or nasal turbinate, are enlarged pathologically or anatomically, nasal respiration is precluded; the result can be an adaptation to oral respiration. Oral respiration and nasal obstruction are common findings among orthodontic patients.
- 20. The adenoid facialtype is characterized as a long, narrow face with anterior open bite, dental protrusion, incompetent lip, narrow maxillary arch, and deep palate; this facial morphology was considered to be caused by mouth breathing for many years.
- 21. Etiology ❇️ Anything thatblocks the nasal airway can prevent nasal breathing. ❇️One of the most common causes of mouth breathing is allergies ❇️ Inflammation and enlargement of tonsils and adenoids
- 22. ❇️Congenital malformations thatcause structural deformities can also block nasal airways. These include deviated or enlarged conchae and deviated septum. ❇️trauma such as a broken nose can distort the anatomy of the nose and cause blockage. ❇️In some children, mouth breathing is considered a habit. This habit is believed to be sustained abnormal breathing following thumb sucking and long pacifier habits.
- 23. Clinical signs The childcan be examined for signs of mouth breathing in two areas: ❇️ general body growth and posture of the child and ❇️ dentofacial characteristics such as orofacial morphology, soft tissue characteristics, and dental occlusion.
- 24. Dental and softtissue changes ❇️ Anterior crowding ❇️ Maxillary incisor proclination ❇️ Anterior open bite
- 25. ❇️ Narrow anteriormaxilla ❇️ Narrow maxillary arch and bilateral posterior crossbite ❇️ Overeruption of molars
- 26. ❇️ Dry lips ❇️Bad breath and periodontal disease, caused by the shift in the bacterial flora in the mouth ❇️ Dark circles under the eyes
- 27. Skeletal changes ❇️ Clockwiserotation of the growing mandible ❇️ Increased lower anterior vertical face height ❇️ Long, narrow face ❇️ Retrognathia of the mandible
- 28. ❇️ Antegonial notching ❇️Increased mandibular steepness ❇️ Narrowed nasal airway passage and decreased internasal capacity
- 29. Orthodontic management ENT specialistshave the ability to assess upper airway conditions and decide whether a medication or surgical intervention for respiratory dysfunction is required. In patients with maxillary constriction, the orthodontic treatment technique of rapid palatal expansion results in significant changes in children’s breathing patterns.
- 30. This type oftreatment corrects transverse occlusal disharmony and functional prob Even after medication, anatomical correction of problems, and orthodontic treatment, the child may continue the mouth breathing habit.
- 31. Myobrace is designedto deal with these incorrect myofunctional habits by teaching children to breathe through their nose, rest the tongue correctly in the roof of the mouth, swallow correctly and continue widening the jaws so they grow to their full and proper size. This results in sufficient room for the teeth, allowing them to come in naturally straight and often without the need for braces.
- 32. It is thehabit of involuntary clenching or gnashing of the teeth. It can either occur when person is awake (awake bruxism) or during the sleep (sleep bruxism). Bruxism
- 33. Occasional grinding ofteeth is not harmful but the problem arises when this habit becomes repetitive. Constant grinding of teeth can cause number of problems like pain in jaw, neck or face, tooth pain or sensitivity, mild headache and wearing a way of biting surfaces of the teeth.
- 34. Etiology The etiology notwell known but it is agreed that it is multifactorial (local/mechanical, psychological ,systemic /neurophysiological. BRUXISM MANAEGMENT • Occlusal adjustment of dentition. • Behavior modification, pharmaceticals. • Interocclusal appliances (bite guard). • A soft or hard bite plate is useful. • Simple Hawley appliance with anterior bite plate; which is not only easy for children to wear but also prevents occlusal wear.
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- 36. Definition habits that involvemanipulation of lips and perioral structures. Classification: ❇️ wetting the lips with the tongue. ❇️ pulling the lips into the mouth between the teeth .
- 38. Clinical features: ❇️protrusion ofupper anteriors & retrusion of lower anteriors. ❇️lower incisor collapse with lingual crowdings.
- 39. ❇️lip trap. ❇️muscular imbalance. ❇️mentolabialsulcus become accentuated.
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- 46. Treatment : ❇️cheek bitinginhibitor ❇️vestibular screen