PEDO- M2

dorland

“defined as a fixed or constant practice established by

frequent repetition ”

buthersworth

“a frequent or constant practice or acquired tendency,

which has been fixed by frequent repetition”

moyers

“are learned patterns of muscular contractions, which

are complex in nature”

3-4 years

Habits beyond __ may become a symptom and

may produce harmful effects on the development of

maxillofacial complex

bad oral habits

can destroy your child's appearance

• intrinsic

• duration

• frequency

FACTORS THAT WOULD AFFECT ORAL HABIT

Intensity

amount of force that is applied to the teeth

while performing the habit

Duration

the amount of lime spent sucking a digit

Duration

plays the most critical role in tooth movement

Frequency

number of times the habit is practiced

throughout the day

• family conflicts

• jealousy

• school pressure

• peer group pressure

• stress

• breathing obstruction

• occlusal interference

etiology of oral habits:

• useful habits

• harmful habits

classification of oral habits

useful habits

habits that considered essential for normal function

such as proper positioning of tongue, respiration,

normal deglutition

harmful habits

habits that have deleterious effect on the teeth and their

supporting structures

thumb and finger habits

defined as the placement of thumb or one or more fingers in

varying depth into the mouth

thumb and finger habits

develops as a habit or due to sense of insecurity

thumb and finger habits

make up to majority of oral habits

thumb and finger habits

classic symptoms:

• anterior open bite

• facial movement of upper and lingual movement of lower

• maxillary constriction

classic symptoms:

• anterior open bite

• facial movement of upper and lingual movement of lower

• maxillary constriction

symptoms of thumb and finger habits

• space between teeth

• gap between upper and lower

• fungal infection of the thumb

results of thumb and finger sucking

Anterior open bite.

the lack of vertical overlap of the

upper and lower incisors when the

teeth are in occlusion, develops

because the digit rests directly an the

incisors

Anterior open bite.

a slightly increased vertical opening is

created

Anterior open bite.

can also be caused by intrusion of the

incisors

Facial movement of the upper incisors and

lingual movement of the lower incisors

depends on how the thumb or finger

is placed in the mouth

Maxillary constriction

due to the change in

equilibrium balance between the oral

musculature and the tongue

PACIFIER HABITS

dental changes created by these habits are similar to change!

created by thumb habits

PACIFIER HABITS

Anterior open bite and maxillary constriction are seen but labiolingual movement of incisors may not be as

pronounced as with a digit habit but is usually present

LIP HABITS

habits that involve manipulation of the lips and perioral structures

LIP HABITS

most common in the mized and

permanent dentitions

LIP HABITS

Treatment depends on the skeletal relationship of the

cheeks on the purpose or absence of space in the arch

lower lip tucked behind the maxillary incisors

most common presentation of lip sucking

• competent lips

• incompetent lips

types of lips

Competent lips

walang shortage ng muscle sa

upper and lower lip

Incompetent lips

may shortage ng muscle sa upper

and lower lip; common sa may

open bite or deep bite

MOUTH BREATHING

usually seen in people with nasal obstruction

TONGUE THRUSTING

the forward movement of the tongue tip between the teeth to

meet the lower lip during deglutition & in sounds of speech, so

that the tongue lies inter-dental (Tulley1969)

• physiologic

• habitual

• functional

• anatomic

classification of tongue thrusting:

physiologic tongue thrusting

Normal tongue thrust swallow of

infancy

habitual tongue thrusting

Tongue thrust present as a habit even

after correction of the malocclusion

functional tongue thrusting

When tongue thrust is an adaptive

behavior

functional tongue thrusting

Developed to achieve an oral seal

anatomic tongue thrusting

Person having an enlarged tongue

NAIL BITING

reaches its peak at adolescence

below 3 years

nail biting is absent

4-6 years old

nail biting incidence rises sharply

7-10 years old

nail biting remains constant

15 years old

nail biting habit is replaced by pencil

biting, hair twirling or gum chewing

• insecurity

• nervous tension

causes/ etiology of nail biting

• chipping of tooth edge

• notching of tooth edge

• loss of tooth vitality

effects of nail biting

BRUXISM

grinding or gnashing of the teeth and is usually reported to be

nocturnal

- results i

SELF MUTILATION

repetitive acts that result in physical damage of an individual, is

extremely rare in the healthy child

SELF MUTILATION

a learned behavior

restraints, protective

padding, and sedation Also the extraction o

treatment o self mutilation aside from behavior modification

Biting of the lips, tongue, and oral mucosa-

a frequent

manifestation of self mutilation

• reminder therapy

• reward therapy

• appliance therapy

different tx approaches of self mutilation

reminder therapy

appropriate for those who want to

stop the habit but need some help to

stop completely

reminder therapy

must be neutral and

not perceived as any form of

punishment

reward therapy

contract is agreed upon between the

child and parent or between the child

and dentist

reward therapy

child will discontinue the habit for a

specified period of time and in return

he/she will receive a reward if the

requirements of the contract are met

reward therapy

does not need to be extravagant but

special enough to motivate the child

appliance therapy

should be left in the mouth for six months

Eating difficulties.

○

Speaking/speech problems

○

Disturbed sleeping patterns

Side effects that may temporarily appear

after the delivery of an appliance:

• fixed appliance

• removable appliance

2 major categories of commonly used

appliance:

fixed appliance

fixed appliance

does not rely on patient compliance

Bluegrass Appliance

based on the concept of horse industry

Bluegrass Appliance

Bluegrass Appliance

indicated for children in the

carly or late mixed dentition

who have a desire to stop

their thumb sucking and

thumb trusting

Bluegrass Appliance

works through a

counter-conditioning

response to the original

conditioned stimulus for

thumb sucking

removable appliance

removable appliance

patient compliance is a major factor

Palatal crib, rakes

designed to reduce comfort

of placing a metal crib over

the most anterior portion of

the palate, preventing the

thumb from resting or

contracting the palate

Palatal crib, rakes

an appliance to stop thumb

sucking and thumb thrusting

Palatal crib, rakes

it prevents the thumb’s

belly to touch the palate

Oral screen

the most effective way to

reestablish nasal breathing,

by preventing air from

entering oral cavity

Oral screen

works on the principle of

both force application and

force elimination

Oral screen

the appliance has to be worn

for 2-3 hrs during the day

and during the sleep at night

Oral screen

appliance to stop mouth

breathing

Nance palatal arch appliance

Nance palatal arch appliance

an appliance to control

tongue thrusting

Occlusal splint

a slim hard acrylic guard

fitted to the upper jaw and

covering the biting surfaces

of your upper teeth

Occlusal splint

guides the jaw into a neutral

position which relieves some of the pressure on the jaw

joint

Occlusal splint

very effectively protects your

teeth against the destructive

forces of bruxism

Palatal expanders

Can be used both in cases of tongue thrusting and thumb sucking

where development of the palate is hampered.

Lip bumper

is positioned in the vestibule

of the mandibular arch &

serve to prohibit the lip from

exerting excessive force on

the mandibular incisors

Lip bumper

fixed and for controlling

lip biting