Oral Habits in Children

Question 1

What are 5 oral habits in children?

Answer 1

1. Non-nutritive sucking habits
2. Bruxism
3. Tongue thrusting
4. Lip biting
5. Mouth breathing

Question 2

What are the effects of sucking habits on dentition?

Answer 2

• Open bite
• Increased OJ (procline upper, retrocline lower)
• Posterior crossbite
• High palatal vault

Question 3

What are the factors affecting the degree of impact of sucking habits on dentition?

Answer 3

Frequency (hours per day) and duration (months/years)

Age of cessation
- Increased risk of AOB 48 months
- Increased risk of increased OJ 36 months
- Increased risk of posterior crossbite 24 months

If habit persists to eruption of permanent incisors – effects likely to be permanent

Question 4

What are the other effects of sucking habits?

Answer 4

• Orthopaedic changes
• Otitis media (middle ear infection)
• Speech defects
• Social impact: aesthetics & speech issues

Question 5

What are the behavioural management options for non-nutritive sucking?

Answer 5

• Counselling and rewards system – calendar rewards for mature children
• Reminders (eg bandaid, unpleasant-tasting nail polish)

Question 6

What are some extra-oral adjunctive therapy methods for mx of sucking?

Answer 6

• ACE bandage
• Thumb guard

Question 7

What are some intra-oral appliances used as adjunctive therapy for sucking habits?

Answer 7

• Palatal crib (>90% effective) – blocks roof of mouth, prevents tongue thrusting (use for 1 year, relapse possible)
• Bluegrass appliance (>90% effective) – spinning roller, prevents sucking + tongue thrusting
• Removable appliance (not effective)

Question 8

What are the effects of bruxism?

Answer 8

• Aesthetic issue
• Functional issue
• Pulp necrosis
• TMD

Question 9

What are the possible causes of bruxism?

Answer 9

• Cerebral Palsy
• Occlusal interference
• Stress

Question 10

What are the Mx options for bruxism?

Answer 10

• Monitor w no tx (most common)
• Counselling: reduce stress
• Mouth guard

For severe cerebral palsy cases:
- Botox: Administered to masseters, Lasts for 11 weeks
- Clonazepam: antiseizure (not really administered)

Question 11

What happens to the tongue during infantile swallowing?

Answer 11

• Tongue positioned forward during swallowing
• Tip protrudes through to achieve anterior lip seal

Question 12

What are the effects of tongue thrusting?

Answer 12

• Open bite
• Speech defects
• Social impact: aesthetic & speech issues