Common bad oral habits

1. POOR ORAL HABITS

2. These habits can alter 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 sucking is 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) Age of 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 Intra oral
❇️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 infection on 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 Behavioral modification 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
. Modified blue 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 tongue thrust 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 having enlarged 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) Tongue posture:-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 is instructed 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 appliance therapy 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
Nance Palatal Arch Appliance
Fixed Habit breaking Appliance

18. Mouth breathing

19. Mouth breathing
Nasal respiration and 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 facial type 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 that blocks 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 that cause 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 child can 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 soft tissue changes
❇️ Anterior crowding
❇️ Maxillary incisor proclination
❇️ Anterior open bite

25. ❇️ Narrow anterior maxilla
❇️ 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
❇️ Clockwise rotation 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 specialists have 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 of treatment 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 designed to 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 the habit 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 of teeth 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 not well 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.

35. Lip habits

36. Definition
habits that involve manipulation 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 of upper anteriors & retrusion of lower
anteriors.
❇️lower incisor collapse with lingual crowdings.

39. ❇️lip trap.
❇️muscular imbalance.
❇️mentolabial sulcus become accentuated.

41. Nail Biting

46. Treatment :
❇️cheek biting inhibitor
❇️vestibular screen