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HABITS

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INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com

www.indiandentalacademy.com
•
•
•
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Thumb / Digit sucking
Tongue thrusting
Lip-sucking / lip-biting
Nail biting
Mouth breathing
Bruxism
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Thumb / digit sucking habit
• Freudian’s psychoanalytic theory

• Benjamin’s learned-behavior theory
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Haryett (1967) experiment
Children were divided into 6 grps.
1) no treatment
2) psychological t/t
3) palatal arch
4) palatal arch & psychological t/t
5) palatal crib*
6) palatal crib & psychological t/t
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Rooting & placing reflex
theory

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Clinical manifestations

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Extra-oral
convex profile, incompetent lips,
Increase in ant. face ht. (long face)
Saggital
• Proclination of upper
anteriors
• Retroclination of
lower anteriors
• Protruded premaxilla
• Retruded mandible
• Class II skeletal
(&/or dental) relation

Vertical
• Anterior open bite
• Intrusion of lower
anteriors
Transverse
• Collapse of upper arch
(posterior crossbite)

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Treatment of thumb-sucking
• Phase 1 – normal & sub-clinically significant
sucking (0-3 yrs.)
encourage breast feeding
Nuk-sauger nipple

• Phase 2 – clinically significant sucking (3-7yrs.)
psychological counseling
extra-oral restraining device

• Phase 3 – intractable sucking (7yrs. Onwards)

psychological counseling
reminder charts & parental guidance
intra-oral appliance
mechanical obstruction
neuromuscular aid
psychological crutch

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Mechanical blocking device
• Rake
• Fork
• Grate

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Tongue thrusting
• Anterior

• Posterior (lateral)

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Etiology of ant. Tongue thrust
•
•
•
•
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Bottle feeding
Inheritance
Enlarged tongue
Ankyloglossia
Enlarged tonsils / adenoids
Secondary to thumb-sucking habit
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• Tongue at rest
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Preparatory swallow :
- bolus collected on posterior part of tongue
- complete seal
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• Oral phase :
-palate withdraws
- Tongue drops
- - hyoid bone starts to rise
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• Pharyngeal phase :
- superior pharyngeal wall constricts
- hyoid moves further upward & forward
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• Esophageal phase :
- return to rest

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Characteristics of tongue thrust
• A thrusting movement of tongue against
ant. teeth
• Slight or no contraction of muscles of
mastication
• Strong contraction of the lip musculature
• Movement of the hyoid bone in oblique or
forward direction
• Distortion of speech sounds

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Lip-sucking / lip-biting
• Mostly lower lip

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Mouth breathing

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Thank you
www.indiandentalacademy.com
Leader in continuing dental education

www.indiandentalacademy.com

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