1. Oral habits in children such as thumb sucking, pacifier use, and tongue thrusting can cause dental issues like anterior open bite, impacted teeth, and crossbites due to the pressure placed on teeth. 2. The duration and frequency of oral habits plays the biggest role in determining the changes to teeth, with 4-6 hours of force daily usually needed to move teeth. 3. Treatment involves stopping the habit, often through reminders or appliances, as well as correcting any resulting malocclusion through appliances or orthodontics. Non-dental interventions are usually first before using devices.

1. Oral habits and treatment
orthodontics
Abd ul karim Mohammad noor alchino

2. Introduction
• Oral habits are very common among children
and they cause a concern to the parents as they
result in many dental manifestations as
improper alignment of teeth and etc .. Oral
habits are considered to be abnormal among
children of 3 – 6 years old

3. the type of changes resulting from Oral habits depends
on :
1 . Intensity
2. Duration
3. Frequency
All those factors together should be considered , but
duration plays the most important role in tooth
movement
Many experimental evidences suggests that 4 to 6
hours of force is needed daily to cause tooth
movement

4. THE oral habits
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Thumb / finger sucking
Pacifier Habits
Lip Habits
Tongue Thrust/and Mouthbreathing Habits
Nail Biting
Bruxism

5. Thumb sucking

6. Thumb / finger sucking
Sucking is a normal baby reflex , beginning around
the 29th week of gestation
the classic symptoms of this habit are :
1. Anterior open bite
2. Labial movement of the upper incisors and
lingual movement of the lower incisors
3. Maxillary constriction

7. Anterior open bite
• Anterior open bite is lack of vertical overlap of
the upper and lower incisors when the teeth are
in occlusion , this results because the digits rest
directly on the incisors
• The digits impedes the eruption of the incisors
while the posterior teeth are free to erupt … to a
lesser degree the anterior open bite might be a
result of intrusion of the incisors

8. Anterior open bite

9. Facio – lingual movement of the incisors
this depends on how the thumb or finger is placed
into the mouth
Usually the finger is placed into the mouth as it
exerts pressure on the palatal aspect of the upper
incisors and labial aspect of the lower incisors ,
this results in increased over jet .

10. Orientation of the finger into the mouth which results in pressure on
the palatal aspects of the upper incisors and the lingual aspect of the
lower incisors resulting in increased overjet

11. Maxillary constriction
Maxillary ach constriction results due to change
in the equilibrium balance between the oral
musculature and the tongue , when the thumb is
introduced into the mouth the tongue is forced
down and away from the palate , and the
orbicularis oris and the buccinator muscles
exert pressure on the buccal ascpect of the upper
teeth , with out the tongue counterbalancing the
force on the lingual aspect of the maxillary teeth
, this results in posterior crossbite .

12. Posterior cross bite resulting from the
maxillary constriction due to change in
the equilibrium balance between the
tongue and the oral musculature
The direction of force exerted
from the oral musculature

13. Treatment
• Treatment time is critical
• The child should be given the opportunity to
stop the habit spontaneously before the eruption
of the permanent teeth
• The treatment is undertaken usually by the age
of 6 years old

14. Non dental intervention
• Reminder therapy is used in child who wants to
quit and needs help , the use of any reminders
as a adhesive badage on the finger bieng sucked
• Reward system therapy
• An elastic bandage wrapped around the elbow
loosely preventing the arm from flexing

15. Dental devices used to correct damage from finger sucking habit

16. • The Palatal Crib is designed to reduce the comfort of thumb sucking by
placing a metal crib over the most anterior portion of the palate, preventing
the thumb from resting along or contacting the palate.
• The Hayrake is a fixed appliance designed to discourage thumb sucking by
adding spurs to a metal crib placed in the anterior portion of the palate.
• The Blue Grass appliance is designed to prevent the patient from sucking
their thumb or tongue thrusting. This fixed appliance uses a spinning roller
to help break the patient's habit and allow the anterior teeth to return to
their normal position
• The Quad Helix appliance is designed to achieve arch development by
providing a light, continuous force to both anterior and posterior segments.
Fabricated as either fixed or removable (MIA), this appliance can also be
used for molar rotation

17. Pacifier habits
• Pacifier habits are similar to thumb / finger
habits as the mechanism is the same and the
change is the same but the facio – lingual
movement us less pronounced in here
• Some manufacturers have developed pacifiers
that claim to be more similar to the mother’s
nipples as to be less harmful to the dentition
than the conventional pacifier or the thumb

18. Pacifier habits
• Pacifier habits
theoretically are more
easier to stop than
thumb habits , they can
be stopped gradually or
at one point of time
under the control of the
parents
• In few cases the child
starts to suck his thumb
or finger

19. Lip Biting

20. Lip habits
• habits the involve manipulation of the lip and perioral
structures
• Most lip habits do not cause dental problems but they
may maintain an existing malocclusion
• The most common presentation of lip habit is the lower
lip tucked back to the maxillary incisors
• lingually directed force is placed on the mandibular teeth
and a palatal force on the maxillary teeth resulting in
proclination of the maxillary incisors, a retroclination of
the mandibular incisors, and an increased overjet

21. treatment
1 . correction of malocclusion
Class 1 with increased over jet :
Fixed or removable to tip the teeth back
Class 2 : growth modification procedures
2. appliance therapy
Oral shield

22. • Lip pumper is used to prohibit lip from exerting
excessive force on the mandibular incisors and
reposition the lip away from the lingual aspect of
the maxillary incisors

23. Nail biting

24. Nail bitting
• Nail biting is a habit rarely seen before 3 to six
years of age.
• The number of people who bite their nails is
reported to increase until adolescence.
• There is no evidence that nail biting can cause
malocclusion or dental change.
• There is no recommended treatment.

25. Tongue thrusthing

26. Tongue thrusting
• a human behavioral pattern in which the tongue
protrudes through the anterior incisors
during swallowing , speech , and while the
tongue is at rest
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Factors that can contribute to tongue thrusting include :
macroglossia
thumb sucking
large tonsils
ankyloglossia
and certain types of artificial nipples used in feeding infants. In
addition, allergies or nasal congestion can cause the tongue to lie low in
the mouth because of breathing obstruction, contributing to tongue
thrusting

27. Effects
• Anterior open bite or posterior open bite
depends on the posture of the tongue
• Proclination of maxillary anterior
• Generalized spacing between teeth
• Retroclination or proclination of the mandibular
incisors
• Posterior crossbite
• Speech defect

28. treatment
• There are two methods for treating tongue
thrusting. The patient may place an appliance
similar to a night guard in the mouth at night, or
may wear a more permanent device that can be
removed and adjusted by a dentist. The other
method requires oral habit training, an exercise
technique that re-educates the muscles associated
with swallowing by changing the swallowing pattern.
This method must be taught by a trained therapist.
Therapy has proven to give the highest percentage of
favorable results; however, the appliance is still used
and is successful in some cases

29. Bruxism

30. Bruxism
• Bruxism is a grinding or gnashing of the teeth and is
usually reported to be nocturnal ( at night ) .
• Most children engage in some bruxism that results in
moderate wear of the primary canines and molars.

31. Treatment
• Treatment should begin with simple measures,
including the elimination of occlusal interferences
and occlusal equilibration if necessary.
• If occlusal interferences are not located or
equilibration is not successful, referral to
appropriate medical personnel should be considered
to rule out any systemic problems (intestinal
parasites, allergies, endocrine disorders, etc.).
• If neither of these two steps is successful, a mouth
guard-like appliance can be constructed to protect
the teeth and try to eliminate the grinding habit.

32. Mouth guard