This report discusses oral habits, specifically thumb sucking, and their effects on malocclusion. It defines oral habits and classifies them as useful or harmful. Thumb sucking is described as a natural reflex for children that can lead to malocclusion if persisted beyond age 3. The effects of thumb sucking include anterior open bite, flaring of maxillary incisors, and narrowing of the maxillary arch. Treatment options are discussed from psychological approaches to different types of appliances. The conclusion emphasizes that most children outgrow thumb sucking by age 5 to avoid needing treatment.

1. Pedodontic
report
2020
DR. MAHA ABDULKAREEM

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Al-Rafidain University College
Dentistry Department
pediatric dentistry
oral habit (thumb sucking )
ghadeer abdulbasit fat'hi
grade five
group A3

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INTRODUCTION
Is a constant or fixed practice established by frequent repetition. Its A
formed reaction that’s resistance to change it depends on the degree to
which its interfere with the child physical ,emotional and social function
Oral habits are habits that frequently children obtained that may either
temporarily or permanently be harmful or useful to dental occlusion for
and to the supporting structure..When habit cause defect in oro-facial
Its also defined as an automatic response to specific situation acquired
normally as a result of repetition and learning . our purpose of study to
determine type of oral habit and type of malocclusion caused by habit.
Classification of oral habit
: habits that consider essential fora) useful habitsjamesliam1.By wil
normal function such us proper tongue position , deglutition ,nasal
breathing ……etc.
habits that have harmful effect on teeth and supportingb) Harmful habits:
structure such us thumb sucking , tongue thrust …...etc
A) compulsive2.by fin
they are deep rooted habits that have acquired a fixation in a child the child
tend to suffer when try to correct.
compulsive) Nonb
Habits that easily learned and dropped as child mature.
that apply force on teeth andA) pressure :3.by Morris and Bohana
supporting structures such as lip sucking , tongue thrusting.
apply force on the teeth and supporting structure: Doesn’tB) non pressure
such as mouth breathing.
.such as lip biting , nail bitingC) biting habits :

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Etiological factors in the development of oral habit
istry that lead toThere are many bad habit concern with dent
thumb sucking , mouth breathing , nail biting , bruxism ,:malocclusion
tongue thrusting , lip biting …..etc.
Its also called digit sucking habit or finger sucking which is mean placement
of finger or thumb in a varying depth into the mouth its observe in most
children beyond 3 years of age About 80 per cent of babies suck their
thumbs. Most stop by themselves between the age of three and six years .
Thumb sucking is a natural reflex for children. Sucking on thumbs, fingers,
pacifiers or other objects may make babies feel so secure and happy and help
them learn about their world practically all children leave this habit and
discontinue with age and maturation if the habit persist beyond this time the
permanent teeth erupt in malocclusion and habit breaker is required .
nosis of thumb sucking in clinic:Diag
.1.Detailed history of the habit taken from parents
2.Child above 4 years with protruding of anterior teeth affected by thumb
sucking.
3.Presence of callous formation on the back of thumb or finger and low
grade of virus infection on skin.
4.Thumb used by the child normally appears to be clean compared to the
other finger.
Thumb sucking

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Effect of thumb sucking on the teeth ;
1.anterior openbite : lack of vertical overlap of the upper and lower incisor
when the posterior teeth are in occlusion because the digit are rest between
maxillary and mandibular incisors this prevent continue or complete
eruption of the incisors whereas the posterior teeth are free to erupt anterior
openbite may also be caused by intrusion of incisors however inhibition of
eruption is easier to accomplish than true intrusion which would be result of
habit of greater duration .
2.flaring of maxillary incisors : achild who actively sucks can create enough
force to tip the upper incisors facially and lower incisors lingually the result
is increase overjet decrease overbite .
3.narrowing of maxillary arch ( posterior crossbite ) .
:Classification of thumb sucking (phases)
Phase I :its start from 3 months to 2 years as the infant use rubber pacifier
and look normal (Subclinical changes).
Phase II :its start from 2 years to 4 years and its cause temporary changes
that return to normal if the habit take up.
Phase III :persistence of habit after 4 years of age and cause malocclusion .
The severity of malocclusion caused by thum sucking depend on three
factors :
1.frequency ( number of time the habit practiced ) .
2.duration :( amount of tim spend on habit) .
3.intensity :( amount of force applied to teeth during sucking) .

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of thumb suckingSequence of treatment
There are many options of treatment different from one child to another
its simplest approach mean:(psychological approach)1.Consuling
discussion between the child and dentist that express concern and include
explantation about the effect of thumb sucking on the teeth and the
malocclusion that will cause in the future . This approach which is cold
“adult approach” its enough to terminate the habit in most older children .
best for the patient who are desire to(gifted approach):2.reminder therapy
stop the habit and need assistant to do . Its include adhesive taps , bandages
to offending digits , undesirable liquid or ointment like hot flavored ,foul
smelling ,bitter testing placed on finger or thumb that are sucked.
If the reminder approach fails , a rewared system can be3.Reward system :
applied that provide small tangible reward (gift) daily for not engaging in the
habit , in some cases a large reward must be given for complete cession of
the habit .

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s the last option’it4.appliance therapy :
of treatment this include either
removable appliance with tongue guard
crib or fixed appliance like quad helix
or maxillary lingual arch with palatal
crib. Quad helix appliance : its an
orthodontic appliance consist of four
helix spring and its attached to the
molars by 2 bands .
Conclusion :
*The period of time between 3 and 6 years of age is an interesting
transitional period for addressing potential oral habits. Digit and
pacifier habits should be decreasing significantly by the end of this period .
*In general child beyond 3 years there is no active intervention regardless of
type and severity of malocclusion because of general emotional immaturity .
*Most children outgrow of habit by 5 years of age and the malocclusion self-
corrected .
*The patient should be at least 7 years old to receive appliance therapy
always parents support and encourgment is necessary to help the child throw
treatment period..
Quad helix appliance

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References
_ Shahraki N, Yassaei S, Moghadam MG. Abnormal oral habits: A
review. J Dent Oral Hyg. 2012;4(2):12–5.
-International Journal of Science and Research (IJSR) ISSN (Online):
2319-7064 Index Copernicus Value (2015): 78.96 | Impact Factor (2015):
6.391. Nowak AJ, et al. Oral habits and orofacial development in
children. Accessed Nov. 19, 2018.
-MCDONALD AND AVERY DENTISTRY CHILD AND
ADOLSCENT
(TENTH EDITION ) JEFFERY A. DEAN .
-PEDIATRIC DENTISTRY INFANCY THROUGH ADOLESCENCE
ARTHUR J. NOWAK (SIXTH EDITION).