O HABITS A T A T A G L A N C EL A N C E . - Columbia University

ORAL HABITS AT A GLANCE Recommendations for Pediatric Oral Health Care Age 6–12 months Clinical oral examination Assess oral growth and development Caries-risk assessment Prophylaxis and topical fluoride treatment Fluoride supplementation Anticipatory guidance Oral hygiene Dietary counseling Injury prevention counseling Counseling for nonnutritive habits Substance abuse counseling Counseling for intraoral/ perioral piercing Radiographic assessment Treatment of dental disease/injury Assessment and treatment of developing malocclusion Pit and fissure sealants Assessment and/or removal of third molars Referral for regular and periodic dental care 12–24 months 2–6 years 6–12 years 12 years 1.1 RICHARD YOON ORAL HABITS DEFINITION Learned patterns of muscular contraction. Interfere with regular patterns of facial growth. 1.2 RICHARD YOON ORAL HABITS BEHAVIORS Digit Sucking Pacifier Sucking Nail Biting Bruxism Therapies Appliances Mouth Breathing Tongue Thrust RICHARD YOON 1.3 1

ORAL HABITS SUCKING MECHANISM Coordinated Reflex Nourishment Security/Warmth Prevalence – 90% Persistency RICHARD YOON 1.4 ORAL HABITS DIGIT SUCKING Amount, Orofacial Facial Position Position frequency, muscle skeletal of of mandible the contractions and pattern digit duration RICHARD YOON 1.5 RICHARD YOON 1.6 ORAL HABITS DIGIT SUCKING 2

ORAL HABITS DIGIT SUCKING Callus Herpetic Whitlow RICHARD YOON 1.7 ORAL HABITS PACIFIER SUCKING Non Attachment Non-nutritive Studies reportsucking that up to habits Sturdy, oneone-piece inyoung children under 5 90% of children Dipping years changes have may somecause history of nonnonin Oral Cleansing the primary dentition but nutritive sucking. Nowak AJ, Warren JJ. 2000. Infant oral are unlikely to cause any health and oral habits. Pediatric Clinics of North America 47(5):104347(5):1043-1066. long-term problems. long Modeer T, Odenrick L, Lindner A. 1982. Sucking habits and their relation to posterior crossbite in 4 year old children. Scandinavian Journal of Dental Research 90(4):32390(4):323-328. RICHARD YOON 1.8 ORAL HABITS DENTAL EFFECTS PRIMARY DENTITION Sucking Mechanism Posterior Crossbite Anterior Open Bite Excessive Overjet Class II Relationship RICHARD YOON 1.9 3

ORAL HABITS DENTAL EFFECTS MIXED DENTITION Class II Malocclusions Posterior Crossbite Excessive Overjet Traumatic Injuries RICHARD YOON 1.10 RICHARD YOON 1.11 ORAL HABITS NAIL BITING ORAL HABITS BRUXISM Emotional Stress Parasomnias Traumatic Brain Injury Neurologic Disabilities Muscle Recruitment Malocclusion RICHARD YOON 1.12 4

ORAL HABITS BRUXISM 20% - 24% Dental Attrition Headaches TMJ dysfunction Muscles of Mastication SelfSelf-limiting RICHARD YOON 1.13 RICHARD YOON 1.14 ORAL HABITS MOUTHBREATHING Chronic Congestion Chronic Obstruction Anatomic Deformities ORAL HABITS MOUTHBREATHING Position of the tongue OpenOpen-mouth posture Narrower maxilla Overeruption of the molars RICHARD YOON 1.15 5

ORAL HABITS MOUTHBREATHING Position of the tongue OpenOpen-mouth posture Narrower maxilla Overeruption of the molars RICHARD YOON 1.16 ORAL HABITS TONGUE THRUST Abnormal Deviated Anterior Protrusion Tongue Open Position Bite 10% Lisping -Swallow 15% RICHARD YOON 1.17 ORAL HABITS ORAL HABIT THERAPY FACTORS Age Maturity Parental Support Timing Assessment RICHARD YOON 1.18 6

ORAL HABITS ORAL HABIT THERAPY INTERVENTIONS Talk with the child Reminder Therapy Reward System HabitHabit-Breaking Appliances RICHARD YOON 1.19 ORAL HABITS HABIT-BREAKING APPLIANCES Crib Appliance RICHARD YOON 1.20 ORAL HABITS HABIT-BREAKING APPLIANCES Bluegrass Appliance RICHARD YOON 1.21 7

ORAL HABITS HABIT-BREAKING APPLIANCES Occlusal Splint 1.22 RICHARD YOON ORAL HABITS KEY POINTS Individualized approach. Encourage treatment. DentoalveolarDentoalveolar-skeletal deformation. 1.23 RICHARD YOON ORAL HABITS BEHAVIORS Digit Sucking Pacifier Sucking Nail Biting Bruxism Therapies Appliances Mouth Breathing Tongue Thrust RICHARD YOON 1.24 8

health and oral habits. Pediatric Clinics of North America 47(5):1043-1066. Non-nutritive sucking habits in children under 5 years may cause changes in the primary dentition but are unlikely to cause any long-term problems. Modeer T, Odenrick L, Lindner A. 1982. Sucking habits and their relation to posterior crossbite in 4 year old children.