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Introduction

Introduction. The following habits could be considered as the most important habits precipitating malocclusion. Digit sucking Lower Lip sucking and biting Mouth Breathing Tongue Thrust Nail Biting Use of Pacifier/bottle feeding.

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Introduction

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  1. Introduction • The following habits could be considered as the most important habits precipitating malocclusion. • Digit sucking • Lower Lip sucking and biting • Mouth Breathing • Tongue Thrust • Nail Biting • Use of Pacifier/bottle feeding

  2. Factors that Affecting the Degree of Damage to Teeth and Investing Tissue • Frequency of habit • The more frequency the more the damage • Duration of habit • The more duration the more the damage • Intensity of habit • Active vs passive

  3. Digit sucking habit

  4. Digit sucking habit • Most prevalent of oral habits, 13% - 100% • If the habit ceases before the permanent teeth begin to erupt, any effects on the dentition are unlikely to be long-term. • If however the habit persists into the mixed and permanent dentitionmalocclusion • Thumb sucking may develop early in life and continue from infancy through the primary dentition and into the mixed and permanent dentition. In many cases, if the thumb habit continues into the mixed dentition a malocclusion may develop (Kaplan 1950; Ruttle et al. 1953; Graber 1959). • Prolonged digit sucking habit may affect occlusion and dentofacial structures.

  5. Factors • Not all habits will result in tooth movement. It is related to frequency, duration and intensity. • Studies suggest that it only takes very light forces to move teeth, if the force is of long enough duration. • The threshold is believed to be 6 hours.

  6. Maxillary changes

  7. Mandibular changes

  8. Others: -arch assymmetry -increased overjet -anterior openbite -posterior crossbite

  9. How to stop? • Gentle discouragement • Oral appliances/ habit breaker -palatal crib -acrylic appliance on finger

  10. Approaches to treat chronic thumb sucking These can be split into three distinct categories: • Behavioural – rewarding a child for not exercising the habit; • Mechanical – preventing or interrupting the process of thumb sucking; • Aversive – generating negative sensations when the habit is exercised, such as bad taste, pain or major discomfort

  11. Fig 1: URA with acrylic ridge Fig 2: Blueglass roller Fig 3: The Rake appliance

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