ArticlePDF Available

Oral Habits in children of Rajnandgaon, Chhattisgarh, India-A prevalence study

Authors:

Abstract and Figures

Background: Early diagnosis of abnormal habits may allow both dentists and parents to discourage
Content may be subject to copyright.
Shetty et al International Journal of Public Health Dentistry
1 International Journal of Public Health Dentistry 2013:4(1):1-7. © Publishing Division, Celesta software Private Limited
RESEARCH ARTICLE
Oral Habits in children of Rajnandgaon, Chhattisgarh, India- A prevalence study
Raghavendra Manjunath Shetty, Manoj Shetty, Nailady Sridhar Shetty, Hanumanth Reddy,
Sunaina Shetty, Anil Agrawal.
Abstract
Background: Early diagnosis of abnormal habits may allow both dentists and parents to discourage
these habits and avoid negative consequences. Aim: The present study was undertaken to assess
the prevalence of oral habits in 6 to 11 year old children in Rajnandgaon city, Chhattisgarh, India.
Methods: A total of 1891 school children aged 6 to 11 years from the city of Rajnandgaon reporting to
the department of pedodontics were selected for the study. A thorough history was obtained on a
specially designed proforma and presence or absence of oral habits like thumb/finger sucking, tongue
thrusting, mouth breathing, lip biting, nail biting and bruxism were recorded. Data was analysed using
chi-square test. Results: Prevalence of oral habits was found to be 33.2% in the total sample studied.
Tongue thrust was the most prevalent habit affecting 17.4% of children, whereas 13% of children had
mouth breathing habit followed by 1.7% of children with thumb/finger sucking. Prevalence of lip biting,
nail biting and bruxism was found to be 0.4%, 0.3% and 0.4% respectively. Age and prevalence of
thumb/finger sucking, tongue thrusting and mouth breathing were found to be statistically highly
significant (p<0.001). No significant differences were found in any oral habits between boys and girls.
Conclusions: Oral habits, especially if they persist beyond the preschool age, have been implicated
as an important environmental etiological factor associated with the development of malocclusion. So,
early diagnosis and proper treatment planning of these habits will reduce the occurrence of
malocclusion.
Keywords: Thumb sucking; Tongue thrusting; Mouth breathing; Oral habits; Prevalence.
Introduction
A wide variety of oral habits in infants and
young child has been the centre of much
controversy for many years. Parents,
pediatricians, psychologist, speech
pathologists and pedodontists have discussed
and argued the significance of these habits,
each from the view point of expertise and
responsibility. Early diagnosis of abnormal
habits may allow both dentists and parents to
discourage these habits to avoid negative
consequence (1). Oral habits, especially if they
persist beyond the preschool age, have been
implicated as an important environmental
etiological factor associated with the
development of malocclusion (2-4).
Thumb and finger sucking habits, or non
nutritive sucking are considered to be the most
prevalent of oral habits, with a reported
incidence ranging from 13% to almost 100% at
some time during infancy (5,6). The finger-
sucking habit, normal in the first two or three
years of life, may cause permanent damage if
continued beyond this time (7). Reported
maxillary changes associated with a prolonged
sucking habit are proclination of the maxillary
incisors increased maxillary arch length,
anterior placement of the maxillary apical
base, increased sella-nasion-point Angle
Shetty et al International Journal of Public Health Dentistry
2 International Journal of Public Health Dentistry 2013:4(1):1-7. © Publishing Division, Celesta software Private Limited
(SNA) and decreased palatal arch width (8,9).
Effects on the mandible include proclination of
the mandibular incisors, decreased sella-
nasion-point B angle and increased intermolar
distance (8,9). Other dental alterations are
increased overjet, decreased overbite and
posterior crossbite. The tongue and lips are
also affected by sucking. Lip incompetence
and tongue thrust are usually associated with
sucking habits (10).
Prolonged tongue thrusting habit has been
shown to be associated with open bite,
however if the open bite is a cause or an effect
is not well established. While it has been noted
that anterior position of the tongue may result
in open bite (11). Tongue thrust with an open
bite has been shown to be associated with
long facial pattern and proclination of upper
anterior teeth (12). Other associated features
with tongue thrust have been high and/or
narrow maxillary arch and Class II div I
malocclusion. It also may lead to lisping or
impaired speech.
During adolescence, the habit of mouth
breathing may develop from recurrent throat
infections, allergic rhinitis or nasal obstruction
due to factors such as a deviated nasal
septum or other anatomical causes. Long
standing mouth breathing and nasal
obstruction can adversely affect dentofacial
growth (13).
In India overall prevalence of oral habits has
been reported to be as low as 3% among the
children of Ambala- North India (14) and
29.7% in Mangalore-South India (15)
respectively. Hence, present study was
undertaken to obtain the prevalence of oral
habits in children of 6-11 years age group in
Rajnandgaon city, Chhattisgarh.
Materials and Methods
A total of 1891 school children reporting to the
Department of Pedodontics of age 6-11 years
between July 2009 and June 2010 were
included in the study. Selection criteria
included absence of previous orthodontic
treatment, premature loss of primary teeth,
trauma or surgery in the dentofacial region,
mental retardation and any systemic diseases.
Written informed consents were obtained from
all the parents. The study was approved by the
ethical committee of Chhattisgarh dental
college and research institute, Rajnandgaon,
Chattisgarh, India.
Each child was asked to sit comfortably on a
dental chair and was subjected to a thorough
history and clinical examination. A thorough
history was obtained on a specially designed
proforma which included the personal data
(age, sex, and residence), presence or
absence of oral habits like thumb/finger
sucking, tongue thrusting, mouth breathing, lip
biting, nail biting and bruxism. As there was a
possibility that the children or parents were not
aware of the tongue thrusting and mouth
breathing, the children were diagnosed for
these habits on the dental chair. The child was
asked to swallow saliva first and then 10 ml of
water. Position of the tongue during
swallowing was evaluated by depressing the
child’s lower lip with the operator’s thumbs and
simultaneously feeling the masseter muscle
activity with the index fingers. Child was
diagnosed as a tongue thruster if he/she
fulfilled any one of the following criteria
established by Weiss and Van Houten (16).
1. He/she thrusted his/her tongue
against the upper central incisors or
between the upper and lower central
incisors during swallowing.
Shetty et al International Journal of Public Health Dentistry
3 International Journal of Public Health Dentistry 2013:4(1):1-7. © Publishing Division, Celesta software Private Limited
2. Swallowed with his/her teeth apart,
and/or
3. Had excessive lower lip activity during
swallowing.
Child was diagnosed as mouth breather by
double ended mirror and water holding test
similar to previous studies reported (14,15). A
single calibrated examiner recorded the
presence or absence of habits. Kappa value
was 0.89. Chi-square statistic (2) was used to
analyze the data. The threshold for the
statistical significance was set at p<0.05. The
statistical package for social sciences (SPSS
11.5 for windows) was used.
Results
Out of the 1891 children included in the study,
1043 were males and 848 were females
[Table 1].
Table 1: Distribution of children according to
age and sex
Age
(Years)
Sex
Total
Male
Female
6
156
126
282
7
181
109
290
8
142
130
272
9
135
156
291
10
197
119
316
11
232
208
440
Total
1043
848
1891
Prevalence of oral habits among children was
found to be 33.2% in the total sample studied.
Tongue thrust was the most prevalent habit
affecting 17.4% of children, whereas 13% of
children had mouth breathing habit followed by
1.7% of children having thumb/finger sucking
habit. Prevalence of lip biting, nail biting and
bruxism was found to be 0.4%, 0.3% and 0.4%
respectively [Table 2].
Association between various habits and age
were tabulated and analyzed [Table 2]. The
association between the age and prevalence
of thumb/finger sucking, tongue thrusting and
mouth breathing were found to be statistically
highly significant (p<0.001). However, no
significant differences were found in lip biting,
nail biting and bruxism when associated with
the age. Prevalence of various oral habits in
relation to the gender was tabulated [Table 3].
However, no significant differences were found
in any of the oral habits between boys and
girls (χ 2=3.6, p=0.72).
Discussion
Oral habits are common in children. These
habits include: non-nutritive sucking habits
(thumb, finger and pacifier sucking habits),
tongue-thrusting, and lip or nail biting habits.
The majority of oral habits are called non-
nutritive sucking habits. Near the end of early
childhood and the beginning of grade school,
any prolonged oral habit is considered socially
unacceptable and can lead to undesirable
dental effects. Present study was conducted to
know the prevalence of oral habits in 6-11 year
old children of Rajnandgaon city, so that
deleterious effects of same can be prevented.
The findings of the present study showed that
33.2% of the children examined had oral habit
of some or the other kind. This finding is in
agreement with the results of Dacosta et al
(17), who found 34.1% of the children
examined presented with an oral habit.
Prevalence of oral habits in Mangalore-South
India was reported to be 29.7% (15) whereas
25.5% in Delhi North India (18). However,
Guaba et al (14) reported that only 3% of
children demonstrated oral habits, which is
very much in disagreement with our findings.
Similar low prevalence (9.9%) of oral habits
has been reported by Onyeoso (19), who
studied the prevalence of oral habits in
Nigerian children of age 7-10 years.
Shetty et al International Journal of Public Health Dentistry
4 International Journal of Public Health Dentistry 2013:4(1):1-7. © Publishing Division, Celesta software Private Limited
Table 2: Prevalence of oral habits according to age
Oral Habit
Significance
6
7
8
9
10
11
Total
2
p value
Thumb-
Sucking
14(5.0%)
13(4.5%)
5(1.8%)
0(0%)
1(0.3%)
0(0%)
33(1.7%)
46.4
<0.001**
Tongue
Thrusting
78(27.7%)
71(24.5%)
61(22.4%)
43(14.8%)
34(10.8%)
42(9.5%)
329(17.4%)
65.5
<0.001**
Mouth
Breathing
0(0%)
3(1.0%)
40(14.7%)
61(21.0%)
70(22.2%)
72(16.4%)
246(13.0%)
123.5
<0.001**
Lip Biting
0(0%)
1(0.3%)
1(0.4%)
0(0%)
3(0.9%)
2(0.5%)
7(0.4%)
5.0
0.405
Nail Biting
1(0.3%)
0(0%)
0(0%)
2(0.7%)
1(0.3%)
2(0.5%)
5(0.3%)
4.8
0.435
Bruxism
2(0.7%)
0(0%)
2(0.7%)
1(0.3%)
1(0.3%)
1(0.2%)
7(0.4%)
3.2
0.667
Total
( in each age
group)
94(15.0%)
88(14.0%)
109(17.4%)
107(17.1%)
110(17.5%)
119(19.0)
627(33.2%)
262.6
<0.001**
*Statistically significant
Table 3: Prevalence of oral habits according to sex
Sex
Oral Habit
Significance
N
Thumb-
sucking
Tongue
Thrusting
Mouth
Breathing
Lip Biting
Nail
Biting
Bruxism
2
p value
Male
1043
19(1.8%)
180(17.3%)
146(14.0%)
4(0.4%)
2(0.2%)
4(0.4%)
3.6
0.72
Female
848
14(1.7%)
149(17.6%)
100(11.3%)
3(0.4%)
3(0.4%)
3(0.4%)
Total
1891
33(1.7%)
329(17.4%)
246(13.0%)
7(0.4%)
5(0.3%)
7(0.4%)
† Not significant at p< 0.05
Tongue thrusting and mouth breathing were
the most prevalent oral habits in the present
study sample. Our findings are concurrent with
the findings of Guaba et al (14) and
Kharbanda et al (18). In contrast digit sucking
was the most frequently occurring oral habits
seen in 50% of the children in the study
reported by Dacosta et al (17).
Present study revealed that tongue thrusting
habit was prevalent in 17.4% of the children.
Similar finding was reported by Kharbanda et
al (18) who reported 18.1% prevalence of
tongue thrust in their study. However, the
present study differed with the findings of
Shetty and Munshi (15) who found a
comparatively low prevalence (3.02%) of
tongue thrust among 560 children in the age
group of 3-16 years.
Mouth breathing habit was the second most
prevalent habit in the present sample with the
prevalence rate of 13%. This prevalence was
higher when compared to the findings of the
previous studies (15,18). Abou-EI-Ezz et al
(20) reported that, 40% of the cases had no
habits, 31% were mouth breathers, 12% had a
combined habit tongue thrust and mouth
breathing, 4% bit their lips, 5% sucked their
thumbs and 7% were tongue thrusters in a
sample of 1120 children. In the present study,
thumb/finger sucking habit was seen only in
Shetty et al International Journal of Public Health Dentistry
5 International Journal of Public Health Dentistry 2013:4(1):1-7. © Publishing Division, Celesta software Private Limited
1.7% of children and was most prevalent habit
after tongue thrusting and mouth breathing.
However various prevalence rates of 0.7%,
3.1%, 8.1% and 16.7% have been reported in
the literature (1,15,18,19). Prolonged
thumb/finger sucking habit can lead to
undesirable tooth movement and
malocclusions. The prevalence of bruxism and
lip biting was found to be 0.4%. Similar low
prevalence were reported by Kharbanda et al
(18). However, the previous literature on the
oral habits also suggests highest prevalence
of bruxism from 6.2% to 30.2% and lip biting
from 1.2% to 6% (1,15,19). Nail biting was
reported to be the least common oral habit
with the prevalence of 0.3%. This observation
is in disagreement with the findings of Shetty
and Munshi (15) who reported 12.7% of
children with nail biting.
There existed difference in prevalence of oral
habits in different age. Oral habits were more
prevalent in 11 year old children with 19%
prevalence, whereas least prevalence of 14%
was found in 7 year old children. A very
significant finding in the present study was
decrease in thumb sucking and tongue
thrusting habit with increase in the age, and
reverse trend in case of mouth breathing
where the habit increased with increase in the
age. Gellin (21) studied the prevalence of
tongue thrusting in American children. He
reported that 97% of the newborns had tongue
thrust and this figure declined to 80% at 5-6
years and then to 3% at 12 years of age. He
concluded that tongue thrusting significantly
decreased with age. A steady decrease in oral
habits with an increase in age was also
observed by Dacosta et al (17).
Karbhanda et al (18) observed that thumb
sucking was more common in girls than boys
whereas mouth breathing was more common
in boys compared to girls. The reason behind
the gender wise difference in the occurrence
of oral habits may be due to the fact that oral
habits in boys are more persistent for longer
period than girls because boys tend to openly
fight against family’s or surrounding society’s
rules than girls, including when they are told to
stop practicing oral habits (22,23). However no
significant gender differences were found in
relation to the oral habits in the present study.
The same pattern was observed among the
seven to ten year old Nigerian children (19).
However, the cross-sectional nature of the
present study may fail to find more accurate
causal relationship that may existed. Hence,
an analytical and prospective study is required
to find out associations and risk factors for the
occurrence oral habits.Oral habits, especially if
they persist beyond the preschool age, have
been implicated as an important environmental
etiological factor associated with the
development of malocclusion. So, early
diagnosis and proper treatment planning of
these habits will reduce the occurrence of
malocclusion.
Affiliations of the authors: 1. Dr. Ragvendra
Manjunath Shetty, PhD Scholar, 2. Dr. Manoj
Shetty, Professor, PhD Guide 3. Dr. Nailady
Sridhar Shetty, Professor, PhD Co-guide, Nitte
University, Mangalore, Karnataka, India 4. Dr.
Hanumanth Reddy, Associate Professor,
Department of Orthodontics, 5. Dr. Sunaina
Shetty, Assistant Professor, Department of
Periodontics,6. Dr. Anil Agrawal, Sr. Lecturer ,
Department of Community Dentistry, Chhattisgarh
Dental College and Research Institute,
Rajnandgaon, Chhattisgarh, India.
Conflict of Interest:
The author(s) declared no conflict of interests.
Source of Funding: Nil.
Shetty et al International Journal of Public Health Dentistry
6 International Journal of Public Health Dentistry 2013:4(1):1-7. © Publishing Division, Celesta software Private Limited
References
1. Murshid ZA, Abdulaziz AA, Amin HE, Al
Nowasier AM. Assessment of
parafunctional oral habits among a sample
of Saudi Dental Patients. JKAU: Med Sci
2007; 14(4):35-47.
2. Holm AK. A longitudinal study of dental
health in Swedish children aged 3-5 years.
Community Dent Oral Epidemiol 1975;
3(5): 228-236.
3. Tomita SE, Bijella VT, Franco LJ. The
relationship between oral habits and
malocclusion in preschool children. Rev
Saude Public 2000; 34(3):299-303.
4. Warren JJ, Bishara SE, Steinbock KL,
Yonezu T, Nowak AJ. Effects of oral
habits’ duration on dental characteristics in
primary dentition. J Am Dent Assoc 2001;
132: 1685-1693.
5. Traisman A, Traisman H. Thumb and
finger sucking: A study of 2,650 infants. J
Pediatr 1958; 52:556-572.
6. Maqurie JA. The evaluation and treatment
of pediatric oral habits. Dent Clin North Am
2000; 44:559-569.
7. Graber TM. Thumb and finger sucking. Am
J Orthod 1945; 45:258.
8. Larsson E. Dummy and finger-sucking
habits with special attention to their
significance for facial growth and
occlusion. Effect of facial growth and
occlusion. Sven Tandlak Tidskr 1972;
65:605-634.
9. Willmot DR. Thumb sucking habit and
associated dental differences in one of
monozygous twins. Br J Orthod 1984;
11:195-199.
10. Shetty RM, Dixit U, Hegde R,
Shivprakash PK. RURS’ elbow guard:
An innovative treatment of the thumb-
sucking habit in a child with Hurler’s
syndrome. J Indian Soc Pedod Prev Dent
2010; 28(3):212-218.
11. Lowe AA and Johnston WD. Tongue and
jaw muscle activity in response to
mandibular rotations in a sample of normal
and anterior open-bite subjects. Am J
Orthod 1979;76:565-576.
12. Cayley AS, Tindall AP, Sampson WJ,
Butcher AR. Electropalatographic and
cephalometric assessment of tongue
function in open bite and non-open bite
subjects. Eur J Orthod 2000;22:463-474.
13. Oulis CJ, Vadiakas GP, Ekonomides J,
Dratsa J. The effect of hypertrophic
adenoids and tonsils on the development
of posterior crossbites and oral habits. J
Clin Pediatr Dent 1994; 18:197-201.
14. Gauba K, Ashima G, Tewari A, Utreja A.
Prevalence of malocclusion and abnormal
habits in North Indian rural children. J Ind
Soc of Pedo Prev Dent 1998; 16(1):26-30.
15. Shetty SR, Munshi AK. Oral habits in
children - a prevalence study. J Ind Soc of
Pedo Prev Dent. 1998; 16(2):61-66.
16. Weiss CE and Van Houten JT. A remedial
program for tongue thrust. Am J Orthod
1972;62:499-506.
17. Dacosta OO, Quashie-Williams R, Isiekwe
MC. The prevalence of oral habits among
4 to 15 year old school children in Lagos,
Nigeria. Niger Postgrad Med J 2010;
17(2):113-117.
18. Kharbanda OP, Sidhu SS, Sundaram KR,
Shukla DK. Oral habits in school going
children of Delhi: a prevalence study. J Ind
Soc of Pedo Prev Dent. 2003; 21(3):120-
124.
Shetty et al International Journal of Public Health Dentistry
7 International Journal of Public Health Dentistry 2013:4(1):1-7. © Publishing Division, Celesta software Private Limited
19. Onyeaso CO. Oral habits among 7-10
year-old school children in Ibadan, Nigeria.
East African Medical Journal 2004;
81(1):16-21.
20. Abou-Ei-Ezz A, Naseef EH, Attia KH.
Prevalence of mouth breathing as etiologic
factors of malocclusion in a group of
Egyptian school children. Official Journal
of the Egyptian Dental Association 2006;
52(2):703-706.
21. Gellin ME. Digital sucking and tongue
thrusting in children. Dent Clin North Am
1978; 22(4):603-619.
22. Massler M. Oral Habits: Development and
Management. J Pedod 1983; 7(2): 109-
119.
23. Polyakov E. digital sucking before the age
4.5. Interpretation and some management
considerations. International Pediatrics
2002;17(4):203-208.
Corresponding author
Dr. Ragvendra Manjunath Shetty,
PhD Scholar, Nitte University, Mangalore,
Karnataka, India.
e-mail: raghavendra77@yahoo.com
... Table 1 summarizes the characteristics of the included studies. Regarding the year of publication, the highest concentration of studies appeared between the years 2012 and 2015 [16,19,22,27,28], mainly in the year 2013 [16,27,28]. Two of the studies were conducted in India [15,28], two in Italy [17,29] and the rest were carried out in different countries: Brazil [26], Argentina [16], Albania [27], Lithuania [19], Romania [22], Ecuador [25], Pakistan [23] and Peru [24]. ...
... Table 1 summarizes the characteristics of the included studies. Regarding the year of publication, the highest concentration of studies appeared between the years 2012 and 2015 [16,19,22,27,28], mainly in the year 2013 [16,27,28]. Two of the studies were conducted in India [15,28], two in Italy [17,29] and the rest were carried out in different countries: Brazil [26], Argentina [16], Albania [27], Lithuania [19], Romania [22], Ecuador [25], Pakistan [23] and Peru [24]. ...
... Regarding the year of publication, the highest concentration of studies appeared between the years 2012 and 2015 [16,19,22,27,28], mainly in the year 2013 [16,27,28]. Two of the studies were conducted in India [15,28], two in Italy [17,29] and the rest were carried out in different countries: Brazil [26], Argentina [16], Albania [27], Lithuania [19], Romania [22], Ecuador [25], Pakistan [23] and Peru [24]. Regarding the type of study, most were cross-sectional observational and two were case-control studies, one of them cross-sectional [15] and another retrospective [22]. ...
Article
Full-text available
The aim of this systematic review is the assessment of the effect of mouth breathing on the prevalence of tongue thrust. The review was performed according to the PRISMA 2020 checklist guidelines, and the protocol was registered with PROSPERO (CRD42022339527). The inclusion criteria were the following: studies of clinical trials and cross-sectional and longitudinal descriptive studies that evaluate the appearance of tongue thrust in patients with mouth breathing; healthy subjects of any age, race or sex; and studies with a minimum sample group of five cases. The exclusion criteria were the following: studies with syndromic patients, articles from case reports, and letters to the editor and/or publisher. Searches were performed in electronic databases such as The National Library of Medicine (MEDLINE via PUBMED), the Cochrane Central Register of Controlled Trials, Web of Science and Scopus, including studies published until November 2023, without a language filter. The methodological quality of the included case–control studies was assessed using the Newcastle–Ottawa Scale (NOS), and the Joanna Briggs Institute (JBI) tool was used for descriptive cross-sectional studies and cross-sectional prevalence studies. A meta-analysis was conducted on studies that provided data on patients’ classification according to mouth breathing (yes/no) as well as atypical swallowing (yes/no) using Review Manager 5.4. From 424 records, 12 articles were selected, and 4 were eligible for meta-analysis. It was shown that there is no consensus on the diagnostic methods used for mouth breathing and tongue thrust. The pooled risk ratio of atypical swallowing was significantly higher in the patients with mouth breathing (RR: 3.70; 95% CI: 2.06 to 6.66). These studies have several limitations, such as the heterogeneity among the individual studies in relation to the diagnostic tools and criteria for the assessment of mouth breathing and atypical swallowing. Considering the results, this systematic review shows that patients with mouth breathing presented higher risk ratios for atypical swallowing.
... For years, oral habits in infants and young children have been debated among parents, pediatricians, psychologists, speech pathologists, and pediatric dentists. Early diagnosis of abnormal habits enables intervention from both dentists and parents to prevent negative outcomes [21][22][23]. ...
Article
Full-text available
Background: Oral health is fundamental to children’s health and well-being. Parental knowledge, awareness, and practices towards oral habits significantly influence children’s oral health. Early diagnosis and intervention to break abnormal oral habits are vital to prevent long-term detrimental effects on oral and facial development. Objective: This study aimed to assess parents’ knowledge, awareness, and attitudes towards their children’s oral habits in Riyadh, Saudi Arabia. Methods: A cross-sectional study design was employed, where 2,000 participants were enrolled, of whom 563 Saudi mothers residing in Riyadh met the inclusion criteria. A validated, self-administered questionnaire was used to collect data on demographics, child information, parental awareness, and parental attitudes. Results: Regarding awareness, moderate overall awareness was reported among mothers, with the majority (over 70%) correctly identifying the negative effects of prolonged pacifier/bottle use and other habits on children’s oral health. As for the attitudes, most mothers recognized the importance of stopping sucking habits (digit and/or pacifier) by 18 months and agreed that persistent oral habits cause malocclusion and growth problems. However, a significant gap existed between knowledge and practice, with most mothers (92.9%) never consulting a dentist regarding their child’s ongoing oral habits. Mothers with higher education levels reported encouraging their children to stop habits and documented improvements observed after habit cessation. Conclusions: Although most mothers demonstrated moderate awareness of the detrimental effects of prolonged oral habits, a clear gap remains between knowledge and practice. This study emphasizes the need for educational programs to improve parental knowledge, attitudes, and practices regarding children’s oral habits. Additionally, addressing cultural beliefs and cost barriers to dental treatment could increase the utilization of dental services, improving children’s oral health.
... The habit is a continuous duplication of an act [2]. Oral habits like thumb/finger sucking, nail biting, lip chewing, tongue thrust, pacifier use and bruxism [3]. Oral habits surprisingly have benefits like lowering caries incidence. ...
Article
Full-text available
Background There are different intraoral appliances for cessation of thumb/finger sucking habit, but they have many disadvantages and to overcome it, extra oral appliances with colourful and attractive shape were developed. Electronic habit reminder in the form of wristwatch with alarming sound was assessed in cessation of thumb/finger sucking habit in children versus palatal crib after 6 and 9 months. Methods This study is a randomized clinical pilot study, with allocation ratio 1:1 parallel group. Recruitment was at the diagnostic clinic, Paediatric Dentistry and Dental Public health Department, Faculty of Dentistry, Cairo University. Blinding was not feasible except for the statistician. Twenty-two children were included with age range (6–14), erupted upper first permanent molar and with thumb/finger sucking habit that resulted in open bite. After random allocation of participants into two groups: intervention group (electronic habit reminder) and control group (palatal crib), impressions were performed for fabrication of the appliances in both groups. Follow up was performed at 2 weeks, 1, 3, 6 and 9 months. Primary outcome was assessing cessation of thumb/finger sucking habit in children. Results The total number of participants who were randomized and analysed was 22 (11 per group). Cessation of thumb/finger sucking habit in the intervention group was 27.3% while in the control group was 54.5% but with no statistically significant difference (P˃0.05). Positive feedback from the parents about the useful instructions, success, and ease of using the appliances but all with no statistically significant difference (P˃0.05). Harms Regarding the palatal crib appliance, there was gingival inflammation that resolved by proper oral hygiene care. Also, interference with speech which disappeared after adaptation. Regarding appliances breakage or dislodgment, it was repaired or replaced with another one. Conclusion Although most of the parents and children accepted both appliances, cessation of the habit was higher in the control group than in the intervention group. Trial registration The trial was registered on clinicaltrials.gov, ‘Trial registration number: NCT04075617 [first submitted -29/8/2019]’.
... Within the limitations of the present study, the age group 18-25 years females had severe handicapping malocclusion and needed mandatory orthodontic treatment compared to males. [6,7]. Malocclusion is a serious health problem as the teeth are unable to perform vital functions due to the misalignment and has been proven to be a predisposing factor for several major dental problems. ...
... [19] There are several other studies done within the Indian subcontinent that quote a lower prevalence of oral habits. [20][21] This difference in the prevalence of the oral habits in different population group can be either attributed to the difference in the calibration or the ethnicity of the population being examined or the geographic location where the population is based or the variation in the sample size of the examined population. ...
Article
Oral habits ought to be of primary clinical concern to orthodontists as they may cause malocclusion and interfere with the treatment progress. Generally, habit control should be achieved earlier to correction of the malocclusion in an effort to eliminate any etiologic factors in development and maintenance of the malocclusion. It is well important for the clinician to understand that habit breaking treatment may need prolonged treatment time because habits may have been present for long periods of time and may be associated with underlying psychological problems. Hence based on above importance the present study was planned to evaluate incidence of different deleterious oral habits in school going children from Darbhanga District, Bihar. The present study was planned in the Department of Dentistry, Darbhanga Medical College and Hospital Laheriasarai, Darbhanga Bihar. Total 50 school going children of the age 4 years to 10 years were enrolled in the present study. Samples were selected from school; simple randomized sampling technique was used. Children with orthodontic appliances, systemic disease were excluded from the study. A closed ended questionnaire was provided to children involved in survey to obtain details like age, sex, presence of habits, its duration and frequency. A detailed history was obtained from parents regarding the habit and its intensity. The data generated from the present study concludes that all habits did not show statistically significant relationship, except tongue thrusting which showed statistically significant relationship and more prevalent in rural areas. Keywords: Deleterious Oral Habits, School childrens, Bihar.
... [21,44,94] reported. [44,51,[95][96][97] In comparison with the previous findings (2 to 5%) occurrence of peg lateral in present survey was 2.5%. [98][99][100][101][102][103] Different racial groups having different prevalence rate of peg lateral in which the occurrence rates were higher in Mongoloid (3.1%) than in black and white subjects while the female subjects shows prevalence rate slightly more than the male subjects which is consistent with the present study. ...
Article
Full-text available
Health is the extent of functional or metabolic regulation of a living body. Many researchers have shown that oral health is directly related to the systemic condition of a person. The various researches done has shown that there is an increase in need for orthodontic treatment in most of the countries. Hence judicious planning of providing orthodontic services on a population basis is necessary to appraise the requirement of resources and manoeuvre for providing such a service. How to cite this article: Avinash B, Shivalinga BM, Balasubramanian S, Shekar S, Chandrashekar BR, Avinash BS. Orthodontic Treatment Needs of 12-year-old School-going Children of Mysuru District, Karnataka, India: A Cross-sectional Study. Int J Clin Pediatr Dent 2018;11(4):307-316.
Article
Full-text available
Aim The anxiety of dental procedure evokes physiological response in the human body similar to fear. The level of cortisol and alpha-amylase in saliva can be considered as one of the major biomarkers of stress and anxiety. Our study was aimed to correlate the stress and anxiety with the levels of salivary cortisol (SC) and salivary alpha-amylase (SAA) in patients undergoing routine dental extraction. Materials and methods The levels of SC and SAA were assessed pre- and postextraction in the salivary samples of 20 children. Results The values of cortisol and alpha-amylase showed a significant increase postextraction. Conclusion Salivary cortisol and SAA can be considered an important and noninvasive tool for assessment of anxiety, such as dental extraction, in children. Clinical significance Increase in the stress levels of a child in the dental operatory procedures like tooth extraction suggests the use of some behavior modification and shaping techniques by dentists to overcome the anxiety of the child before commencement of the procedure. This can aid in better cooperation of the child during treatment as well as helps in internal motivation toward future dental treatment. How to cite this article: Chaturvedi Y, Chaturvedy S, Marwah N, Chaturvedi S, Agarwal S, Agarwal N. Salivary Cortisol and Alpha-amylase—Biomarkers of Stress in Children undergoing Extraction: An in vivo Study. Int J Clin Pediatr Dent 2018; 11(3):214-218.
Article
Full-text available
The aim of this study is to assess the prevalence of parafucntional oral habits including breathing disorder, bruxism, thumb-sucking, clenching and some of the related factors among a group of Saudi dental patients ranging from 6 to 16 years of age. The sample of this study comprised 1032 Saudi children (712 boys and 320 girls) collected from the screening clinic, Faculty of Dentistry, King Abdulaziz University. Standardized questionnaire form, information about the presence or absence of different parafunctional oral habits and the participant's oral health knowledge was obtained. Age, sex and number of siblings were collected. Descriptive statistics, t test and Chi square test were used as appropriate. The prevalence of breathing disorders, bruxism, thumb-sucking and clenching habits were 20.2%. 30.2%, 16.7% and 13.6%, respectively. Bruxism was more prevalent in boys (33.1%) than girls (23.7%), while girls had a significantly higher prevalence of thumb-sucking and clenching (p=0.001). The number of siblings had a significant effect on bruxism and thumb-sucking (p=0.04), but not on breathing disorder (p=0.44) or clenching (p=0.22). Oral health knowledge had insignificant effect on breathing disorders, bruxism, thumb-sucking and clenching (p=0.88, 0.71, 0.28 and 0.31, respectively).
Article
Full-text available
Thumb sucking is the process of sucking on the thumb for oral pleasure. Thumb and finger sucking habits, or nonnutritive sucking, are considered to be the most prevalent of oral habits. Some parents are concerned by thumb sucking and may even try to restrain the infant or child. In most cases, this is not necessary. Most children stop thumb sucking on their own. When older children continue to suck their thumbs, it could mean they are bored, anxious, or have emotional problems such as depression. This article presents a case report of a child with Hurler's syndrome along with thumb sucking/biting habit. Hurler's syndrome, also known as mucopolysaccharidosis I, is a rare condition inherited as an autosomal-recessive trait. It represents the classical prototype of mucopolysaccharide disorder. A unique appliance to prevent thumb sucking/biting was developed and termed as "RURS' elbow guard," which was successfully used to break thumb sucking of the child with Hurler syndrome. The present report also describes the steps in fabrication of this new habit-breaking appliance, which is also designed to protect the finger from the effects of the sucking habit.
Article
Objective: To provide information regarding the prevalence of oral habits among a group of Nigerian children. Study Design: This is cross-sectional study of 928 children, 431 males and 497 females aged 4 to 15 years from both rural and urban areas of Lagos State in Nigeria. Habits assessed included digit, lip and tongue habits. Results: Thirty four point one per cent of the children examined presented with an oral habit. Of these, digit sucking was the most frequently occurring, seen in 50% of the children with oral habits. Tongue and lip habits occurred in 27% and 23% of children respectively. There was observed a steady decrease in oral habits with an increase in age. The prevalence being highest among 4 to 5 year olds (44.2%) and gradually decreasing to 11.8% among the 14 to 15 year age group. Oral habits were found to be slightly more common among males than females, though this finding was not significant. Socio-economic status (SES) was found to have a significant effect on the occurrence of oral habits. Forty eight per cent of all children of high SES engaged in an oral habit, whereas this was observed in only 24.4% of all children of low SES. Conclusion: The findings of this study indicate that there is an increased prevalence of oral habits among children in the population in recent times. The occurrence of these habits is more frequently seen in children from families of high socio-economic status. .
Article
The adequate control of the digit sucking habit (DS), which is com- mon among children before the age of 4.5, requires an understand- ing of the etiology and an awareness about associated problems. The adaptive value of normal DS behavior, possible destructive fac- tors, and possible dental or other effects of this habit are described. Management considerations, methods to combat this habit, when it is necessary, and pitfalls of a conservative approach are discussed from a psychological and medical prospective. The material in this article may be addressed primarily to pediatricians because they deal with kids in early childhood on a regular basis, and have an opportunity to contribute to their patient's oral health during well-
Article
The finger-sucking habit, normal in the first two or three years of life, may cause permanent damage if continued beyond this time. Of gravest concern is the creation of an excessive overjet which, in turn, fosters abnormal lip and tongue muscle activity. It is this activity that causes the real damage so often attributed to the finger habit alone. There are several conditioning factors, the most important being the original morphology, the duration, the frequency, and the intensity of the sucking habit. For the normal child, the placement of an interceptive appliance after the age of 3 to 4 years can eliminate muscle perversions and allow autonomous adjustment of the incipient malocclusion.
Article
A conservative approach to the management of the child and parent and to the treatment by the dentist for both digital sucking and tongue thrusting is advocated. Because the prevalence of both activities continues to decrease with age, various age ranges are selected as guidelines for the dentist in selecting an approach for the management and treatment of either activity. Successful closure of an anterior open bite after the cessation of digital sucking and tongue thrusting is directly related to the ability of the dentist to assess the growth pattern and especially to determine whether there is a skeletal component contributing to an increase in the certical dimension.
Article
In order to investigate the effect of mandibular rotations in human subjects, the electromyographic activity from the left GG, left masseter, and left orbicularis oris muscles was recorded during voluntary opening movements of the mandible that were monitored by an electronic transducer. For each muscle, a computer-based system was used to calculate a threshold incisor-separation position corresponding to a 20 percent increase in base line muscle activity. The mean threshold level for the GG muscle in a sample of twenty subjects with normal occlusions was 53.0 percent (S.D. +/- 22.8)of maximum jaw opening. By contrast, a sample of nine subjects with anterior open-bite malocclusions had a statistically significant (p less than 0.001) lower mean threshold of 5.9 percent (S.D. +/- 4.5) of maximum jaw opening. No significant differences in masseter or orbicularis oris muscle activity were found between the two samples. Since postural tongue activity could play an important role in the development of the anterior dentition, the lower threshold for the GG muscle activity in response to jaw opening in anterior open-bite subjects may be of significant clinical importance.
Article
This paper presents data concerning caries, gingivitis, interdental spacing, occlusion and oral habits obtained in a longitudinal investigation of 177 children at the ages of 3, 4 and 5 years. It was found that between 3 and 5 years of age, deft increased from 2.01 to 4.05 and defs from 2.69 to 5.98. The occlusal surfaces of the primary second molars and the occlusal and distal surfaces of the primary first molars were the ones most often affected. The mean Gingival Index decreased from 3 to 5 years (P less than 0.05) and also the number of children with a score of 2 from 4 to 5 years (P less than 0.05). The sagittal and transversal relationship between the jaws remained unchanged in most of the children, while the vertical relationship varied with changes in sucking habits. Dummy sucking was initially more than three times as common as finger sucking, but decreased markedly with increasing age. The children with the habit of finger sucking tended to keep this habit. Nocturnal grinding of the teeth was reported by the parents of 13 % of the children. Dental treatment was needed by 61 % at the age of 3, by 71 % at the age of 4 and by 68 % at the age of 5, as they had caries and/or gingivitis with a gingival score of 2. Futhermor, there was a need for orthodontic supervision including treatment. Caries prophylactic treatment was necessary in all age groups.
Article
A treatment program for tongue-thrust has been discussed in an attempt to clarify and share some basic remedial procedures that have been effective in patients with certain kinds of tongue-thrust. The four phases of the program—tongue placement, upper and lower molar approximation, lip placement, and carry-over—may be used totally or in part, depending on the specific habits of the patient. A myriad of remedial activities is not needed for modifying a tongue thrust, but individualized procedures are needed. Usually the general emphasis of remediation is stabilization of the tongue tip, upward and backward orientation of the tongue, relatively close approximation of the upper and lower molars, de-emphasis on use of the lower lip, and greater emphasis on use of the upper lip during mastication and deglutition.The sequence of activities progresses from swallowing saliva, to other liquids, to solids, or from the relatively easy exercises to the more difficult exercises. Carry-over should be assessed with different techniques and in different settings over a period of time. Treatment must be consistent, systematic, meaningful, quantifiable, and based on a carefully made differential diagnosis that not only determines whether the patient has a detrimental rather than a benign tongue-thrust, but also the exact habits the patient has, so that specific antagonistic remedial procedures can be employed for him. Finally, there may be, tongue-thrusters who cannot be helped, or who can be helped only a little, so caution must be exercised by the speech pathologist before he decides to work with a particular patient.