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What is nutritive vs. non-nutritive sucking?
- Nutritive (breast and bottle feeding)
- Non-nutritive (objects like toys or pacifiers, fingers)
Is it natural for kids to have a natural drive to suck? What is abnormal?
- Yes, it is inherent
- Abnormal upon what they are sucking, how frequently, and
- how long into childhood they continue to suck
What are some possible outcomes of abnormal sucking?
- Increased risk for early childhood caries (nutritive)
- Increased risk for orthodontic problems (non-nutritive)
Which teeth are affected by ECC most?
- Maxillary incisors
- Maxillary and mandibular first molars
- Sometimes mandibular canines
Which behaviors are associated with early childhood caries?
- Excessively frequent bottle feeding (sleep with bottle)
- Prolonged bottle or breast feeding (beyond 18 months)
What times of life do kids get maxillary anterior caries? Fissure molar caries? Posterior proximal caries?
- Maxillary anterior: 10-12 months
- Molar fissures: 13-15 months
- Posterior proximal: 19-21 months
What does the learning theory suggest about sucking?
- Non-nutritive sucking is an adaptive response that is often rewarded and becomes a learned habit
- Occurs without psychological abnormality
How many children during 1st year of life have an oral habit?
90% or more
When do most children stop their oral habits?
What factors are associated with prolonged sucking?
- Older maternal age
- Higher maternal education level
- No older siblings
When do we start to care about oral habits?
When it impacts the occlusion or dentition
Which factors do we consider that impact occlusion and dentition? Which of these is most important?
- Intensity (amount of force applied)
- Duration (amount of time spent) MOST IMPORTANT FACTOR
- Frequency (number of times practiced)
How long of applied force is the minimum for tooth movement?
4-6 hours per day
What does the AAP suggest about pacifier use?
- They advocate pacifier use in infants
- They suggest a decrease in SIDS incidence
Between pacifier and thumb, which lasts longer?
Thumb habits last longer, becomes more prevalent at 36 months
Which change in dentition rarely fixes itself spontaneously. Which can?
- Posterior crossbite rarely fixes itself
- Anterior open bite and overjet can resolve spontaneously
By which age should we intervene with oral habits?
- Problems arise by age 4
- We should intervene at 3-4 yo
When does pacifier cessation occur? Is it before/after digit habits?
- 90% before age 5100% before age 8
- Usually occurs before digit habit (parental control)
What might anterior open bite with no sucking habits correlate with?
What is the age that most open bites close spontaneously
Which features are correlated with mouth breathing?
- Long lower face
- Maxillary constriction
- Adenoid facies (swollen tonsils)
What are the treatments for mouth breathing by airway obstruction?
- Medical management of airway
- Turbinectomy and adenoidectomy are no longer common
How do we treat bruxism?
- ID and equilibrate occlusal interferences
- Rule out systemic problems
- Stainless steel crowns as needed
Which habits may maintain malocclusion or a poor growth pattern?
- Lip habits
- Tongue thrust
- Mouth breathing