Development Of Anterior Open Bite Research Articles

The effect of feeding methods and non-nutritive sucking habits on early childhood caries and development of occlusion (A cross-sectional study)

Background and objectives: Early Childhood Caries (ECC ) is the most common chronic disease conditioning childhood and involves the presence of one or more decayed (noncavitated or cavitated lesions),missing(due to caries), or filled tooth surfaces in children under 72 months of age.Time and frequency of breast-feeding, artificial feeding and of non-nutritive sucking habits can influence orofacial development, and when negative can provoke instability of orofacial function. Sucking habits involving digits or dummies are the most tangible environmental factors that play a role in the etiology of malocclusion.Subjects and method: A cross sectional study performed on aconvenient samples of 500 preschool child renaged between 4-6 years old in Erbil city. Parents (mothers ) were asked for a permission to include their children in the study. A short interview with the mothers of the children preceded the dental examination. The clinical examination included child weight, height determination and dental examination.Results: The results showed that prevalence of caries in breast fed children was (70.6%), in bottle was (62.4%) and both fed children was (65%) with no significant association between type of feeding and caries prevalence (P=0.298). Mean dmfs in males was (9.84±12.99) which is higher than mean dmfs of females (7.39 ±10.58). Class II canine classification was higher in bottle and both feeding than in breast feeding and there was no prevalence of Class III canine relation was found in bottle feeding.Conclusion: Type of feeding was not found to be related to development of early childhood caries in primary dentition of preschool children. Bottle feeding was considered as a risk factor for development of class II canine relation. Non-nutritive sucking (finger, pacifier sucking and both) were found to be risk factors for the development of anterior open bite and posterior cross bite. Finger sucking produces the development of unilateral posterior cross bite in primary dentition.

Characterisation of anterior open bite in primary school-aged children: A preliminary study with artificial neural network analysis.

Non-nutritive sucking habits, bottle feeding, and facial hyperdivergency have been suggested as the influencing factors of anterior open bite (AOB). There was inconsistent reporting of prevalence and a gap of knowledge in the literature. The aim of this study was to investigate the prevalence of AOB in 7- to 12-year-olds, with a special interest to characterise the determinants of this malocclusion. A sample of 203 children aged 7 to 12years were selected from a primary school in regional Australia. The legal guardian of each child completed a self-administered questionnaire. Data were assessed using methods of univariate statistics and neural analysis. The prevalence of AOB and thumb sucking was 24.1% and 23.2%, respectively. AOB was associated with the habit (correlation=0.754) and duration (correlation=0.574) of thumb sucking. Age, gender, birth order, feeding modality, sleep patterns, history of orthodontic treatment and tonsil, adenoid or grommet surgery, and parents' level of education were not related to AOB (correlation absolute value≤0.474). Thumb sucking, specifically for prolonged duration, increases the risk of development of AOB. Cessation of thumb sucking habits should be encouraged at an early age to avoid the development of AOB.

Impact of two non-nutritive sucking patterns on the development of anterior open bite in children of two kindergartens in Baghdad city

Background: Non-nutritive sucking habit (NNSH) is the main environmental causative factor that disturbs normal orofacial development. In spite of the harmful effect of pacifier as a NNSH, mothers aware from the other types of NNSH like thumb sucking far more than pacifier use. Open bite is one of the most challenging malocclusions in orthodontics due to the high prevalence of relapse after treatment, so preventing the causative factor of its occurrence is essential at early age of child life. This study aims to assess the impact of two non-nutritive patterns on the development of anterior open bite in primary dentition and to compare which of these habits mostly affect open bite development. Materials and Methods: The sample consisted of 313 Iraqi children (135 boys, 178 girls), aged 3-5 years, enrolled at two public kindergartens in Baghdad city, the Capital of Iraq. A pre-tested questionnaire with clinical examination were used to obtain data regarding thumb sucking, pacifier and the presence of open bite. Excel sheets were used for data processing, and Chi square test was used in data analysis. Results: There was a significant association between NNSH and the development of open bite (p value = 0.01). No gender differences in open bite prevalence were observed. The prevalence of non-nutritive sucking habits and open bite was 63.11% and 52.9% respectively with no gender difference. There was no significant differences between the effect of pacifier and thumb sucking habits on the development of an anterior open bite. Conclusion: Both pacifier and thumb sucking at preschool age are significant causative factors that lead to development of open bite in primary dentition. Encouraging mothers to ban and discontinue pacifier and thumb sucking habits as early as possible in the child's life is a crucial factor to prevent open bite development. On the other hand if general health of the child indicates the use of pacifier, mothers should use an orthodontic pacifier and for short time.

The effects of thumb sucking habit on the development of malocclusions in preschool age children in Hilla city

Background: habit is any purposeless action repeated unconsciously. It is a sign of lack of harmony between the subject and the surrounding environment. Deleterious oral habits such as finger sucking could be one of the etiological factors for altered oro-facial growth development. This study conducted to explore the association between finger sucking habit and malocclusion in deciduous dentition. Materials and method: Totally 40 chronic thumb sucker and 40 controls matching in age and gender were enrolled in the study. A study conducted by verifying different occlusal trait through the intra-oral examination. Thumb sucking habit diagnosed using data gathered from parents. Results: The statistical analysis showed a highly significant difference (p>0.01) in the occurrence of anterior open bite, increased over jet between study and controls, in addition to that thumb sucking habit increased the likelihood of development of anterior open bite, increased overjet and posterior cross bite by 39 folds, 40 folds and 3 folds respectively. Conclusions: Thumb sucking habit found to be a risk factor for the development of anterior open bite and increased overjet.

The Fallacy of Tongue Thrust and Non-Surgical Treatment of a Severe Anterior Open Bite

1.1.Introduction: The causal relation between tongue thrust swallowing/habit and development of anterior open bite continues to be made in clinical orthodontics yet studies suggest a lack of evidence to support a cause and effect. Treatment continues to be directed towards closing the anterior open bite frequently with surgical intervention to reposition the maxilla and mandible. This case report illustrates a highly successful non-surgical orthodontic treatment without extractions. 1.2.Case report: After seeking treatment options since the age of 12 and undergoing several unsuccessful attempts to close her anterior open bite, the patient who is a dentist presents at the age of 33 and successfully completes non-extraction orthodontic treatment in 15 months. Post treatment results show a dramatic closure of the anterior open bite and proper interception of teeth with a proper over jet and overbite relation. A stable occlusion without an anterior overbite relapse is maintained at a two-year recall visit. 1.3.Conclusion: Tongue thrust swallowing as a cause of an anterior open bite appears more a fallacy than a direct cause. This case report illustrates the potential of non-extraction orthodontic therapy with a system of braces that utilizes light forces and moves the tooth roots toward their final position from the onset of treatment in a short of amount of time from weeks to months.

The prevalence of malocclusion and oral habits among 5-7-year-old children.

BackgroundDigit sucking, tongue thrust swallowing, and mouth breathing are potential risk factors for development of malocclusion. The purpose of this study was to verify the prevalence of different occlusal traits among 5–7-year-old children and assess their relationship with oral habits.Material/MethodsThe study included 503 pre-school children (260 boys and 243 girls) with a mean age of 5.95 years. Different occlusal traits were verified by intraoral examination. Oral habits were diagnosed using data gathered from clinical examination of occlusion and extra-oral assessment of the face, combined with a questionnaire for parents.ResultsThe study demonstrated that 71.4% of the children presented with 1 or more attributes of malocclusion and 16.9% had oral habits. The vertical and sagittal malrelation of incisors, as well as spacing, were the predominant features.This study showed that digit suckers have higher incidence of anterior open bite (P=0.013) and posterior crossbite (P=0.005). The infantile type of swallowing demonstrated strong association (P=0.001) with anterior open bite.ConclusionsNon-nutritive sucking habits and tongue thrust swallowing are significant risk factors for the development of anterior open bite and posterior crossbite in pre-school children.

Prevalence and associated factors for the development of anterior open bite and posterior crossbite in the primary dentition.

The aim of the study was to verify the prevalence of anterior open bite (AOB) and posterior cross-bite (PC) in the primary dentition and the association with sociodemographic factors, presence and duration of nutritive and non-nutritive habits. A cross-sectional study was carried out with 732 preschoolers in Campina Grande, PB, Brazil. Clinical exams were performed by three calibrated examiners (Kappa: 0.85-0.90). A questionnaire addressing sociodemographic data as well as nutritive and non-nutritive sucking habits was administered to parents/caregivers. Data analysis involved descriptive statistics and Poisson regression analysis (α=5%). The prevalence of AOB and PC was 21.0% and 11.6%, respectively. AOB was significantly associated with the three-year-old age group (PR: 1.37; 95%CI: 1.24-1.52), enrollment in public school (PR: 1.09; 95%CI: 1.01-1.17) and duration of pacifier sucking ≥ 36 months (PR: 1.41; 95%CI: 1.30-1.53). PC was associated with pacifier use (PR: 1.11; 95%CI: 1.05-1.17) and duration of breastfeeding <12 months (PR: 1.05; 95%CI: 1.00-1.10). Socioeconomic factors appear not to be related to AOB or PC in the primary dentition, except type of preschool. Breastfeeding should be encouraged for longer periods and the use of pacifier beyond 3 years of age represents a predisposing factor for both types of malocclusion, especially AOB.

Anterior open bite in pregnancy: a case series

The development of anterior open bite in adult patients, once growth is completed, is an unusual presenting problem in OMFS units. The underlying causative factors are most commonly related to trauma, infection or inflammation. There are other rare causes, which include endocrine conditions such as acromegaly.

Anterior open bite: a case–control study

The aim of this study was to assess the influence of sucking habits and facial pattern measurements on the development of anterior open bite (AOB). A case-control study was carried out on 60 children aged 7 and 8 years attending municipal public schools in the city of Recife, Brazil. Data collection included interviews with guardians, oral examinations, and facial growth pattern analysis using cephalometric radiographs. The following cephalometric measurements were assessed: SN.Gn, SN.GoGn, FMA, and Facial Axis. Statistical analyses were performed using the Student's t-test and Pearson's chi-square test at a 5% level of significance. The percentage of children with sucking habits in the case group was much higher than in the control group (53.3%vs 16.7%) (P = 0.003). Children with sucking habits were six times more likely to develop AOB. Regarding the measurements assessed, no statistically significant differences were observed between groups. This study found no evidence that variations in cephalometric angles (SN.Gn, FMA, SN.GoGn, and facial axis) are risk factors for AOB. Only sucking habits demonstrated a positive correlation with an increased AOB.

Etiological aspects of anterior open bite

Open bite is a multifactorial phenomenon and no single factor can account for open-bite. Etiology plays an important role in diagnosis. Heredity, unfavorable growth patterns, incorrect jaw postoure, are the characteristics of skeletal open bite. Depending on where the thumb is placed, a number of different types of dental problems can develop. Malocclusions of the late mixed or permanent dentitions, caused by thumb sucking are not self corrected and orthodontic treatment is necessary for their correction. In order to produce oral respiration, the mandible is postured inferiorly with the tongue protruded and resting against the oral floor. This postural alteration induces dental and skeletal modifications similar to those caused by thumb sucking. This may cause excessive eruption of the posterior teeth, leading to an increase in the vertical dimension of the face and result in development of anterior open bite. Tongue habits cause an anterior open bite or they develop secondarily to thumb sucking. In skeletal open bite the tongue habit acts as a secondary factor which helps to maintain or exacerbate the condition. Many orthodontists have had a discouraging experience of completing dental treatment, with what appeared to be good results, only to discover that the case had relapsed because the patient had a tongue thrust swallowing pattern. Dentoalveolar or habitual open bite is caused by habits, which influence the growth and development of dentoalveolar processes and contribute to occlusal disharmonies. Prior to eruption of adult dentition, open bite related to oral habits is usually not a concern as when the habits stop, because the erupting dentition tends to improve spontaneously. Treatment is usually not necessary until permanent teeth erupt (approximately 6 years old).

Aspectos etiológicos da mordida aberta anterior e suas implicações nas funções orofaciais

Open bite is a complex anomaly that has a difficult treatment. Frequently, unsatisfactory results and relapse of orthodontic treatment are observed. To associate orofacial malfunction and deleterious oral habits to anterior open bite. To congregate evidences for the better understanding of the etiology and of the development of anterior open bite and its potential association to myofunctional disorders. An exploratory study, to obtain relative risk measurements associating clinical characteristics, sucking habits and myofunctional alterations in 130 scholars. This study was developed in two stages: the first was based on a questionnaire about the child's oral habits which was answered by the parents, and the second involved odontologic and speech-language evaluations. In this sample, the most prevalent occlusion disorder was anterior open bite, which was associated to vertical facial growth (relative risk (RR) 3.12; confidence internal (CI) 1.20-9.90) and to Angle's Class II malocclusion (p-value = 0.01). An association was also observed for anterior open bite and lingual interference (RR 2.44; CI 1.13-5.27). The same was not observed for speech disorders (RR 0.80; CI 0.20-2.30). A correlation exists between the etiology of anterior open bite, deleterious oral habits, and a few orofacial malfunctions. An association between the history of deleterious habits and the occurrence of lingual interposition during swallowing, as well as with speech disorders was identified. These findings emphasize the necessary interaction between orthodontists and speech-language pathologist during the treatment of patients. The rehabilitation role of speech-language therapy stands out, through the oral myofunctional therapy, emphasizing the positioning of the tongue during swallowing, speech and when in habitual position.

A retrospective and prospective view of orofacial myology

Orofacial myofunctional disorders include specific conditions or behaviors that can have a negative impact on oral postures and functions. Historically, interest has focused on behaviors in the horizontal plane, highlighted by tongue thrusting. Currently, the scope of practice also includes tongue forward posturing, lip incompetence, open mouth rest posture, thumb and finger sucking, bruxism, and biting habits involving lips, fingers, tongue and cheeks. The common denominator for myofunctional conditions is a change in the inter-dental arch vertical rest posture dimension, the dental freeway space. The purposes of myofunctional therapy include normalizing the freeway space dimension by eliminating noxious habits or postures related to freeway space change. Improving cosmesis with a lips-together rest posture is also an important treatment goal. The clinical significance of the freeway space is explained in terms of the dental consequences of differential eruption patterns that can develop from postural modification of the freeway space. When the freeway space is opened for extended periods beyond the normal range, the tongue can act as a functional appliance and contribute to the development of anterior open bite or a Class II malocclusion. A clinical procedure is proposed for evaluating the freeway space dimension and incorporating the information into treatment planning and evaluation of treatment success. While dentistry/orthodontics has a primary focus on dental occlusion, or teeth-together relationships, orofacial myologists focus on teeth-apart behaviors and postures that can lead to, or have already resulted in malocclusion.

The effects of myotonic dystrophy and Duchenne muscular dystrophy on the orofacial muscles and dentofacial morphology

This article takes a closer view of two of the less rare myopathies, myotonic dystrophy (MyD) and Duchenne muscular dystrophy (DMD). A high prevalence of malocclusions was found among the patients affected by these diseases. The development of the malocclusions in MyD patients seems to be strongly related to the vertical aberration of their craniofacial growth due to the involvement of the masticatory muscles in association with the possibly less affected suprahyoid musculature. Thus, a new situation is established around the teeth transversely. The lowered tongue is not in a position to counterbalance the forces developed during the lowering of the mandible by the stretched facial musculature. This may affect the teeth transversely, decreasing the width of the palate and causing posterior crossbite. The lowered position of the mandible, in combination with the decreased biting forces, may permit an overeruption of the posterior teeth, with increased palatal vault height and development of anterior open bite. The development of the malocclusions in DMD patients also seems to be strongly related to the involvement of the orofacial muscles by the disease. However, the posterior crossbite is not developed owing to the narrow maxillary arch, as is the case in MyD patients. On the contrary, the posterior crossbite in DMD is due to the transversal expansion of the mandibular arch, possibly because of the decreased tonus of the masseter muscle near the molars, in combination with the enlarged hypotonic tongue and the predominance of the less affected orbicularis oris muscle.

Differences between the functional matrices in anterior open-bite and in deep overbite

The position of the three neural foramina describing the course of the inferior alveolar nerves was studied, with the aid of a previously determined logarithmic spiral, in cases of anterior open-bite and deep overbite. In anterior open-bite, the position of the foramen ovale was shown to be characteristically lower on this spiral than it is in any other condition studied; indeed, it is a diagnostic characteristic. The significance of this finding in the discussion of the problems of mandibular size and shape in these conditions was discussed. The etiologic role of periosteal and capsular functional matrices in the development of anterior open-bite was analyzed, and capsular matrices, with their related processes of passive translative growth, were held to be developmentally primary. Finally, an associated difference in the spatial location of the oral space in anterior open-bite was discussed. In essence, anterior open-bite was found to be a condition associated with specific spatial and developmental abnormalities of the oral functioning space, acting as a capsular matrix. All observed skeletal tissue changes are but secondary, compensatory, and mechanically obligatory responses to the morphogenetically and temporally prior alterations of this capsular matrix. Clinicians should carefully differentiate between the causes of an observed deformation of the orofacial skeleton and its etiologic factors. In anterior open-bite, they are completely different.