Digit Sucking Research Articles

Persistência de hábitos de sucção não nutritiva: prevalência e fatores associados

OBJETIVOS: identificar a prevalência de hábitos de sucção não nutritiva em pré-escolares e verificar fatores associados a sua persistência. MÉTODOS: estudo transversal e analítico realizado por meio de questionário com responsáveis de 524 crianças em 17 centros educacionais públicos de Recife/PE. Variáveis dependentes (sucção digital e de chupeta) e independentes, relacionadas à criança (sexo, idade, aleitamento materno, uso de mamadeira, enurese noturna, turnos na unidade educacional, cuidador, ordem de nascimento, visita ao dentista) e a sua mãe (escolaridade, idade, renda familiar, trabalho fora do domicilio, turnos de trabalho, coabitação, orientação sobre hábitos), foram associadas, usando os testes estatísticos qui-quadrado de Pearson, Exato de Fisher e regressão Poisson. RESULTADOS: prevalência de hábitos de sucção não nutritiva de 57%: 47,5% apenas sucção de chupeta. Após análise multivariada, as variáveis: tempo de aleitamento materno e uso de mamadeira continuaram associadas ao uso de chupeta, enquanto que as variáveis: escolaridade materna, uso de mamadeira, idade e sexo da criança encontraram-se fortemente associadas à sucção digital. CONCLUSÕES: alta prevalência de hábitos de sucção não nutritiva, sendo a chupeta mais frequente. Aspectos associados ao padrão de aleitamento foram apontados como principais fatores explicativos à persistência destes hábitos em pré-escolares e os aspectos psicossociais tiveram poder de associação relevante.

Interceptive orthodontics – current evidence-based best practice

This article examines the key areas relating to interceptive orthodontics, ie crossbites, anterior and posterior; eruption problems and impaction (including incisors and canines); poor quality first permanent molars; infra-occluded primary molar teeth; non-nutritive sucking habits (digit and pacifier sucking) leading to anterior openbite, posterior crossbite and increased overjet; centreline shifts related to unilateral loss of primary teeth; and increased overjet and associated risk of trauma. It aims to provide information and recommendations. The GDP requires evidence to support the clinical management of common problems presenting in the mixed dentition.

Nonextraction treatment of open-bite by sequential uses of tongue crib, temporary anchorage devices and myofunctional therapy: A case report of an adolescent

This report of a case describes the nonsurgical and nonextraction treatment of a female adolescent with severe skeletal open-bite using the tongue crib appliance, the quad-helix appliance, temporary anchorage devices (TADs) and myofunctional therapy. The tongue crib appliance and the quad-helix appliance were used to eliminate the digit sucking habit and to modify the tongue position. With TADs, the overerupted molars were intruded. After the post-active treatment, daily gum-chewing exercise for 15min and lip closure training were performed to produce effective retention. Successful esthetic improvement from convex type profile to straight type profile was achieved, and post-treatment occlusal stability was maintained after 3-year retention with the strengthened masticatory muscle tone and modified tongue position.

Oral Sessions

Background: Approximately 10% of children have maintained a digit sucking habit which is associated with anterior open bite and other malocclusions. Effects and costs of appliances developed to correct the oral habit and the consequent malocclusions remain controversial. Aim: To conduct a case-control study of digit sucking behaviour in a sample of 4-to-12-year-olds in Australia, with a special interest in the effect of orofacial myology management on cessation of the oral habit and correction of the consequent anterior open bite. Design: With appropriate ethics approval, patient records from a local clinic were de-identified and screened. Children having displayed digit sucking behaviour and anterior open bite were included. A 3-month management programme containing daily placement of a stomahesive wafer on the incisive papilla, behaviour shaping, reward charts and supportive phone calls was carried out. Data collected included age, gender, digit sucking behaviour and anterior open bite. A paired-samples t-test was used to examine occurrence of digit sucking behaviour and anterior open bite over the 3-month course. Results: Twenty-one (67.7%) girls and 10 (32.3%) boys completed the programme. There was no difference in age distribution between girls and boys (t = 1.434, df = 29, P = 0.162). Upon completion, twenty-six out of 31 children (83.9%) gave up digit sucking behaviour (t = 12.490, df = 30, P < 0.001). Occurrence of anterior open bite reduced from 19 patients (61.3%) to five patients (16.1%) (t = 4.971, df = 30, P < 0.001). Conclusion: The 3-month programme of orofacial myology management is effective in cessation of digit sucking behaviour and correction of digit-sucking-related anterior open bite. Future investigation is indicated.

Digit sucking – what to do

Dentists are often questioned by anxious parents about the effects of digit sucking and the possible ways of stopping their child's habit. This article discusses the aetiology, prevalence and effects of digit sucking, various means of stopping the habit and the problems that may occur if digit sucking persists into the permanent dentition. Clinical Relevance: Digit-sucking habits can have a detrimental effect on the development of the occlusion. Various methods are discussed to help children to stop.

Modified quad helix appliance for thumb sucking and cross bite correction

Digit sucking habit is a learned pattern of behavior commonly seen in children of preschool age. Prolonged digit sucking beyond the preschool age, lead to the development of malocclusion such as anterior open bite, maxillary constriction and posterior crossbite. Treatment strategies include interception of habit and correction of the malocclusion. The present case report describes a modified quad helix appliance used successfully in a 9-year-old child to intercept thumb sucking habit and simultaneous correction of posterior crossbite. The appliance has the advantage of easy fabrication, being versatile and more patients compliant.

Onychophagia and postorthodontic isolated gingival recession: Diagnosis and treatment

This clinical report describes the diagnosis and the management of isolated-type recession defects of complex etiology in 2 healthy postorthodontic patients. The lesions were confined to 1 mandibular incisor and were associated with an abnormal buccolingual inclination of the affected tooth despite a lingual retainer made with a round stainless steel twisted wire. After careful questioning, it was determined that the recession defects were indirect effects of habitual onychophagia. The concomitant fingernail-biting habit and the lingual bonded retainer led to the indirect development of bone dehiscence and, consequently, gingival recession.

Prevalence of non-nutritive sucking habits and its relation with anterior open bite in children seen in the Odontopediatric Clinic of the University of Pernambuco

OBJECTIVE: The aim of this work was to establish the prevalence of non-nutritive sucking habits (pacifier and/or digit sucking) and to assess its relation with anterior open bite. METHODS: The sample consisted of 980 records of children of both genders, with ages between 3 and 12 years, who were treated at the Pediatrics Clinic of the University of Pernambuco (FOP/UPE), from February 2000 trough December 2005, both sexes. Pearson's Chi-square test at 5% level of significance was used for statistical assessment. RESULTS: It was observed that 17,7% of the sample had some habit at the moment of the anamnesis (9,6% of digit sucking habit, 8,8% of pacifier sucking habit and 0,7% of both habits) and that the prevalence of open bite was 20,3%. The prevalence of sucking habits in girls was much higher than in boys (22,6% and 12,9%, respectively) and this difference was statistically significant (p = 0,000). A correlation between habits and open bite was proved statistically (p = 0,000): Children with sucking habits had 8 times more chances of developing anterior open bite. CONCLUSIONS: Anterior open bite was associated to the presence of non nutritive sucking habits; sucking habits were more prevalent in girls and in children between three and six years of age.

Oral habits in a group of consecutively treated orthodontic patients, using standardized video recordings for diagnosis

Objective.To investigate the prevalence and correlation of soft tissue dysfunctions documented by standardized video recordings in a group of orthodontic patients and to evaluate orthodontic treatment changes. Subjects and methods.The presence of an oral habit was evaluated from standardized pre- and post-treatment video recordings of 80 consecutive patients (30 boys and 50 girls, mean age 12.2 ± 1.7 years). Any digit-sucking habit was noted during a routine interview. Pre- and post-treatment cephalograms were traced to assess sagittal and vertical jaw and incisor relationships. Correlations and differences were tested for statistical significance using the t-test and Odds-ratio. Results.56.3% had one or more habits before treatment. The total prevalence fell during treatment. A clear correlation was found between digit sucking and atypical tongue activity. Pre-treatment cephalograms showed that patients with a habit had a larger overjet, smaller overbite, more proclined and protruded incisors, a greater ANB angle and a greater inter-maxillary angle (ML/NL) than those without a habit. Cephalometric differences between the groups after orthodontic treatment were much less pronounced. Those with an oral habit also showed a tendency for increased treatment time/number of visits. Conclusions.Standardized video recordings improved the reliability of the recordings of the oral soft tissue dysfunctions. Their overall reduction after the end of orthodontic treatment coincided with a normalization of the sagittal skeletal and dental variables.

Bottle feeding, increased overjet and Class 2 primary canine relationship: is there any association?

The aim of this study was to investigate the association between bottle feeding and prevalence rates of increased overjet and Class 2 primary canine relationship. The sample consisted of 911 children (461 boys, 450 girls) aged 3 (13.9%), 4 (40.8%), 5 (34%) and 6 (11.3%) years, with complete primary dentition. Information about nutritive and nonnutritive (pacifier and/or digit) sucking habits was collected through questionnaires. Three calibrated dentists (κ: 0.9-1.0 and Rs > 0.90) performed the clinical assessments. The children were divided into four groups: G1 - not bottle-fed; G2 - exclusively bottle-fed; G3 - breast- and bottle-fed, bottle feeding ceased before 3 years of age; and G4 - breast- and bottle-fed, bottle feeding ceased between 3 and 4 years of age. Associations between nutritive and nonnutritive sucking behaviors and the malocclusions studied were analyzed by multiple binary logistic regression (α= 0.05). The frequencies of increased overjet were: 25.3% (G1), 38.8% (G2), 39.2% (G3) and 47.8% (G4). The percentages of Class 2 canine relationship were: 27.9% (G1), 48.8% (G2), 43.4% (G3) and 43% (G4). No significant effect of bottle feeding was found. The chances of diagnosing increased overjet (O.R. = 4.42, p < 0.001) and Class 2 canine relationship (O.R. = 4.02, p < 0.001) were greater for children with pacifier and/or digit-sucking habits, compared to those without a history of nonnutritive sucking behavior. It may be suggested that bottle feeding alone is not directly associated with higher prevalence rates of increased overjet and Class 2 canine relationship in the primary dentition.

Confirmational study: a positive-based thumb and finger sucking elimination program

This article emphasizes the critical need for information specifically regarding the topic of retained sucking behaviors. The study aimed to confirm results provided by Van Norman of 723 subjects in 1997. Parent surveys were collected on 441 subjects who received an orofacial myofunctional treatment program provided by one certified orofacial myologist. Results of this study do confirm that retained digit sucking behavior may be addressed successfully and expediently by a program based on positive behavior modification techniques.

Correction of Anterior Open Bite and Facial Profile by Orthognathic Surgery– A Case Report

This case report describes the treatment of a severe anterior open bite, Class III malocclusion with a history of digit sucking. An 18 years-old male presented with a significant anteroposterior and vertical discrepancy of face. The patient’s face was concave with procumbent lips. He had an anterior open bite of 11 mm, a reverse overjet of 8 mm, and a transverse maxillary deficiency on right side. The orthognathic surgery was elected as an option of treatment to correct the anterior open bite with improvement of facial profile. Keywords: Anterior open bite; Transverse maxillary deficiency; Vertical excess; Orthognathic surgery. DOI: 10.3329/bsmmuj.v3i1.5512 BSMMU J 2010; 3(1): 31-34

The occlusal effects of digit sucking habits amongst school children in Northamptonshire (UK)

To compare the occlusal characteristics of persistent digit suckers with those of a group of individuals who reported never to have sucked their thumb or finger. School children and regular attenders to four general dental practices in Kettering, UK. Cross-sectional, observational. Prevalence of anterior open bite, posterior crossbite, size of overjet, overbite and buccal segment relationship. The exposed group consisted of 7-13-year-old children with a persistent digit sucking habit or those who had given up the habit less than 2 years previously, compared with an unexposed group of children who had never reported a history of the habit. Upper and lower alginate impressions were taken and the resultant study models were used to measure occlusal differences between the two groups. Following exclusions, 39 digit suckers were compared to 36 non-suckers. The odds of a reduced overbite being present were significantly higher in the digit sucking group compared to the non-suckers (OR: 5.6, 95% CI: 1.6-20.8). The prevalence of anterior open bites was higher in the digit suckers (P<0.001). Although the overjet was slightly increased in the digit suckers compared with the non-suckers (mean difference: 1 mm, P = 0.036), this result needs to be interpreted with caution. No significant differences were seen in the presence of posterior crossbites or buccal segment relationships between the two groups. This study has shown that reduced overbite and anterior open bites were significantly more prevalent in digit suckers. The orthodontic management of anterior open bites can involve complex and prolonged treatment. Early intervention to eliminate digit sucking habits is therefore recommended on both oral health and health economic grounds.

A survey of methods and practices used to stop digit sucking in 2-5 year old children in Benin Cit, Edo State

A survey of methods and practices used to stop digit sucking in 2-5 year old children in Benin Cit, Edo State

Hábitos de Sucção Não Nutritivos, Respiração Bucal, Deglutição Atípica - Impactos na Oclusão Dentária

ObjectiveReview the consequences of non-nutritive sucking habits, oral breathing and atypical deglutition on the occlusion. TopicsBreastfeeding duration has directly been related with the appearance of non-nutritive sucking habits. On the digital sucking as well as on the atypical deglutition there is a certain age when the habit turns pathologic. This will have poor consequences on the stomatognathic system. Oral breathing and its consequences must be handled by a multidisciplinary team of professionals in order to achieve success. Developed workThe bibliographic research was made on a series of data bases, like Medline database, B-on, Scielo, Scopus and Cochrane Library.

Digital sucking induced trophic ulcers caused by nerve deficit from amniotic constriction band

Two infants presented with amniotic constriction bands (ACB) in the distal third of the forearm. After teeth eruption they developed recurrent skin ulcerations mainly in the distribution of the median nerve from digital sucking. Both patients underwent reconstruction with multiple Z-plasties, followed by neurolysis of the ulnar nerve and sural nerve grafting of the median nerve. This neurological complication presented late in ACB as ulcerative lesions and secondary infection from digital sucking on the insensate digits. Thorough physical examination of the extremities at an early stage in children with ACB is essential to exclude an occult neurological dysfunction. Exploration of peripheral nerves is warranted in cases of deep forearm ACB during their soft tissue reconstruction.

A influência do padrão de aleitamento no desenvolvimento de hábitos de sucção não nutritivos na primeira infância

This study verified the relationship between nonnutritive sucking habits and feeding methods in children from 12 to 36 months of age, attending public nursery schools in the city of João Pessoa, Paraíba State. The sample consisted of 292 children of both gender and the data were collected by interviewing the children's mothers or minders. The information of the forms consisted on the description of the frequency and duration of the nonnutritive sucking habits, as well as on the feeding methods. The data were analyzed through the statistical program SPSS, taking place distributions of frequencies and qui-square test and Fisher Exact. In relation to the presence of nonnutritive sucking habits, 69.2% of the children had some type of habit, being 61.6% the pacifier sucking and 8.2% the digital sucking. From the entire sample, 10.2% presented exclusive breastfeeding, 4.9% were just bottle-fed and 84.9% were breast-fed and bottle-fed. Considering the methods of feeding, 83.8% of the children presented exclusive breastfeeding during the first 6 months of life. The feeding methods presented significant association with the presence of nonnutritive sucking habits. As larger the duration of the exclusive breastfeeding, smaller the prevalence of sucking habits.

Oral habits, prevalence and effects on occlusion of 4-15 year old school children in Lagos, Nigeria

To determine the prevalence of oral habits and assess the effects of these habits on the occlusion in a group of Nigerian schoolchildren. A cross-sectional study of 928 children aged 4-15 years from Eti -Osa local government area in Lagos, Nigeria. The sample population was selected from 2 private and 3 public schools. Three hundred and sixteen children (34.1%) of total children examined, exhibited one form of oral habit or another. The most common habit observed was digit sucking which was observed in 17% of the children. Increased overjet was observed in 33% of the habit children. This was significantly higher than findings in children without the habit who recorded an increased overjet of 25.3%. Anterior open bite was observed in 12.5% of habit children and 3.1% of non-habit children. Statistically significant differences in the occurrence of upper incisor proclination, lower incisor retroclination and lip incompetence were also observed occurring more frequently in the oral habit group. Posterior crossbite was observed in 1.9% of the habit group and 1.5% of the non-habit group. This difference was not statistically significant. This study shows an increased prevalence of oral habits when compared to previous studies in this region. Increased overjet and anterior open bite were the most commonly occurring occlusal anomalies associated with oral habits. There is a need to reduce the occurrence of permanent occlusal deformation due to the persistent form of these habits through dental health education among Nigerian children.

Contexto familiar e alterações oclusais em pré-escolares no município de Salvador, Bahia, Brasil

OBJETIVOS: avaliar a prevalência e a associação entre variáveis sócio-ambientais e a maloclusão infantil. MÉTODOS: estudo transversal, em crianças de 1-5 anos, residentes em seis áreas do Programa de Saúde da Família, em Salvador, Bahia, Brasil. Foram sorteadas 360 famílias pré-estratificadas, pelo cadastro das famílias das Unidade de Saúde da Família (USF) (415 pré-escolares). Após a identificação, foram realizadas visitas domiciliares onde foram entrevistados os pais/responsáveis e as crianças examinadas. Foram utilizados como instrumentos a ficha A - Sistema de Atenção Básica, e o exame oclusal - presença ou ausência de alteração e tipo de desvio. A análise de regressão logística foi utilizada (p&lt;0,05). RESULTADOS: 34,5 % das crianças apresentaram maloclusão; 77,2% residiam em habitações com mais de quatro cômodos e 64,8% das crianças foi aleitada naturalmente e destas, 50,6% por sete meses ou mais. Não tinham o hábito da sucção digital, 89,6% das crianças, mas uso da chupeta foi registrado em 47%. A análise de regressão logística identificou as associações: o número de indivíduos menores de 14 anos na residência (OR=1,44; IC95%: 1,02 - 2,26), sucção digital (OR=1,75; IC95%: 1,08-3,46) e ter adulto com uso abusivo de álcool (OR=1,22; IC95%: 1,04 - 2,02). CONCLUSÕES: ampliar o acesso à saúde oral pode refletir positivamente na saúde oral e qualidade de vida das crianças.

Self-Inflicted Gingival Injury Due to Habitual Fingernail Scratching: A Case Report with a 1-Year Follow Up

Injuries to oral soft-tissues can occur due to accidental, iatrogenic, and factitious traumas. Traumatic lesions, whether chemical, physical, or thermal in nature, are among the most common in the mouth. A type of physical injury to the gingival tissues is self-inflicted. Sometimes the lesions are termed gingivitis artefacta. Self-inflicted gingival injuries in children and adolescents can occur as a result of accidental trauma, premeditated infliction, or chronic habits such as fingernail biting, digit sucking, or sucking on objects such as pens, pencils or pacifiers. The purpose of this case report was to illustrate the destructive nature of the habit and to describe the successful treatment of this case. A 14-year-old girl with moderate pain, gingival bleeding and recession in the anterior mandibulary region was admitted to periodontology clinic. Upon questioning, the patient readily admitted traumatizing her gingiva with her fingernail. Treatment consisted of oral hygiene instruction, mechanical debridement, psychological support and surgical periodontal treatment. Postoperatively, complete root coverage, gains in clinical attachment levels, and highly significant increases in the width of keratinized gingiva were observed. This case report shows that it is possible to treat gingival injury and maintain the periodontal health of a patient with destructive habit. Patient compliance, regular dental follow-ups, and psychological support may be useful in stabilizing the periodontal condition of these patients. Dentists must be aware that self-inflicted gingival injury, although thought to be uncommon, is quite widespread.