Parafunctional Oral Habits Research Articles

Problematic screen exposure and oral health in preschool children: a comparison study

ObjectivesRecent studies have highlighted the association between problematic screen exposure (PSE) in preschool children and various health issues. This study aims to determine the relationship between PSE and oral/dental health as well as parafunctional oral habits in this population.MethodsHealthy children aged 3 to 6 years who visited the pediatric dentistry outpatient clinic were included in the study. PSE was evaluated using the parent-reported ‘Seven-in-Seven-Screen-Exposure Questionnaire’. An intraoral examination was conducted to record the number of decated, missing, and filled teeth, along with scores from the International Caries Detection and Assessment System II (ICDAS II), as well as dental plaque and gingival indices.ResultsA total of 210 mother–child pairs were included in the study, comprising 70 pairs with PSE and 140 pairs without PSE. The sociodemographic characteristics, frequency of daily tooth brushing behaviors, use of children's toothpaste, and regular dental examinations were statistically evaluated between the PSE and non-PSE group (p > 0.05). Additionally, there was no statistically significant difference between the groups in terms of having abnormal oral habits (p > 0.05). In the PSE group, the median scores for gingival and plaque index were significantly higher (p = 0.011 and p = 0.006, respectively). The median number of decayed teeth was significantly higher in the PSE group (p = 0.039).ConclusionsTurkish preschool children with PSE were found to have a significantly higher likelihood of experiencing poor oral health. Consequently, it is essential to conduct oral health examinations for Turkish preschool children exhibiting PSE. The study may have clinical implications for the evaluation of preschool children with problematic media use within dental practice.

The Association Between the Central Sensitisation Inventory and Temporomandibular Disorders Is Confounded by Migraine, Depression, Widespread Pain and Parafunction. A Cross-Sectional Telehealth Study.

Temporomandibular disorders (TMDs) are conditions that involve the temporomandibular joints, masticatory muscles, and associated tissues, causing orofacial pain. Central sensitisation (CS) is a relevant part of the TMD pathophysiology. Migraine, psychological aspects, parafunctional oral habits and widespread pain are commonly associated with both TMD and CS and could confound the association between them. To investigate the association between painful TMD and the Central Sensitisation Inventory (CSI) score, and to assess the presence of confounders in this association. Cross-sectional study that assessed women with and without orofacial pain complaints using telehealth. The TMD Pain Screener and an online physical examination determined the presence of painful TMD. The following questionnaires were applied: CSI, Headache Screening Questionnaire, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, Oral Behavior Checklist, Jaw Functional Limitation Scale and the Nordic musculoskeletal questionnaire. A single regression investigated the association between the CSI score and TMD, and a multiple regression investigated the effect of the other outcomes as possible confounders. Confounding was considered present when the association between TMD and the CSI score changed more than 10% after adding a possible confounder to the regression model. Forty-two women with painful TMD and 53 without TMD were included. There was a significant association between the CSI score and the presence of painful TMD (R2 = 0.639; p < 0.001). This association changed when the following outcomes were added to the model: presence of migraine, symptoms of depression, widespread pain and parafunctional oral habits. The positive association between TMD and the CSI score was confounded by migraine, symptoms of depression, widespread pain and parafunctional oral habits.

The Potential of Percent Agreement as an Adjunctive Diagnostic Tool for Acute Temporomandibular Disorder.

Background/Objectives: It is well established that individuals with chronic temporomandibular disorder (TMD) exhibit differences in their physical and psychosocial characteristics from those with acute TMD. However, few studies have analyzed the physical and psychosocial characteristics of patients with acute TMD. The objective of this cross-sectional study is twofold: first, to ascertain whether there are differences in physical and psychosocial factors among patients with acute TMD based on the percent agreement between patient-reported pain sites and pain sites identified through standardized palpation and, second, to determine the potential of percent agreement as a diagnostic and prognostic factor. Methods: We analyzed physical and psychosocial factors in 309 patients diagnosed with acute TMD. Of these, 171 patients were selected for an analysis of their response to treatment. These patients were divided into three groups based on their percent agreement: Group A (agreement under 80%), Group B (agreement 80-89%), and Group C (agreement 90% or over) in the initial analysis and Group a (agreement under 80%), Group b (agreement 80-89%), and Group c (agreement 90% or over) in the subsequent analysis. This study was approved by the Ethics Committee of Pusan National University Dental Hospital (IRB No. 2023-05-011, 25 May 2023). Results: The lower the percent agreement, the greater the parafunctional oral habits, stress, chronicity, somatization, depression, anxiety, and number of painful sites. A lower percent agreement was associated with poorer treatment outcomes. The percent agreement demonstrated a 41.2% capacity to predict residual pain after treatment. Conclusions: Clinicians can utilize percentage agreement as an adjunctive diagnostic tool to provide more suitable treatments to patients.

The Effect of Implant Length and Bone Quality on the Biomechanical Responses of Dental Implant and Surrounding Bone – A Three-Dimensional Finite Element Analysis

The robustness of dental implant systems in the context of occlusal restoration relies significantly on biomechanical factors associated with the imposition of excessive loads. These factors encompass the macro geometries of the implants, bone qualities, parafunctional oral habits, and specific materials employed. The choice of different implant lengths in different bone qualities may give rise to distinct effects on the way loads are distributed across the interface between the implant and the adjacent bone. As of now, the influence of implant length and bone quality on the surrounding tissues and the stability of implant structure continues to be a matter of debate and uncertainty, particularly in situations involving the possibility of implant failure. This study employed three-dimensional finite element analysis to investigate five distinct implant lengths (4, 6, 10, 13, and 15 mm) in two types of bone quality (type II and III). The bone tissues were characterized through the utilization of computed tomography image datasets and then underwent processing within the SolidWorks software. All geometric configurations were transformed into finite element models, which were subjected to analysis within the ANSYS software. Anisotropic and isotropic properties were attributed to the bone and implant models, respectively. A dynamic occlusal loading quantified at 300 N was applied to the implant body, accompanied by a pre-tension force of 20 N on the screw component. The longer implants exhibited decreased stress magnitudes in type II bone (87.86 – 36.66 MPa) and increased stress magnitudes in type III bone (80.5 – 2128.9 MPa) within the surrounding bone tissue, in comparison to the shorter implants. However, stress within the implant body was generally elevated with the use of longer implants in both bone types (type II: 505.32 – 625.35 MPa; type III: 500.45 – 2186.7 MPa). Irrespective of bone quality, the longer implants predominantly led to lower bone strain levels (type II: 0.006828 – 0.003328; type III: 0.054250 – 0.021678) and overall deformation of the implant-abutment assembly (type II: 0.1458 – 0.1348 μm; type III: 0.1754 – 0.1492 μm) compared to their shorter counterparts. Among all the assessed findings, type III bone displayed a more pronounced adverse impact on the biomechanical responses of the dental implant and neighbouring bone except for the implant stresses under the applied physiological loading.

Impact of working and learning from home during the COVID-19 pandemic on the head, the neck and orofacial health: A cross-sectional pilot study.

During the coronavirus disease 2019 (COVID-19) pandemic, about 81% of the world's population moved their workplace to a home office. The main objective of this cross-sectional pilot study was to determine the impact of working and/or learning from home during the COVID-19 pandemic on the head, the neck and orofacial health in university students, faculty and staff. Participants from 4 universities were recruited for an online survey. The survey included 33 questions related to demographics, health issues before and during the lockdown, work/study from home, and the awareness of the health effects of the lockdown. Descriptive statistics and single logistic regression analysis were employed. A total of 96 subjects aged 26 ±10.5 years participated in the study. Of these, 60% did not consider their home workstation to be adequate. The development of new symptoms or the worsening of the pre-existing symptoms was observed in 67%, 24%, 59%, and 37% of the participants with regard to neck pain, temporomandibular joint (TMJ)-related issues, headaches, and parafunctional oral habits, respectively. In addition, 87% of the respondents reported that their oral habits were aggravated by neck pain and a bad posture. As compared to the faculty and the staff, the students were more likely to experience headaches or the exacerbation of the pre-existing headaches during the pandemic. In the survey, 91% of the participants reported an increased awareness of the impact of the lockdown on their head and neck, and orofacial health. The present study helps understand the self-perceived effects of working and/or learning from home during the COVID-19 pandemic, and may facilitate implementing the appropriate models of treatment of the craniocervical-mandibular region during a pandemic.

Cheiloscopy patterns in individuals with and without parafunctional oral habits: A cross-sectional observation pilot study.

Lip prints are unique and have potential for use as a human identifier. The purpose of this study was to observe possible cheiloscopy differences of individuals with and without parafunctional oral habits such as smoking, vaping, playing a wind instrument or using an asthma inhaler. This IRB approved blinded cross-sectional observation pilot study collected lip prints from 66 individuals, three of which were excluded. Participants cleansed their lips, then lipstick was applied to the vermillion zones of the upper and lower lips. Adhesive tape was applied to the lips and prints were transferred to white bond paper for viewing purposes. Each set of included lip prints was divided into quadrants and dichotomized into a group of those with an oral parafunctional habit or with no such habits. Each quadrant sample was then manually analysed and classed according to the gold standard Suzuki and Tsuchihashi system. A total of 252 dichotomized lip print quadrants (with habits n = 76, 30.2%, and without habits n = 176, 69.8%) were analysed. Type II patterns were the most common for examined quadrant samples; however, no statistically significant differences (Pearson's chi-squared test, p = 0.366) were observed between pattern classifications of samples with and without parafunctional oral habits. There is no statistically significant difference of lip print patterns between individuals with and without parafunctional oral habits. Further research on populational variations is needed for cheiloscopy to aid in human identifications.

Bruxism, parafunctional oral habits and oral motor problems in children with spastic cerebral palsy: A cross-sectional study.

Individuals with spastic cerebral palsy are more predisposed to parafunctional oral activities and oral motor problems because of spasticity. The aim of the study was to evaluate the relationship between the gross motor function classification system score (GMFCS), age, bruxism, parafunctional oral habits and oral motor problems in children with cerebral palsy. This cross-sectional study included 63 children with spastic cerebral palsy, aged 3-18 years, with developmental disabilities. The relationship between parentally reported bruxism, parafunctional oral activity rates, oral motor problems, and GMFCS was analysed. The prevalence of bruxism was 52.4%, and the rate decreased as age increased. There was a greater likelihood of bruxism in individuals with tongue thrust (OR [95% CI] = 8.15 [1.4-47.3]) and swallowing problems (OR [95% CI] = 5.78 [1.3-24.68]). In children with spastic cerebral palsy, bruxism and the rate of parafunctional oral habits were high, thus affecting oral motor activities. A relationship was found between oral motor problems and increased GMFCS levels, but no relationship was found between bruxism and GMFCS levels. Children with spastic cerebral palsy who display tongue thrust or swallowing problems have an increased likelihood of presenting with bruxism.

Problematic media use is associated with poor oral health in Turkish school-age children: a pilot cross-sectional study

ObjectivesIn the recent years, problematic media use (PMU) has become a serious health concern for children. The precisely defined effects of PMU on children’s oral health are unknown. It was aimed to investigate the relationship between the PMU and oral health and oral habits in school-age children.MethodsIn this cross-sectional study, mothers and their healthy children aged 6–11 years who applied to pediatric dentistry outpatient clinic were enrolled. PMU was assessed using the parent-reported Problematic Media Use Measure Short Form (PMUM-SF). PMUM-SF scores were divided into 3 groups from the lowest to the highest tertile. Multivariable logistic regressions for PMU (moderate-high vs. low) were used to predict the odds of having good and parafunctional oral habits, poor oral hygiene, gingivitis and caries.ResultsTotally 153 mother–child pairs participated in this study. Plaque index, gingival index, ICDAS-II (International Caries Detection and Evaluation System), DMFT and DMFS [decayed (D), missing (M), filled (F) tooth (T) /surfaces (S)] scores were significantly higher in children with moderate-high PMU (P < 0.05). After adjusting for potential confounders, moderate-high PMU decreased the probability of good oral habit of daily toothbrushing [Odds (95% CI) = 0.43 (0.20–0.94)] while it increased the risk of oral parafunctional habit of object sucking/biting [Odds (95% CI) = 3.34 (1.27–8.74)]. Moderate-high PMU increased the risk of moderate-severe gingivitis, moderate-extensive caries and the presence of DMFT [Odds (95% CI) = 2.13 (1.01–4.50); 4.54 (1.11–18.54) and 2.16 (1.07–4.36), respectively].ConclusionsTurkish school-age children with a remarkable PMU were significantly more likely to have poor oral health and exhibit oral parafunctional habits Oral health screening seems to be needed for Turkish children experiencing PMU.

Parafunctional Oral Habits: Frequency and Association with Malocclusion Traits in Adolescents

OBJECTIVE: To determine the frequency of parafunctional oral habits and their association with types of malocclusions in all three planes among the adolescents. METHODOLOGY: This cross-sectional study involved 610 students studying in 8 different schools of Raiwind, Lahore. Ethical approval for the study was obtained from Sharif Medical and Dental College, Lahore. Data was collected by the primary researcher and recorded in predesigned proforma. Each student was inspected while seated in an upright position in natural day light, using disposable wooden blades to retract the cheek to record posterior dental relationships and to retract lips to record anterior dental relationships. Data was scrutinized using SPSS and chi-square test was used to find the statistical significance of the association between various parafunctional oral habits and types of malocclusions. RESULTS: The frequency of parafunctional oral habits was 57.3% among 610 adolescent students, being more prevalent in females (72.9%) than males (52.3%). The most common oral parafunctional habit was bruxism (18.0%) and least frequent was thumb sucking (8.4%). Association between oral parafunctional habits and malocclusion in all three planes was found to be significant (p=0.0). CONCLUSION: The parafunctional oral habits such as bruxism, tongue thrusting, nail biting, mouth breathing and thumb sucking are very commonly found among adolescents in the same descending order. Most common malocclusions found to be associated with parafunctional oral habits are exaggerated over-jet, open bite and deep bite. Parafunctional oral habits have a strong influence on developing malocclusion traits in all three dimensions. KEYWORDS: Parafunctional oral habits, malocclusion, thumb sucking, tongue thrusting, mouth breathing, bruxism, nail biting.

THE EFFECT OF MATERIAL STIFFNESS ON DENTAL IMPLANT STABILITY – A FINITE ELEMENT ANALYSIS

The perseverance of dental implant system in restoration of occlusion is highly dependent on biomechanical overloading factors such as implant macro geometries, parafunctional oral habits, and material. Different implant materials could affect the load transfer at the bone-implant interface differently which is related to stress shielding phenomenon. To date, the role of various implant materials on the surrounding tissues as well as implant stability is still debatable and unclear especially when the implant failure is of concern. Through this study, implant body with different materials or stiffnesses that are zirconia, Ti-6Al-4V, cpTi, TiZr, and PEEK were investigated via 3-D FEA. The bone tissues were modelled based on CT image datasets and subsequently be processed in SolidWorks software. All geometries were converted into finite element models and analysed in ANSYS software. The bone and implant models were assigned with anisotropic and isotropic properties, respectively. A dynamic occlusal loading of 300 N and pretension of 20 N were applied on the implant body and screw, respectively. The results showed that the less stiff implant increased the bone stress and decreased the implant body stress values compared to the stiffer implant. Moreover, the implant with lower stiffness exhibited lower bone strain and higher implant deformation than the implant with higher stiffness. Of all implant materials analysed, PEEK is observed to be the most satisfactory. However, further modifications on PEEK would be necessary to improve inherent bioactivity and osseointegration.

Pediatricians’ Knowledges, Attitudes and Practices on Parafunctional Oral Habits and Orthodontic Problems in Children

ABSTRACT&#x0D; Objective: Treatment of dentofacial deformities via orthodontics can improve the health of the teeth and the gums and also numerous malpositioned teeth and jaws and increase the quality of life in children affected with malocclusion. The purpose of this research was to examine whether pediatricians refer their patients to pediatric dentists, whether they have sufficient knowledge and awareness in parafunctional habits and basic orthodontic principles and whether they examine their patients for parafunctional habits and malocclusions. &#x0D; Methods: A descriptive, cross-sectional survey was sent to a sample of pediatricians in Turkey. The questionnaire, consisted of 42 questions in five domains. A total of 166 pediatricians participated in the survey.&#x0D; Results: In the assessment of the examination of the oral cavity, a low frequency of examination for the malocclusion (28,9%) and oral functional habits (43,4%) was found. Reasons pediatricians referred patients to specialists varied from over-bite 24% to crowding 87%. In the chi-square test for the effect of work sector, years of experience, training about parafunctional oral habits and orthodontic problems, patients per day in the knowledge, attitude and practices of pediatricians regarding orthodontic problems and parafunctional oral habits in children, we could identify significant predictors (p

Prevalence Of Different Types Of Oral Habits Among School-Children Aged 6-12 Years In Alexandria (A Survey Study)

Objective: The purpose of this study is to identify the prevalence of parafunctional oral habits among schoolchildren aged 6 to 12 years in Alexandria, Egypt. Materials and methods: A total of 255 Egyptian children, consisting of 158 males and 94 females were randomly examined. The examination included 1-Tongue thrusting: masseteric palpation 2-Thumb sucking: finger examination and intra-oral examination. 3-Mouth breathing: a. medical history. b. Mirror test (fog test) c. Jwemen’s Butterfly test. d. Water Holding Test (Masslers test). 4-Nail biting: fingers, nails examination and intraoral examination. Questionnaires were handed out to the parents to obtain information about the child’s gender, age, medical and dental history and any noticeable oral habits and collected a week later. Data was collected, sorted and registered. The subjects were assigned to different groups according to the habit. Percentile distribution of the subjects was calculated for different habit and their relation to each other, Categorical variables were analyzed using the chi-square test and Student t-test. Significance of the obtained results was judged at the 5% level (P ≤ 0.05). Results: the majority of subjects shows with 41.07% of the subjects had nail biting followed by tongue thrust with 29.4% then mouth breathing with 15.9% and the least prevalent oral habit was thumb sucking with 14.73%. 32.1% of the subjects had no habits at all and 67.9% had at least one habit. conclusion: Nail biting was the most dominant oral habit and the least common was thumb sucking, no patients were found practicing more than 3 habits.

Malocclusion trait and the parafunctional effect among young female school students.

Extraneous activities of either the mouth, tongue or the jaw comprise the oral parafunctional habits of the stomatognathic system. This denominated habit is expressed through bruxism, digit sucking, nail biting to name a few, have led to hypothesizing the possible relationship of evolution of occluso-facial abnormalities such as malocclusion thereby hindering the conventional developmental process. Hence, the present study aimed to determine the prevalence and the possible relationship of parafunctional oral habits with the types of malocclusions among 12–16 years old females in Jeddah, Saudi Arabia. This cross-sectional study was conducted through questionnaire and clinical examinations, where the sagittal abnormalities within a randomly selected 672 participants who met the eligibility criteria were tabulated and analyzed. A positive history of the presence of parafunctional habit was recorded among all the participants with nasal and mouth breathing [46.6%], nail biting [39.6%] being predominant. 36.4% presented with significantly higher prevalence of bi-maxillary protrusion in mouth breathers while 17.1% with moderate overbite in participants with nail biting habit. Therefore, within the limitations of the present study, the findings do support the literature on the prevalence and the possible association of these habits with the malocclusion development thereby emphasizing on the importance of early recognition, management and prevention of them.

Dental malocclusion among children with attention deficit hyperactivity disorder

Children with attention deficit hyperactivity disorder (ADHD) have more sleep breathing problems and parafunctional oral habits than individuals without ADHD. However, there is scarce information on the correlation between their dental malocclusion and these functional disorders. The objective of this study was to assess the severity of malocclusion in patients with and without ADHD and to evaluate the correlation between their functional disorders and dental malocclusion. Eighty-eight patients aged 6-17years were divided into 2 groups: ADHD (n=44) and control (n=44). A medical questionnaire to assess functional disorders and an orthodontic examination to evaluate malocclusion were completed for each patient. Distribution of the data was evaluated using Shapiro-Wilk test, whereas the 2 groups were compared with a t test, Mann-Whitney U test, Fisher exact test, and Spearman correlation. The association between parafunctional oral habits, ADHD drug intake, and malocclusion severity were assessed with a t test and Mann-Whitney U test. Patients with ADHD had significantly higher severity of malocclusion (P=0.042), more dental rotation (P=0.021) and more parafunctional oral habits (P=0.001), specifically bruxism (P=0.005), and a history of pacifier use (P=0.009), than the control group. It is important to be aware of the increased risk of parafunctional oral habits and dental malocclusion among ADHD patients to develop preventive programs, as well as therapeutic strategies for them.

Oral parafunctions, personality traits, anxiety and their association with signs and symptoms of temporomandibular disorders in the adolescents.

To investigate the association between oral parafunctions, personality traits, anxiety and signs and symptoms of temporomandibular disorders in the adolescents. Two hundred and seventy adolescents were examined clinically for the signs and symptoms of temporomandibular disorders. Participants completed questionnaires about demographic variables, medical history, symptoms of temporomandibular disorders, parafunctional oral habits, Minnesota Multibasic Personality Inventory, and Spielberger State-Trait Anxiety Inventory. Logistic regression analyses revealed that bruxism was associated with joint tenderness (Odds ratio (OR)=6.38, p < 0.01), joint noises (OR=6.02, p < 0.01) and masticatory muscle tenderness (OR=4.19, p < 0.05) to palpation. State anxiety showed increased risk of joint tenderness (OR=2.47, p < 0.05) and muscle tenderness (OR=3.25, p < 0.05) to palpation. Within the limitations of this study, it was concluded that oral parafunctions, especially bruxism, state anxiety, depression and hysteria were associated with signs and symptoms of temporomandibular disorders in adolescents.

Hábitos orales parafuncionales y características de la dentición primaria en un grupo de preescolares de Tlaquepaque, Jalisco, México.

The aim of this study was to evaluate the relationship between some characteristics of primary dentition, and the frequency of parafunctional oral habits, with age and sex. Material and Methods: A cross-sectional study was carried out in a sample of 227 preschool children. Subjects’ parents or guardians were asked to sign an informed consent form. The epidemiological survey consisted of an oral examination and the application of a questionnaire (Cronbach's alpha=0.881), after calibration of a dentist (Kappa=0.932). To measure the reliability of the questionnaire, Cronbach's alpha was calculated, and for the associations, Mantel and Haenszel Square Chi-square test and likelihood ratio for contingency tables greater than 2x2 values were calculated. Results: Type 2 arch (72.7%), mouth breathing (26.0%) and onychophagia (17.2%) were the risk factors observed more frequently in the group under study. The type of arch was the only variable that was associated with sex (X2MH=4.443, p=0.035). Conclusion: A significant proportion of the subjects had at least one risk factor that may alter the development of dental occlusion; consequently, the implementation of preventive actions in this population must be considered

Anxiety and clenching as contributing factors of recurrent aphthous stomatitis

Background: Recurrent aphthous stomatitis (RAS) is a common oral mucosa disease. Anxiety plays a role in the development of RAS, as it can lead to parafunctional oral habits such as bruxism (teeth grinding or jaw clenching) that may injure the mucosa, and this physical trauma can trigger ulceration in susceptible individuals with RAS. This case report describes the parafunctional oral habits caused by anxiety as the contributing factors of RAS. Case Report: A 17-year-old female came to the Dental Hospital, Faculty of Dentistry, Universitas Indonesia, with the complaints of ulcers at the lateral aspect of the tongue for 4 days since the tongue was bitten while she was sleeping. From the patient history, clinical evaluation, and investigation of the questionnaire, we detected a bruxism habit. We assumed that clenching was a contributing factor for the ulcers in this case. Intra-oral examination revealed two irregular ulcers of about 3 mm and 0.5 mm that were surrounded by erythematous halos and were yellow at the floors of the 46 and 36 teeth. The patient completed the Hospital Anxiety and Depression Scale and the Hamilton Rating Scale for Anxiety; the results of both were moderate anxiety. The management we suggested to the patient to control the anxiety was referral to a psychologist and an orthodontist; we gave chlorhexidine 0.2% to compress the lesions three times a day. Conclusion: Anxiety can produce a parafunctional oral habit that is a contributing factor of RAS. Coping with anxiety is needed to improve the clenching activity and RAS.

Duration of Breastfeeding, Bottle-Feeding, and Parafunctional Oral Habits in Relation to Anxiety Disorders Among Children.

The aim of the present study is to investigate the duration of breastfeeding in relation to various parafunctional oral habits in children with anxiety disorders. The study includes 195 children and adolescents with anxiety disorders and age- and gender-matched 255 healthy control subjects. Diagnoses were made with semistructured interview (K-SADS). Information about breastfeeding and parafunctional oral habits was investigated via a questionnaire prepared for the study. The mean age was 11.50 ± 2.50 years for clinical group and 11.27 ± 2.33 years for controls. Fifty-four percent of the clinical group and 56% of the control group were female subjects. Duration of exclusive (4.72 ± 2.86, 5.55 ± 2.36; p = 0.002) and total breastfeeding (12.38 ± 10.32, 15.89 ± 9.09; p < 0.001) was significantly lower and duration of bottle-feeding (22.30 ± 19.54, 16.64 ± 12.79; p = 0.005) was higher than controls in the clinical group. Duration of exclusive breastfeeding was significantly correlated with duration of bottle-feeding (r = -0.263, p < 0.001) and duration of pacifier use (r = -0.249, p = 0.001). Multiple regression analysis showed that duration of exclusive breastfeeding (β = 0.88, p = 0.006) and bottle-feeding (β = 1.02, p = 0.005), as well as various oral habits, was associated with diagnosis of an anxiety disorder. Nutrition methods in early years of life may result in long-term consequences regarding anxiety disorders for children. Clinicians should encourage parents for a shorter duration of bottle-feeding and a longer duration of exclusive breastfeeding.

Presence of parafunctional habits in temporomandibular articulation disorders in university students

Objective: To identify the presence of parafunctional oral habits and to evaluate its association with signs and symptoms of Temporomandibular Joint Disorders in university students. Methods/Statistical Analysis: A non-experimental design with a transversal descriptive cut was assumed. The sample was non-probabilistic at convenience: 168 students of the Physiotherapy Program. Students who will use the orthodontic devices were excluded. The instruments used were the selfreport questionnaire for Parafunctional Oral Habits, the Mobility Tests and the Krogh-Paulsen Test. The data were analyzed statistically, by means of the χ ^ 2 and Fisher Exacta Tests. Findings: In relation to Parafunctional Habits, 69% share large fruits with their mouths; 40% had temporomandibular joint disorder. The application of the Krogh Paulse Test found an association between pain areas and Parafunctional Habits (p < 0.05). Using a multivariate analysis, the results showed that chewing gum has a significant relationship with the pain that originates when speaking (p = 0.025), yawning (p = 0.011) and biting (p = 0.01). The introduction of hard objects to the mouth is significantly related to facial swelling (p = 0.042). Application/Improvements: High presence of Parafunctional Oral Habits was observed, such as splitting large fruits with the mouth, introducing hard objects to the mouth and chewing gum, which were the most significantly associated with TMJ disorder in university students who did not present orthodontic device. Keywords: Disorders, Parafunctional Oral Habits, Temporomandibular Articulation, University Students.

Oral parafunctional habits among preschool children in Riyadh, Saudi Arabia

Aim: The aim of the study is to assess the prevalence and the related factors of parafunctional oral habits among preschool children in Riyadh, Saudi Arabia. Materials and Methods: The study sample included 435 children (3–6 years) randomly selected from public and private preschools in the different regions of Riyadh. Questionnaires were distributed to be filled by children's parents. The questionnaire included questions concerning child's feeding method during infancy, number of the child siblings, and his/her order among them. The other part of the questionnaire included questions concerning the types of parafunctional habits that the child might suffer from. The last part inquired if the child suffered from psychological, social, medical, or sleeping problems. Descriptive statistics were performed and Pearson's Chi-square test was used to observe the relations between categorical study and outcome variables. Results: Nail-biting habit was highly prevalent among the study samples (27.2%), followed by mouth breathing during sleeping (13.8%), thumb sucking (7.4%), and teeth clenching (6.0%). A statistically significant relation was found between the age groups and teeth clenching and lip sucking habits (P = 0.001).There was a highly statistically significant relation between malocclusion and the habits of thumb sucking and pacifier sucking (P = 0.001 and 0.01, respectively). Protrusion of anterior teeth was statistically significantly related to thumb sucking (P Conclusion: Nail-biting habit was highly prevalent among preschool children in Riyadh, followed by mouth breathing, thumb sucking, and teeth clenching. Malocclusion was the main factor related to the habits of thumb sucking and pacifier sucking. Respiratory and tonsils problems were related to mouth breathing. Teeth clenching was highly related to the presence of carious teeth.