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WHAT IS HABIT?
Habit can be defined as -
Fixed or constant practice established by
muscular contractions-MATHEWSON(1982)
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Pedodontist
Parents
Orthodontist
ORAL HABIT
Speech
Pathologist
Pediatrician
Psychologist
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MOUTH BREATHING HABIT
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DEFINITION
Defined as a prolonged or continued
exposure of the tissues of anterior
areas of mouth to the drying effects
of inspired air .(CHACKER,1961)
Defined as habitual respiration
through the mouth instead of the
nose. (SASSOUNI, 1971)
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CLASSIFICATION
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ETIOLOGY
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2.Abnormally short upper lip preventing
proper lip seal
3.Obstruction in the bronchial tree or
larynx
4.Obstructive sleep apnoea syndrome
5. Genetically predisposed individuals
-Ectomorphic children having a genetic
type of tapering face & nasopharynx
are prone for nasal obstruction
6. Thumb sucking or other oral habits
can be the instigating agent
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CLINICAL FEATURES
General effects-
-Pigeon chest
-Low grade esophagitis
-Blood gas constituents
Effects on dentofacial structures-
Facial form –
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Adenoid facies –Characterized By
-Long narrow face
-Narrow nose & nasal passage
-Flaccid lips with upper lip being short
-Dolicocephalic skeletal pattern
-Nose is tipped superiorly in front
-Expressionless face
-V shaped maxillary arch & high
palatal vault.
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Dental defects :
• Upper & lower incisors
are retroclined.
• Posterior cross bite
• Anterior open bite
• Narrow palatal & cranial
width.
• Flaring of incisors
• Decrease in vertical
overlap of anterior
teeth.
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Speech defects:
- Nasal tone in voice
Lips:
- Short thick incompetent upper lip.
- Voluminous curled over lower lip.
- Gummy smile
External Nares:
- Slit like external nares with a narrow nose
due to atrophy of lateral cartilage.
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Gingiva:-
• Inflammed & irritated gingival
tissue in the anterior maxillary
arch.
• Classic rolled marginal gingiva
and enlarged interdental papilla.
• Inter proximal bone loss and
presence of deep pockets.
Other Effects:-
• Otitis Media
• Dull sense of smell and loss of
taste
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DIAGNOSIS
1. History
2. Clinical Examination
Look for lip competency
Size and shape of external nares.
3. Clinical Tests
- Mirror test
- Butterfly test
- Water test
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4. Rhinomanometry (inductive
Plethysmography)
5. Cephalometrics
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MANAGEMENT
Elimination of the cause
Symptomatic treatment
Interception of the habit :- If the
habit continues even after removal of
obstruction, then it should be
corrected. Correction can be done by:
• Physical exercise
• Lip exercises
• Maxillothorax myotherapy
• Oral screen
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Oral Screen:-
• Most effective way to reestablish nasal
breathing is to prevent air from entering the
oral cavity.
• Oral screen should be constructed with a
material compatible with the oral tissues.
• Reduction in the anterior open bite is
obtained after treatment for 3-6 months.
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PRE ORTHODONTIC TRAINER
It is used in mouth breathers, tongue
thruster & thumb suckers.
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• Construction of the membrane
• Construction of the cast
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REFERENCES
Textbook of Orthodontics :
Gurkeerat Singh
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