Resident: Adam J. Bottrill
Date: 08JUN11
Region: Providence
Article title: Effects of oral habits' duration on dental characteristics in the primary dentition
Journal: JADA
Page #s: 1685-1693
Vol:No Date: 132, Dec 2001
Major topic: Oral Habits, Primary Dentition
Minor topic(s): None
Type of Article: Longitudinal Study
Main Purpose: The purpose of this study was to assess the effects of different durations of nonnutritive sucking habits on the occlusal relationships and the dental arch characteristics in the primary dentition.
Key points in the article discussion:
I. General:
A. Studies have demonstrated that long-term nonnutritive sucking habits can lead to occlusal abnormalities. Not much known about habits of shorter duration.
II. Methods:
A. Longitudinal data collected on nonnutritive sucking among children through a series of questionnaires. (547 children)
B. Ages 4-5, study models obtained. (526 children)
C. Excluded those with permanent dentition and insufficient descriptive data. (372 children)
D. Dental arch parameters measured
E. Occlusal conditions analyzed for the groups of children with nonnutritive sucking habits of different durations.
III. Results:
A. Only 8 of the 372 children reported no sucking habit.
B. Children with nonnutritive sucking habits that continued to 48 months of age or beyond demonstrated many significant differences from children with habits of shorter duration:
1. narrower maxillary arch widths, greater overjet and greater overjet and greater prevalence of open bite and posterior crossbite.
C. Even when the habit was ceased between 2-3yo, pts still had increased risk of developing posterior crossbite and increased mandibular arch width when compared to those ceasing at 12mo.
D. Those who ceased at 36mo vs 12mo of age had significantly greater mandibular canine arch widths, maxillary canine arch depths and overjet and open bite.
E. Prevalence of anterior open bite, posterior crossbite and excessive overjet increased with duration of habits.
IV. Conclusions:
A. Children with shorter sucking habits also have detectable differences in dimensions
B. As pediatric dentists, we may consider revisiting our suggestions that sucking habits may last until permanent dentition eruption with little concern.
C. Will attempt to follow the children into mixed dentition and draw further conlclusions.
D. Recommending children stop habits prior to 24 months of age is unrealistic.
E. The results of this study suggest 24 months is a realistic and beneficial age to begin the tapering and ceasing of nonnutritive sucking habits.
Assessment of Article: These sucking habits were followed on an ongoing basis and at regular intervals, rather than relying on retrospective gathering of the data. As an observational cohort study, it was not limited to those children "seeking treatment" which lends to it's validity. HOWEVER... This article describes something I believe we all consider intuitive. Longer habit = worsened occlusion
Showing posts with label 06/08/2011. Show all posts
Showing posts with label 06/08/2011. Show all posts
Wednesday, June 8, 2011
Tuesday, June 7, 2011
06/08/2011 Predictors of Bruxism, Other Oral Parafunctions, and Tooth Wear over a 20-Year Follow-up Period
Resident: J. Hencler
Date: 06/08/2011
Article title: Predictors of Bruxism, Other Oral Parafunctions, and Tooth Wear over a 20-Year Follow-up Period
Author: Carlsson et al
Journal: Journal of Orofacial Pain Volume 17, Number 1, 2003
Major topic: Oral parafunctions
Type of Article: Longitudinal study
Main Purpose:
Analyze predictors of bruxism, other oral parafunctions, and anterior tooth wear by the use of logistical regression models w/ variables recorded at the first exam as independent variable.
Overview of method of research:
Originally 402 randomly selected 7-, 11-, and 15-year old patients were examined clinically and by questionnaire. Twenty years later 320 completed and returned the questionnaire. 100 returned patients underwent a clinical exam focusing on occlusal factors and function/dysfunction of the masticatory system. For analyses of predictors of oral parafunctions and tooth wear registered at the 20 yr f/u, logistic regression was used w/ recordings at the first exam as independent variables.
Findings:
The bivariate analyses between the dependent variable (reported bruxism at 20 year f/u) and selected variables from the first exam 20 years earlier resulted in five significant associations. These 5 variables (reported bruxism and other oral parafunctions, headache, pain after heavy chewing, TMD symptoms including pain after chewing) plus 1 dental variable (anterior open bite) were included in the logistical regression model with reported bruxism at the 20 year f/u as the dependent variable. See tables for details.
Key points in the article discussion:
The hypothesis was that bruxism and other oral parafunctions in childhood would be identified as predictors of bruxiam and other oral parafunctions and tooth waer 20 years later. Many clinicians have suggested a positive between relationship bruxism and TMD but the knowledge of what causes TMD is limited. The etiology of bruxism has also been controversial and theories have considered occlusal, psychological, genetic, and stress factors. Currently, there is a concensus about the multifactorial nature of its etiology, and bruxism is thought to be a CNS phenomenon related to stress and pain behavior more than to structural components.
Summary of conclusions:
This study found:
1) Reports in childhood bruxism, tooth clenching, tooth grinding at night and nail biting and/or other parafunctions were predictors of the same oral parafunctions 20 yrs later. This suggests that oral parafunctions may be a persistent trait in many subjects
2) Predictors of the 2 components of bruxism, tooth clenching during daytime and tooth grinding at night, were not the same, which supports the opinion that these 2 occlusal parafunctions may be different
3) Postnormal occlusion (Class II) and tooth wear in childhood predicted increased tooth wear in adulthood
4) Nonworking-side interference reduced the risk for extensive tooth wear of the anterior teeth in 100 35-year old subjects.
Assessment of article:
Interesting conclusion. I find that many parents report that their children grind their teeth and want to know if there are any specific causes and possible treatment to make them stop. I find the answer to this question one of the more difficult to explain to parents because we don’t really know the answer for sure. Usually occlusal guard or TMJ therapy is not indicated in very young patients so the best we can do is encourage the parents and continue to monitor the bruxism.
Date: 06/08/2011
Article title: Predictors of Bruxism, Other Oral Parafunctions, and Tooth Wear over a 20-Year Follow-up Period
Author: Carlsson et al
Journal: Journal of Orofacial Pain Volume 17, Number 1, 2003
Major topic: Oral parafunctions
Type of Article: Longitudinal study
Main Purpose:
Analyze predictors of bruxism, other oral parafunctions, and anterior tooth wear by the use of logistical regression models w/ variables recorded at the first exam as independent variable.
Overview of method of research:
Originally 402 randomly selected 7-, 11-, and 15-year old patients were examined clinically and by questionnaire. Twenty years later 320 completed and returned the questionnaire. 100 returned patients underwent a clinical exam focusing on occlusal factors and function/dysfunction of the masticatory system. For analyses of predictors of oral parafunctions and tooth wear registered at the 20 yr f/u, logistic regression was used w/ recordings at the first exam as independent variables.
Findings:
The bivariate analyses between the dependent variable (reported bruxism at 20 year f/u) and selected variables from the first exam 20 years earlier resulted in five significant associations. These 5 variables (reported bruxism and other oral parafunctions, headache, pain after heavy chewing, TMD symptoms including pain after chewing) plus 1 dental variable (anterior open bite) were included in the logistical regression model with reported bruxism at the 20 year f/u as the dependent variable. See tables for details.
Key points in the article discussion:
The hypothesis was that bruxism and other oral parafunctions in childhood would be identified as predictors of bruxiam and other oral parafunctions and tooth waer 20 years later. Many clinicians have suggested a positive between relationship bruxism and TMD but the knowledge of what causes TMD is limited. The etiology of bruxism has also been controversial and theories have considered occlusal, psychological, genetic, and stress factors. Currently, there is a concensus about the multifactorial nature of its etiology, and bruxism is thought to be a CNS phenomenon related to stress and pain behavior more than to structural components.
Summary of conclusions:
This study found:
1) Reports in childhood bruxism, tooth clenching, tooth grinding at night and nail biting and/or other parafunctions were predictors of the same oral parafunctions 20 yrs later. This suggests that oral parafunctions may be a persistent trait in many subjects
2) Predictors of the 2 components of bruxism, tooth clenching during daytime and tooth grinding at night, were not the same, which supports the opinion that these 2 occlusal parafunctions may be different
3) Postnormal occlusion (Class II) and tooth wear in childhood predicted increased tooth wear in adulthood
4) Nonworking-side interference reduced the risk for extensive tooth wear of the anterior teeth in 100 35-year old subjects.
Assessment of article:
Interesting conclusion. I find that many parents report that their children grind their teeth and want to know if there are any specific causes and possible treatment to make them stop. I find the answer to this question one of the more difficult to explain to parents because we don’t really know the answer for sure. Usually occlusal guard or TMJ therapy is not indicated in very young patients so the best we can do is encourage the parents and continue to monitor the bruxism.
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