Resident’s Name: Anna Haritos Date: May 1, 2009
Article title: Damage to the primary dentition resulting from thumb and finger (digit) sucking
Author(s): Fukuta, et al.
Journal: Journal of Dentistry for Children
Volume (number): 63
Month, Year: Nov – Dec 1996
Major topic: digit habits
Minor topic(s): age to eliminate digit habits
Type of Article: research article
Main Purpose(s): to investigate the influence of thumb and finger sucking on malocclusion (both the anterior and posterior sections of the primary dentition in three age groups (3, 4 and 5 yrs))
Overview of method of research: retrospective chart review (2018 charts); habit was determined from parent and patient reports that had been documented in the chart. 930 subjects met the inclusion criteria: no oral habits, only indulged in digit sucking, complete primary dentition, no permanent dentition, no dental caries, restorations or missing teeth. Of these 930 subjects, 671 had no history of oral habits, and 259 had oral habits. The following data was obtained: anterior overjet and overbite, mesial, flush or distal step of second primary molars. Hypothesis: higher incidence of overjet and overbite in oral habit group than non-oral habit group.
Findings: Of the original 2018 charts, 59.8% had no oral habit, while 40.2% had an oral habit. Maxillary protrusion was significantly higher in 3 year old digit suckers than 3 year olds without a digit sucking habit. In three to five year olds, the digit sucking group had a significantly higher frequency of open bite than the non-digit sucking group. Variations of terminal plane types were not significant between the two groups in 3 and 4 year olds; however of the 5 year olds, distal steps were significantly more frequent in the digit sucking group than the non digit sucking group.
Key points/Summary: Anterior open bite and maxillary protrusion represent the most frequent malocclusion associated with digit sucking. Potential that posterior occlusion damage is a late manifestation of the digit habit. Age of cessation should be at 3 to 4 years of age, before the terminal plane begins to change from the habit.
Assessment of article: good article to confirm anticipatory guidance used by the clinician
Thursday, April 30, 2009
Wednesday, April 29, 2009
Management of Non-Nutritive Or Digit Sucking Habits in Children- A Practical Approach
Resident’s Name: Laura Randazzo Sabnani Date: May 1, 2009
Article title: Management of Non-Nutritive Or Digit Sucking Habits in Children- A Practical Approach
Author(s): Morley K, McIntyre T
Journal: Journal of Pediatric Dentistry
Volume (number):60:11
Month, Year: November 1994
Major topic / Main purpose: To review reasons for and treatment for cessation of non-nutritive or digit habits in children
Methods and Materials: N/A
Result/Summary: There are two different views regarding thumbsucking. The psychoanalytical believe that if digit sucking continues past age 4 it is indicative of an underlying psychological disturbance. The behavioral theorist believe that digit sucking is a learned habit with no underlying emotional or psychological cause. The negative effects of thumb sucking are increased overjet, anterior open bite, and posterior crossbite. These are dependant on the intensity, duration, and frequency of habit. This article advises that a digit habit should be ignored until age 4. At that time the societal background should be investigated because children coming from an unstable home environment the digit sucking is a sense of security for them. The presence of other habits needs to be addressed and caution should be used when stopping the digit habit. School and peer relationships should be address and stopping a habit should not be initiated when a child first starts a new school. Family employment status should be reviewed and evaluted if there is recent increased stress for the family. To stop the habit behavior modification should be initiated. The child should be shown models and photographs of children who have stopped their digit habit. The parents are asked to place stars on a calender everytime a child stops sucking their thumb. Appliance therapy can also be used in addition to behavior modification. The author recommends a fixed digit crib over a removable one.
Assessment of article: Good article with a great example of a handout to give to parents.
Thumb Sucking
Resident’s Name: Chad Abby Date: 5/1/2009
Article title: Thumb-sucking: Literature review
Author(s): Eric D. Johnson DDS, Brent E. Larson DDS
Journal: Journal of Dentistry for Children
Month, Year: November-December 1993
Major topic: Thumb-sucking
Type of Article: Literature review
Author(s): Eric D. Johnson DDS, Brent E. Larson DDS
Journal: Journal of Dentistry for Children
Month, Year: November-December 1993
Major topic: Thumb-sucking
Type of Article: Literature review
Main Purpose: To review the literature relative to the causes, risks prevalence, and contributing factors of Non-Nutritive Sucking (NNS) habits.
Overview of method of research: Reviews of literature
Findings: Two theories of behavior that address the problem of NNS are the psychoanalytic theory of psychosexual development and the learning theory. The psychoanalytic theory holds that the response arises from an inherent psychosexual drive, and that digit sucking represents a type of anxiety management by the child and abruptly extinguishing it could be detrimental to the normal emotional development of the child. The learning theory advocates that NNS stems from an adaptive response and assumes no underlying psychological cause to prolonged NNS. It assumes all forms of NNS had adaptive value at some earlier developmental stage and the response was subsequently rewarded and eventually became a “learned habit.” Although overwhelming evidence supports the learning habit it has been suggested that an increase in stress or anxiety in a child’s life can convert an empty thumb habit into a meaningful stress-reduction response. Therefore it is important as physicians to screen patients with an NNS habit properly for possible psychological disturbances before initiating treatment.
Findings: Two theories of behavior that address the problem of NNS are the psychoanalytic theory of psychosexual development and the learning theory. The psychoanalytic theory holds that the response arises from an inherent psychosexual drive, and that digit sucking represents a type of anxiety management by the child and abruptly extinguishing it could be detrimental to the normal emotional development of the child. The learning theory advocates that NNS stems from an adaptive response and assumes no underlying psychological cause to prolonged NNS. It assumes all forms of NNS had adaptive value at some earlier developmental stage and the response was subsequently rewarded and eventually became a “learned habit.” Although overwhelming evidence supports the learning habit it has been suggested that an increase in stress or anxiety in a child’s life can convert an empty thumb habit into a meaningful stress-reduction response. Therefore it is important as physicians to screen patients with an NNS habit properly for possible psychological disturbances before initiating treatment.
Key points/Summary: Prolonged digit-sucking habit can have significant effects on dentofacial development. Malocclusion caused by thumb-sucking is more a matter of individual response to stimuli than a highly classified cause and effect syndrome. Some spontaneous corrections of the dentofacial effects can be expected, if the NNS habit persists until nine years of age and is then stopped. This spontaneous correction takes place primarily during the first year after habit cessation and is involved with dentoalveolar changes – a decrease in dental openbite and retroclination of the upper incisors. Studies demonstrate a decrease in digit-sucking habits with an increase in pacifier use, less than 3 percent of children who used a pacifier developed a thumb-sucking habit. The prevalence of digit-sucking in North American children at ages two and five is approximately 23 and 18%. The thumb sucking habit has been found to be stronger, more persistent, and more widespread in girls than in boys, however there are no sex-linked factors that account for the sex differences in thumb-sucking habits. The majority of children with an NNS habit began the habit during the first three months of life. Every study that linked thumb-sucking with age demonstrated a decreased prevalence of NNS habits with increased age. There has been no correlation found between thumb-sucking and mode of feeding. Also it has been found that children who sucked their thumbs were less likely to have a care-giver present as they fell asleep. Children from a “high socioeconomic group” demonstrated oral habits (finger-sucking, fingernail biting, tongue habits, and lip or check habits) more frequently than children from a middle or low socioeconomic class. Children of parents with an extensive education were more likely to develop a finger-sucking habit whereas children whose parents had little or no theoretical education were more likely to develop a pacifier habit.
Assessment of article: Good article – a great literature review on numerous thumb-sucking studies
Post-Exposure Treatment of HIV – Taking Some Risks for Safety’s Sake
Author(s): David K. Henderson MD
Journal: The New England Journal of Medicine
Month, Year: November 2007
Major topic: HIV exposure management
Type of Article: Editorial
Findings: The occupational infection and eventual death of a health care worker in 1988 was controversial and led to a variety of post exposure protocols. These included increased education about HIV, safety measures like plastic coated test tubes and the investigation and eventual implementation of a chemoprophylaxis with nucleoside analogue zidovudine secondary to exposure. Education and informed consents were given before beginning the course. This course has some scientific evidence but it was mainly done so that the hospital would be seen as a worker advocate. The workers were told about the mutagenic and teratogenic risk but it still was scrutinized in the media and scientific literature. Current literature and experiences support the earlier decision, although the course has been modified to include antiretrovirals and other nucleoside analogues. Risk factors have also been elucidated as part of a 1995 study; a deep injury, injury with a device visibly contaminated with blood from the source patient, a procedure involving a needle placed in the source patient’s artery or vein and exposure to a source patient who dies of AIDS within 2 months. Post exposure chemoprophylaxis with zidovudine was associated with a reduction in risk of transmission by 81%, although the study was performed under non-ideal conditions. While the efficacy and risk of administering chemoprophylactic drugs, most people have found the fear of infection outweighs the inherent risks of prophylactic treatment.
Key points/Summary: While the efficacy and safety of chemoprophylactic treatment has not been absolutely determined, it is still often used at the very least to offset the fear and trepidation secondary to occupational exposure.
Assessment of article: An editorial but well written and good information to have on hand particularly if a member of your staff is exposed.
Brian Schmid DMD
Journal: The New England Journal of Medicine
Month, Year: November 2007
Major topic: HIV exposure management
Type of Article: Editorial
Findings: The occupational infection and eventual death of a health care worker in 1988 was controversial and led to a variety of post exposure protocols. These included increased education about HIV, safety measures like plastic coated test tubes and the investigation and eventual implementation of a chemoprophylaxis with nucleoside analogue zidovudine secondary to exposure. Education and informed consents were given before beginning the course. This course has some scientific evidence but it was mainly done so that the hospital would be seen as a worker advocate. The workers were told about the mutagenic and teratogenic risk but it still was scrutinized in the media and scientific literature. Current literature and experiences support the earlier decision, although the course has been modified to include antiretrovirals and other nucleoside analogues. Risk factors have also been elucidated as part of a 1995 study; a deep injury, injury with a device visibly contaminated with blood from the source patient, a procedure involving a needle placed in the source patient’s artery or vein and exposure to a source patient who dies of AIDS within 2 months. Post exposure chemoprophylaxis with zidovudine was associated with a reduction in risk of transmission by 81%, although the study was performed under non-ideal conditions. While the efficacy and risk of administering chemoprophylactic drugs, most people have found the fear of infection outweighs the inherent risks of prophylactic treatment.
Key points/Summary: While the efficacy and safety of chemoprophylactic treatment has not been absolutely determined, it is still often used at the very least to offset the fear and trepidation secondary to occupational exposure.
Assessment of article: An editorial but well written and good information to have on hand particularly if a member of your staff is exposed.
Brian Schmid DMD
Friday, April 24, 2009
Feeding, Artificial Sucking Habits, and Malocclusions in 3-year-old Girls in Different Regions of the World
Department of Pediatric Dentistry
Lutheran Medical Center
Resident’s Name: Dan Boboia Date: 4/24/09
Article title: Feeding, Artificial Sucking Habits, and Malocclusions in 3-year-old Girls in Different Regions of the World
Author(s): Calgar, Esber et al.
Journal: Journal of Dentistry for Children
Volume (number): 72:1
Month, Year: 2005
Major topic: To determine feeding methods, artificial sucking habits, and the presence of malocclusions in 3-year-old girls living in different regions of the world
Methods:
Children from the following countries were involved in this study: Brazil, Japan, Mexico, Norway, Sweden, Turkey and the U.S.
Sixty 3-year-old girls were selected from each of these populations; due to attrition the group size decreased to 49 by the time the children reached age 3
During the interview and examination the following variables were evaluated:
1) breast-feeding, bottle-feeding, duration, and frequency
2) sucking habits
3) posterior and anterior crossbites
4) other malocclusions / normal occlusion
Results:
High prevalence of breast-feeding in all groups (78-98%)
High prevalence of bottle-feeding (almost all had used a bottle for various periods of time)
Except for the US, digit-sucking was considered low; it was noted that those who started digit-sucking had difficulty discontinuing it
Pacifier sucking was popular in most areas with the exception of Nigeria
Malocclusion ranged from 38-98%; great differences in the prevalence of malocclusions were registered in this study; only one Japanese patient had a malocclusion; in the Oslo, Norway sample only 38% of children had normal occlusion; its concluded that this resulted from high prevalence and long duration of artificial sucking habits
Conclusions:
1) High prevalence of breast-feeding was over 78% in the countries studied
2) Almost all subjects used a nursing bottle for some time
3) Low prevalence of digit-sucking, with the exception of the US sample
4) Pacifier-sucking is popular in most areas; however, none of the Japanese girls experienced the habit
5) Prevalence of normal occlusion in different samples ranged from 38-98%
Article Assesment:
Fair article; would have liked to see more discussion regarding the differences in malocclusion among the groups studied
Lutheran Medical Center
Resident’s Name: Dan Boboia Date: 4/24/09
Article title: Feeding, Artificial Sucking Habits, and Malocclusions in 3-year-old Girls in Different Regions of the World
Author(s): Calgar, Esber et al.
Journal: Journal of Dentistry for Children
Volume (number): 72:1
Month, Year: 2005
Major topic: To determine feeding methods, artificial sucking habits, and the presence of malocclusions in 3-year-old girls living in different regions of the world
Methods:
Children from the following countries were involved in this study: Brazil, Japan, Mexico, Norway, Sweden, Turkey and the U.S.
Sixty 3-year-old girls were selected from each of these populations; due to attrition the group size decreased to 49 by the time the children reached age 3
During the interview and examination the following variables were evaluated:
1) breast-feeding, bottle-feeding, duration, and frequency
2) sucking habits
3) posterior and anterior crossbites
4) other malocclusions / normal occlusion
Results:
High prevalence of breast-feeding in all groups (78-98%)
High prevalence of bottle-feeding (almost all had used a bottle for various periods of time)
Except for the US, digit-sucking was considered low; it was noted that those who started digit-sucking had difficulty discontinuing it
Pacifier sucking was popular in most areas with the exception of Nigeria
Malocclusion ranged from 38-98%; great differences in the prevalence of malocclusions were registered in this study; only one Japanese patient had a malocclusion; in the Oslo, Norway sample only 38% of children had normal occlusion; its concluded that this resulted from high prevalence and long duration of artificial sucking habits
Conclusions:
1) High prevalence of breast-feeding was over 78% in the countries studied
2) Almost all subjects used a nursing bottle for some time
3) Low prevalence of digit-sucking, with the exception of the US sample
4) Pacifier-sucking is popular in most areas; however, none of the Japanese girls experienced the habit
5) Prevalence of normal occlusion in different samples ranged from 38-98%
Article Assesment:
Fair article; would have liked to see more discussion regarding the differences in malocclusion among the groups studied
Pacifier use, early weaning, and cry/fuss behavior
Department of Pediatric Dentistry
Lutheran Medical Center
Resident’s Name: Craig Elice Date: 4/25/2009
Article title: Pacifier Use, Early Weaning, and Cry/Fuss Behavior
Author(s): Kramer MS, Barr RG, et al..
Journal: JAMA 286(3)
Volume (number): 322-326
Date: July 18, 2001
Major topic: Pacifier and its effect on Breast feeding
Type of Article: Double blind, randomized clinical trial
Main Purpose: This study evaluated whether advice to avoid use of the pacifier and use other techniques to soothe an infant reduces the risk of early weaning from breast feeding, and increases the risk of crying and fussing.
Materials and Methods: 281 randomized mothers were placed into two groups. Both groups received a basic breastfeeding package consisting of a 45 minute interview promoting breastfeeding. In the experimental group, mothers were asked to avoid pacifiers when the infant cried or fussed, and instead offer the breast. In the control group, all options were suggested to calm the infant. Follow up calls were placed at 10 days and 3 weeks postpartum. A behavior diary was completed by the mothers at 4, 6, and 9 weeks for 3 days at each interval.
Findings: 258 mothers, 127 experimental and 131 controls completed the study. The experimental intervention resulted in 38.6% avoiding the pacifier use, while the control group avoided pacifiers in 16% of the cases. The diaries confirmed a reduced number of pacifier insertions per day. However, early weaning from breast feeding was similar between the two groups at 3 months of age (18.9% vs 18.3%). Observation analysis indicated the daily pacifier use was more significant for early weaning, 25% vs. 12.9% who had never received a pacifier. The response rate for the diaries was fair with only 57.4% at the 9 weeks. Observations noted included slightly less crying and fussing at 4 and 6 weeks, and identical at 9 weeks
Key points/Summary : The experimental intervention reduced pacifier use, yet it did not reduce crying and fussing behavior at all time intervals. It also did not have an effect on reducing the risk of early weaning of breast feeding. However the pacifier use was strongly associated with early weaning, perhaps because of breastfeeding difficulties or reduced motivation to breastfeed.
Assessment of article: Interesting study to contrast with the advocates of breastfeeding who suggest that pacifiers use cause nipple confusion and early weaning
Lutheran Medical Center
Resident’s Name: Craig Elice Date: 4/25/2009
Article title: Pacifier Use, Early Weaning, and Cry/Fuss Behavior
Author(s): Kramer MS, Barr RG, et al..
Journal: JAMA 286(3)
Volume (number): 322-326
Date: July 18, 2001
Major topic: Pacifier and its effect on Breast feeding
Type of Article: Double blind, randomized clinical trial
Main Purpose: This study evaluated whether advice to avoid use of the pacifier and use other techniques to soothe an infant reduces the risk of early weaning from breast feeding, and increases the risk of crying and fussing.
Materials and Methods: 281 randomized mothers were placed into two groups. Both groups received a basic breastfeeding package consisting of a 45 minute interview promoting breastfeeding. In the experimental group, mothers were asked to avoid pacifiers when the infant cried or fussed, and instead offer the breast. In the control group, all options were suggested to calm the infant. Follow up calls were placed at 10 days and 3 weeks postpartum. A behavior diary was completed by the mothers at 4, 6, and 9 weeks for 3 days at each interval.
Findings: 258 mothers, 127 experimental and 131 controls completed the study. The experimental intervention resulted in 38.6% avoiding the pacifier use, while the control group avoided pacifiers in 16% of the cases. The diaries confirmed a reduced number of pacifier insertions per day. However, early weaning from breast feeding was similar between the two groups at 3 months of age (18.9% vs 18.3%). Observation analysis indicated the daily pacifier use was more significant for early weaning, 25% vs. 12.9% who had never received a pacifier. The response rate for the diaries was fair with only 57.4% at the 9 weeks. Observations noted included slightly less crying and fussing at 4 and 6 weeks, and identical at 9 weeks
Key points/Summary : The experimental intervention reduced pacifier use, yet it did not reduce crying and fussing behavior at all time intervals. It also did not have an effect on reducing the risk of early weaning of breast feeding. However the pacifier use was strongly associated with early weaning, perhaps because of breastfeeding difficulties or reduced motivation to breastfeed.
Assessment of article: Interesting study to contrast with the advocates of breastfeeding who suggest that pacifiers use cause nipple confusion and early weaning
Thursday, April 23, 2009
The effect of sucking habits, cohort, sex, intercanine arch widths, and breast or bottle feeding on posterior crossbite in Norwegian and Swedish 3 yea
Department of Pediatric Dentistry
Lutheran Medical Center
Resident’s Name: Craig Elice Date: 4/25/2009
Article title: The effect of sucking habits, cohort, sex, intercanine arch widths, and breast or bottle feeding on posterior crossbite in Norwegian and Swedish 3 year-old children
Author(s): Ogaard B, Larsson E., Linsten R.
Journal: Am. J. Orthod. 106 (2)
Volume (number): 161-6
Date: August 1994
Major topic: Habits influence on posterior cross-bites
Type of Article: Research article
Main Purpose: This study evaluated the prevalence of posterior cross-bites in children from Norway and Sweden and its relationship with sucking habit.
Materials and Methods: 445 3 year olds, 250 from Norway, and 195 from Sweden were included in the study. During the exam, the families were questioned about sucking habits , duration of finger sucking or dummy sucking (pacifier) and if ongoing, gender, and if Swedish. Clinically, intercanine width of both maxillary and mandibular arches were measured, and if a posterior cross-bite was present. As a control, 15 medieval skulls with full primary dentition were measured. No sucking habits were assumed from these skulls.
Findings: Of the posterior cross-bites, 90% involved cuspids. Finger sucking was more common in females. The duration of pacifier use is longer in Swedish children. In finger suckers, posterior cross-bites could be predicted with upper intercanine width while in the pacifier group, posterior cross-bite groups could be predicted with upper and lower intercanine widths. Both arches were narrower in Swedish children, especially in girls, and pacifier use decreased upper and increased lower intercanine width. At least 2 years of pacifier use affected the upper jaw and 3 years in lower jaw. Breast vs. bottle feeding had no influence on the development of posterior. Swedish children tended to have narrower jaws and also a higher prevalence of posterior cross-bites. Norwegian children had a normal or slightly increased prevalence of posterior cross-bites with pacifier use. Intercanine width was significantly influenced by the duration of the habit in years. It was seen that the longer the pacifier habit, the stronger the effect of the intercanine width: decrease in maxillary width and increased mandibular width. “This study supports the hypothesis that in a pacifier habit, the cheeks show increased activity and the tongue repositions back and downward. The low position of the tongue decreases maxillary arch development thus decreasing intercanine width and expands the lower arch causing the lower intercanine width to increase.
Key points/Summary : Nonsuckers showed no relationship between the tested variables and development of a posterior cross-bite. Pacifier use influences development of a posterior cross-bite. And lastly, finger sucking has some effect but it is less certain
Assessment of article: Thorough discussion of the influence of habits on intercanine width. Useful in practice.
Lutheran Medical Center
Resident’s Name: Craig Elice Date: 4/25/2009
Article title: The effect of sucking habits, cohort, sex, intercanine arch widths, and breast or bottle feeding on posterior crossbite in Norwegian and Swedish 3 year-old children
Author(s): Ogaard B, Larsson E., Linsten R.
Journal: Am. J. Orthod. 106 (2)
Volume (number): 161-6
Date: August 1994
Major topic: Habits influence on posterior cross-bites
Type of Article: Research article
Main Purpose: This study evaluated the prevalence of posterior cross-bites in children from Norway and Sweden and its relationship with sucking habit.
Materials and Methods: 445 3 year olds, 250 from Norway, and 195 from Sweden were included in the study. During the exam, the families were questioned about sucking habits , duration of finger sucking or dummy sucking (pacifier) and if ongoing, gender, and if Swedish. Clinically, intercanine width of both maxillary and mandibular arches were measured, and if a posterior cross-bite was present. As a control, 15 medieval skulls with full primary dentition were measured. No sucking habits were assumed from these skulls.
Findings: Of the posterior cross-bites, 90% involved cuspids. Finger sucking was more common in females. The duration of pacifier use is longer in Swedish children. In finger suckers, posterior cross-bites could be predicted with upper intercanine width while in the pacifier group, posterior cross-bite groups could be predicted with upper and lower intercanine widths. Both arches were narrower in Swedish children, especially in girls, and pacifier use decreased upper and increased lower intercanine width. At least 2 years of pacifier use affected the upper jaw and 3 years in lower jaw. Breast vs. bottle feeding had no influence on the development of posterior. Swedish children tended to have narrower jaws and also a higher prevalence of posterior cross-bites. Norwegian children had a normal or slightly increased prevalence of posterior cross-bites with pacifier use. Intercanine width was significantly influenced by the duration of the habit in years. It was seen that the longer the pacifier habit, the stronger the effect of the intercanine width: decrease in maxillary width and increased mandibular width. “This study supports the hypothesis that in a pacifier habit, the cheeks show increased activity and the tongue repositions back and downward. The low position of the tongue decreases maxillary arch development thus decreasing intercanine width and expands the lower arch causing the lower intercanine width to increase.
Key points/Summary : Nonsuckers showed no relationship between the tested variables and development of a posterior cross-bite. Pacifier use influences development of a posterior cross-bite. And lastly, finger sucking has some effect but it is less certain
Assessment of article: Thorough discussion of the influence of habits on intercanine width. Useful in practice.
modifications of the palatal crib habit-breaker appliance to prevent paltal soft tissue embedment
Article title: Modifications of the palatal crib
Author(s):Gawlik JA, Ott NW, Mathieu GP
Journal: Journal of Dentistry for Children
Volume (number):
Date: November-December 1995
Major Topic: Habit breaking appliances
Type of Article: Professional Opinion
Main Purpose: Review purpose and design of habit breaking appliance and recommend improvements in design
Materials and Methods:
Literature concerning habit-breaking appliances was reviewed. The most common problems were discussed and recommendations to the design were made.
Findings:
Design of palatal crib appliance: bands on first permanent or second primary molars. A palatal arch wire is formed using a .036 or greater diameter heavy stainless steel wire. Shorter lengths of wire are positioned and soldered to the arch to form a smooth rounded crib. Sharp spurs or hay rakes should not be used. Wires should be passive with .5-1mm relief from the tissue. The crib should be in the intercanine area, covering the extent of the open bite. It should also not interfere with the mandibular teeth.
A problem encountered with this appliance is the wire embeds into the palatal tissue. When this happens, removal can be very painful and require local anesthesia.
Modified design: Orthodontic acrylic can be added to the palatal region of the appliance, so that it is supported by the acrylic and the wire is incapable of being imbedded in the palatal tissue. Palatal acrylic and a crib can also be added to a Hawley retainer, but this treatment is often compromised by poor compliance.
Key points/Summary:
Goals of a habit therapy include a design that is nonpunitive, unobtrusive and nondamaging to oral soft and hard tissues.
The author recommends addition of an acrylic palatal button with .040 or .045 inch palatal wires.
Assessment of article:
It’s a pretty good idea. Habit appliances are pretty much a toss-up anyway. I’ve seen them imbed, but usually the kid is sucking even thought the appliance is there.
Wednesday, April 22, 2009
Prevalence of Bruxism and Associated Correlates in Children as Reported by Parents
Department of Pediatric Dentistry
Lutheran Medical Center
Resident’s Name: Derek Banks Date: April 24, 2009
Article title: Prevalence of Bruxism and Associated Correlates in Children as Reported by Parents
Author(s): A Cheifetz, S Osganian, E Allred, H Needleman
Journal: Journal of Dentistry for Children
Volume (number): 72:2
Month, Year: 2005
Major topic: Oral Habits
Minor topic(s): Amalgam in Pediatric Dentistry
Type of Article: Bruxism
Main Purpose: Evaluate reported prevalence of nocturnal bruxism, and demographic correlations
Overview of method of research: 854 surveys were given to parents of patients at 4 private pediatric dental offices and at Children’s Hospital Boston Dental Clinic about nocturnal bruxism, demographic information, and questions about purported associated factors.
Findings: Due to differing methodologies in different studies (e.g. parent/patient report vs. observation of wear facets intraorally), the precise prevalence of bruxism is not known. Other studies have shown that bruxers respond more negatively to life events and tend to be more anxious, aggressive, and hyperactive. Bruxism was reported to commence at a mean age of 3.6 years and ceased at a mean age of 6 years. Only 5% of the study population reported subjective TMD symptoms such as jaw clicking, muscle tenderness, pain on opening, or limited opening. There was a statistically significant association between the child’s bruxism habit and parental bruxism (P<0.0005). 48% of children reported to be bruxers had at least one parent who also had a history of bruxism, which was true for only 32% of reported nonbruxers. Naturally, bruxism was reported more often in families who sleep with the doors open. Children with psychological disorders are 3.6 times more likely to brux. Droolers were 1.7 times more likely and sleeptalkers 1.6 times more likely to brux. Children with oral habits (e.g. thumb, pacifier) were less likely to brux than their non-habit-posessing counterparts.
Key points/Summary : Of the 38% of parents reporting that their children brux, the following factors were significantly associated with the reported bruxism: familial history, open bedroom doors, drooling, sleeptalking, and psychological disorders
Assessment of article: Interesting.
Lutheran Medical Center
Resident’s Name: Derek Banks Date: April 24, 2009
Article title: Prevalence of Bruxism and Associated Correlates in Children as Reported by Parents
Author(s): A Cheifetz, S Osganian, E Allred, H Needleman
Journal: Journal of Dentistry for Children
Volume (number): 72:2
Month, Year: 2005
Major topic: Oral Habits
Minor topic(s): Amalgam in Pediatric Dentistry
Type of Article: Bruxism
Main Purpose: Evaluate reported prevalence of nocturnal bruxism, and demographic correlations
Overview of method of research: 854 surveys were given to parents of patients at 4 private pediatric dental offices and at Children’s Hospital Boston Dental Clinic about nocturnal bruxism, demographic information, and questions about purported associated factors.
Findings: Due to differing methodologies in different studies (e.g. parent/patient report vs. observation of wear facets intraorally), the precise prevalence of bruxism is not known. Other studies have shown that bruxers respond more negatively to life events and tend to be more anxious, aggressive, and hyperactive. Bruxism was reported to commence at a mean age of 3.6 years and ceased at a mean age of 6 years. Only 5% of the study population reported subjective TMD symptoms such as jaw clicking, muscle tenderness, pain on opening, or limited opening. There was a statistically significant association between the child’s bruxism habit and parental bruxism (P<0.0005). 48% of children reported to be bruxers had at least one parent who also had a history of bruxism, which was true for only 32% of reported nonbruxers. Naturally, bruxism was reported more often in families who sleep with the doors open. Children with psychological disorders are 3.6 times more likely to brux. Droolers were 1.7 times more likely and sleeptalkers 1.6 times more likely to brux. Children with oral habits (e.g. thumb, pacifier) were less likely to brux than their non-habit-posessing counterparts.
Key points/Summary : Of the 38% of parents reporting that their children brux, the following factors were significantly associated with the reported bruxism: familial history, open bedroom doors, drooling, sleeptalking, and psychological disorders
Assessment of article: Interesting.
Tuesday, April 21, 2009
The effect of hypertrophic adenoids and tonsils on the development of posterior crossbite and oral habits
Author(s): Constantine Oulis, George Vadiakas, John Ekonomides and Joanna Dratsa
Journal: Journal of Clinical Pediatric Dentistry
Month, Year: 1994
Major topic: adenoid effect on bite and habits
Type of Article: Observational study
Findings: Adenoids are described as hypertrophied state of the pharyngeal tonsils in the upper posterior wall of the nasopharynx and consist of the upper part of the Waldeyer Ring. Adenoids may be associated with rhinitis, sinusitis and otitis media. The inferior posterior movement of the tongue and mandible to achieve an open airway may posturally affect the position of the teeth. This investigation studied the incidence of crossbite and oral habits in children whose hypertrophy was significant enough to require surgical treatment. One hundred twenty Caucasian children in Athens, Greece, who had an adenoidectomy scheduled were included in the study. They were screened for the number of teeth in crossbite and oral habits. Severity of airway obstruction was determined surgically and radiographically. The children were split into 2 age groups: 3-5 y.o. and 5-8 y.o. There was a 74% agreement between ragiographic and surgical screening of airway obstruction confirming lateral cephalometrics as a viable addition to screening of restricted airways. 45.8% and 47.2% of patients had posterior crossbite in the younger and older populations respectively (normally 7-10% in the mixed dentition). 89% of permanent molars had erupted in crossbite. The higher the degree of obstruction, the higher the number of children in crossbite. Eighty percent of children with a 3rd or 4th degree obstruction were in crossbite. Only 13% of patients with a 1st or 2nd degree obstruction were in crossbite. All children, according to parental interview, with a posterior crossbite had a history of mouth-breathing during sleep. 71.4% were continuous mouth-breathers. Interestingly, the use of a pacifier or a digit sucking habit was not correlated with crossbite.
Key points/Summary: Larger airway obstructions in young children will very often lead to posterior crossbite. Patients in crossbite who do not have a history of digit sucking or pacifier use should be evaluated for upper airway obstruction with the lateral ceph film a valuable tool.
Assessment of article: Interesting correlation and something to look out for in our population.
Brian Schmid DMD
Journal: Journal of Clinical Pediatric Dentistry
Month, Year: 1994
Major topic: adenoid effect on bite and habits
Type of Article: Observational study
Findings: Adenoids are described as hypertrophied state of the pharyngeal tonsils in the upper posterior wall of the nasopharynx and consist of the upper part of the Waldeyer Ring. Adenoids may be associated with rhinitis, sinusitis and otitis media. The inferior posterior movement of the tongue and mandible to achieve an open airway may posturally affect the position of the teeth. This investigation studied the incidence of crossbite and oral habits in children whose hypertrophy was significant enough to require surgical treatment. One hundred twenty Caucasian children in Athens, Greece, who had an adenoidectomy scheduled were included in the study. They were screened for the number of teeth in crossbite and oral habits. Severity of airway obstruction was determined surgically and radiographically. The children were split into 2 age groups: 3-5 y.o. and 5-8 y.o. There was a 74% agreement between ragiographic and surgical screening of airway obstruction confirming lateral cephalometrics as a viable addition to screening of restricted airways. 45.8% and 47.2% of patients had posterior crossbite in the younger and older populations respectively (normally 7-10% in the mixed dentition). 89% of permanent molars had erupted in crossbite. The higher the degree of obstruction, the higher the number of children in crossbite. Eighty percent of children with a 3rd or 4th degree obstruction were in crossbite. Only 13% of patients with a 1st or 2nd degree obstruction were in crossbite. All children, according to parental interview, with a posterior crossbite had a history of mouth-breathing during sleep. 71.4% were continuous mouth-breathers. Interestingly, the use of a pacifier or a digit sucking habit was not correlated with crossbite.
Key points/Summary: Larger airway obstructions in young children will very often lead to posterior crossbite. Patients in crossbite who do not have a history of digit sucking or pacifier use should be evaluated for upper airway obstruction with the lateral ceph film a valuable tool.
Assessment of article: Interesting correlation and something to look out for in our population.
Brian Schmid DMD
Subscribe to:
Posts (Atom)