Gender as risk factor for mouth breathing and other harmful oral habits in preschoolers

Aim: To analyze associations between the mouth-breathing pattern and other harmful oral habits among preschoolers. Methods: An observational, cross-sectional study was carried out involving 198 children from 3 to five 5 of age. A questionnaire, clinical evaluation and specific tests (mirror and water tests) were used for confirmation of the mouth-breathing pattern. Results: Mean age of the participants was 4.13 ± 0.8 years and 57.1% were male. A total of 87.4% exhibited one or more harmful oral habits. Harmful habits were more common in the male gender (61.8%); this association was statistically significant (p<0.001). Mouth breathing was the most prevalent habit (49%), followed by biting/sucking on objects (33.3%). Regarding gender, statistically significant associations were found for bottle feeding (p=0.02) and nail biting (p=0.02). Mouth breathing was associated with biting on object (p=0.00), pacifier use (p=0.02) and thumb sucking (p=0.00). Conclusions: The results of the present study suggest that mouth breathing is significantly associated with biting/sucking on objects, pacifier use and thumb sucking in preschoolers and that the occurrence of harmful oral habits is more prevalent among the male gender. Early diagnosis and intervention should be established in order to avoid future consequences involving the orofacial region.

Evaluación de la variabilidad de la dimensión vertical de oclusión en niños y adolescentes / Evaluation of variability of vertical dimension of occlusion in children and adolescents

La reproducción correcta de la dimensión vertical de oclusión es la base para la mantención de la salud del sistema estomatognático.Algunos métodos permiten la medición facial de forma reproducible, como la comparación de la distancia Comisura labial – Ángulo del ojo, así como la distancia Nasion-Menton. El objetivo de este trabajo fue evaluar la medida de la Dimensión Vertical de Oclusión y sucorrelación con género en niños y adolescentes. Fueron evaluados 176 individuos, de los cuales 48 fueron selecionados dentro de los criterios de inclusión. La medida de la dimensión vertical de oclusión fue realizada por medio de calibrador digital y fue registrada en fichas individuales. Los datos fueron estratificados por grupo etáreo y analizados por el T-test. Valores de p menores a 0,05 fueronconsiderados significantes. Los resultados evidenciaron que la Dimensión Vertical de Oclusión demostró medidas distintas por grupoetáreo y género, variando de 47,70 mm a 70,20 mm para Ángulo externo del ojo-Comisura labial y 52, 30 mm a 70,60 mm para Nasion – Menton, en el género femenino. Se observó alteración estadísticamente significativa entre estas distancias en las edades de 10 y 12 años en el género masculino, mientras que para el género femenino no fue constatada diferencia significativa, considerando el nivel designificancia de 5%. Se concluye que es necesario el registro correcto de la Dimensión Vertical de Oclusión para la reproducción de esta medida, respetándose la diferenciación por grupo etáreo y género, dado que las alteraciones de la Dimensión Vertical de Oclusión pueden llevar al paciente a alteraciones oclusales, musculares y articulares, además de predisposición a maloclusiones.

The correct reproduction of the vertical dimension of occlusion (VDO) is the basis for restoring health to the stomatognathic system. A number of methods allow facial measurement in a safe, reproducible manner, such as the comparison of distance from the lipcommissure to corner of the eye (LC-CE) to the distance from the base of the nose to the chin (N-Ch). The aim of the present study was to determine VDO length in children between 7 and 12 years of age and the correlation of this length with gender. One hundredseventy-six children were evaluated, among which 48 fulfilled the inclusion criteria. The data were stratified by age and analyzed using the paired Student’s t-test. All p-values less than 0.05 were considered statistically significant. There were different measures of VDOwith regard to age and gender, ranging from 52.30 mm to 70.20 mm for the LC-CE distance and 52.30 mm to 70.60 mm for the N-Ch distance in the girls. There was no statistically significant difference between these distances in the ages of 10 and 12 years for malesand that the correlation between LC-EC and N-Ch was not significant for females. For women, there was a correlation between LC-EC and N-Ch, considering the significance level of 5%. There was conclude that it is necessary to measure the correct VDO and standard measures for reproduction of this measure, while the differentiation by age and gender, since the change in VDO can lead the patientto occlusal changes, muscle and joint pain, beyond the predisposition to malocclusion.

Ocorrência de mordida aberta anterior e hábitos bucais deletérios em crianças de 4 a 6 anos / Occurrence of anterior open bite and harmful oral habits in children from 4 to 6-year old

OBJETIVO: verificar a ocorrência de mordida aberta anterior e de hábitos orais deletérios em crianças de quatro a seis anos de idade. MÉTODOS: foram avaliadas 266 crianças de quatro a seis anos incompletos, de ambos os gêneros, na cidade de Suzano - São Paulo. As avaliações constaram de aplicação de ficha de avaliação para detecção de ocorrência de hábitos bucais deletérios aos responsáveis e da realização de exame clínico constituído por avaliação da oclusão das crianças. RESULTADOS: verificou-se que 221 crianças (83,1 por cento) apresentaram pelo menos um hábito bucal deletério, sendo o mais frequente o uso de mamadeira 167 (75,6 por cento). A ocorrência simultânea de hábitos deletérios e alterações de oclusão dentária foi observada em 119 crianças (44,1 por cento da amostra) e nestas, a maior prevalência foi a presença da mordida aberta anterior, presente em 89 (79,8 por cento). CONCLUSÃO: a mordida aberta anterior (MAA) foi a alteração oclusal mais prevalente nas crianças, havendo associação estatisticamente significante entre hábitos orais deletérios, como uso de mamadeira, chupeta e ocorrência de bruxismo e presença de mordida aberta anterior.

PURPOSE: to determine the occurrence of anterior open bite and harmful oral habits in children from four to six-year old. METHODS: a total of 266 four-to-six-year-old male and female children in the city of Suzano (São Paulo, Brazil) were evaluated. An assessment chart for detecting the occurrence of harmful oral habits was administered to the guardians and clinical exams were performed for assessing occlusion in the children. RESULTS: a total of 221 children (83.1 percent) had at least one harmful oral habit, the most frequent of which was the use of a feeding bottle (n=167; 75.6 percent). The occurrence of simultaneous harmful habits and dental occlusion abnormalities was observed in 119 children (44.1 percent of the sample); among these children, the greatest prevalence was of anterior open bite (n=89; 79.8 percent). CONCLUSION: anterior open bite was the most prevalent occlusion alteration in the children and had a statistically significant association with harmful oral habits, such as the use of a bottle and/or pacifier and teeth grinding.

Avaliação cefalométrica de pacientes respiradores bucais / Cephalometric evaluation of mouth-breathing patients

Introdução: A respiração ocupa um importante papel na matriz functional, assim como no crescimento e desenvolvimento do complexo maxilofacial. Objetivo: A proposta deste estudo foi avaliar a cefalometria de pacientes respiradores bucais. Método: A análise foi realizada em 40 pacientes, 22 do gênero feminino e 18 do masculino, de 5 anos a 14 anos e 4 meses de idade. Foram obtidas telerradiografias laterais, nas quais se realizou a análise cefalométrica sumária de Ricketts e o cálculo VERT. Resultados: Os resultados das análises apontaram uma diminuição do ângulofacial, altura facial inferior e arco mandibular e aumento da altura facial total, convexidade do ponto A e do grau de convexidade do perfil mole. A profundidade facial, ângulo do plano mandibular e profundidade maxilar ficaram dentro dos valores de normalidade. Na análise dentária, os incisivos inferiores e os molares superiores mostraram-se em posições normais, assim como a inclinação do incisivo inferior. Além disso, após análise estatística dos dados, constatou-se uma característica dolicofacial severa. Conclusão: O padrão de respiração bucal foi responsável por várias anormalidades no crescimento e desenvolvimento craniofacial.

Introduction: Breathing plays a part in the functional matrix, acting on plastic dynamics as well as the growth and development of the maxillofacial complex. Objective: The aim of the present study was to assess the cephalometrics of mouth-breathing patients. Methods: Analysis was carried out on 40 patients (22 females and 18 males), between five and 14 years of age at the Functional Orthopedics of the Maxillae Clinic of the Universidade Camilo Castelo Branco (SP, Brazil). Lateral tele-radiographs were obtained, for which Ricketts’s cephalometric analysis was performed and the VERT index was calculated. Results: The results of the analysis revealed a reduction in the angles of facial axis, height of the lower face and mandibular arch as well as an increase in total facial height, convexity of Point A and the degree of convexity of the soft profile. Facial depth, angle of the mandibular plane and maxillary depth were within the range of normality. In the dental analysis, the lower incisors, upper molars and inclination of the lower incisors were positioned normally. The VERT index value was high, indicating a severe dolichocephalic (long face) characteristic. Conclusion: The mouth breathing pattern was responsible for various abnormalities in craniofacial growth and development.

Prevalência de sinais e sintomas de DTM's e de hábitos deletérios em crianças / Epidemiology of signs and symptoms of temporomandibular dysfunctions of children

As desordens nas articulações têmporo-mandibulares são resultados de seu funcionamento anormal e podem aparecer em situações como mordida instável, mau alinhamento dentário, bruxismo e traumas na cabeça ou pescoço, podendo causar problemas como dor e desconforto. Desta forma, este trabalho teve como intuito avaliar a relação entre sinais, sintomas e fatores predisponentes das desordens têmporo-mandibulares em crianças portadoras de dentição decídua e mista, assim como a presença de hábitos deletérios nesta amostra. Foram avaliadas 77 crianças na faixa etária de 3 a 11 anos, sendo 40 do sexo masculino e 37 do feminino; por meio de questionário, exame físico e exame da oclusão, obtiveram-se os seguintes resultados: o sinal mais prevalente foi a dor de cabeça (39%), enquanto a presença de hábitos não nutritivos foi encontrada em 53,3% da amostra, sendo a onicofagia a de maior prevalência (20%). Os estalidos na ATM ocorreram em 10,3% de toda amostra.

Temporomandibular disorders in the joints resulted of its abnormal functioning and can appear for diverse reasons. Situations as bitten thus unstable, bad dental alignment, bruxismo, trauma in the head or the neck can cause problems as pain and discomfort. In such a way, this research has as intention to evaluate it has relation between the signals, symptoms and predisposes factors of the temporomandibular disorders with the malocclusion gifts in the children with deciduos or mixing dentition. The sample was constituted of 77 children in the band of 3-11 years old, being 40 of masculine sex and 37 of the feminine esx. Through the questionnaire, of the physical examination and the examination of the occlusion, we got the following results: The signal most prevalent in signal most prevalent in the sample was to the migraine (39%), whereas the predispose factor: it was to the precence of not nutritional habits (53.3%), being the onicofagia the habitat of bigger prevalence (20%). The click ones in the TWJ had occurred and 10.3% of all samples accidental of the disorders.