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      Timetable for oral prevention in childhood—developing dentition and oral habits: a current opinion

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          Abstract

          As most of the etiologic factors of malocclusion are of genetic origin and thus cannot be prevented, environmental causative factors have become the focus for correction. Early interception of oral habits may be an important step in order to prevent occlusal disturbances in children. The identification of an abnormal habit and the assessment of its potential immediate and long-term effects on the dentition and potentially on the craniofacial complex should be made at an early stage. This paper focuses on the most common oral habits influencing dentofacial growth in childhood and management of these habits in the developing dentition.

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          Diagnosis and management of childhood obstructive sleep apnea syndrome.

          Carole L Marcus, Lee Jay Brooks, Kari Draper … (2012)
          This technical report describes the procedures involved in developing recommendations on the management of childhood obstructive sleep apnea syndrome (OSAS). The literature from 1999 through 2011 was evaluated. A total of 3166 titles were reviewed, of which 350 provided relevant data. Most articles were level II through IV. The prevalence of OSAS ranged from 0% to 5.7%, with obesity being an independent risk factor. OSAS was associated with cardiovascular, growth, and neurobehavioral abnormalities and possibly inflammation. Most diagnostic screening tests had low sensitivity and specificity. Treatment of OSAS resulted in improvements in behavior and attention and likely improvement in cognitive abilities. Primary treatment is adenotonsillectomy (AT). Data were insufficient to recommend specific surgical techniques; however, children undergoing partial tonsillectomy should be monitored for possible recurrence of OSAS. Although OSAS improved postoperatively, the proportion of patients who had residual OSAS ranged from 13% to 29% in low-risk populations to 73% when obese children were included and stricter polysomnographic criteria were used. Nevertheless, OSAS may improve after AT even in obese children, thus supporting surgery as a reasonable initial treatment. A significant number of obese patients required intubation or continuous positive airway pressure (CPAP) postoperatively, which reinforces the need for inpatient observation. CPAP was effective in the treatment of OSAS, but adherence is a major barrier. For this reason, CPAP is not recommended as first-line therapy for OSAS when AT is an option. Intranasal steroids may ameliorate mild OSAS, but follow-up is needed. Data were insufficient to recommend rapid maxillary expansion.
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            Oral health risk assessment timing and establishment of the dental home.

            , J. Hale (2003)
            Early childhood dental caries has been reported by the Centers for Disease Control and Prevention to be perhaps the most prevalent infectious disease of our nation's children. Early childhood dental caries occurs in all racial and socioeconomic groups; however, it tends to be more prevalent in low-income children, in whom it occurs in epidemic proportions. Dental caries results from an overgrowth of specific organisms that are a part of normally occurring human flora. Human dental flora is site specific, and an infant is not colonized until the eruption of the primary dentition at approximately 6 to 30 months of age. The most likely source of inoculation of an infant's dental flora is the mother or another intimate care provider, through shared utensils, etc. Decreasing the level of cariogenic organisms in the mother's dental flora at the time of colonization can significantly impact the child's predisposition to caries. To prevent caries in children, high-risk individuals must be identified at an early age (preferably high-risk mothers during prenatal care), and aggressive strategies should be adopted, including anticipatory guidance, behavior modifications (oral hygiene and feeding practices), and establishment of a dental home by 1 year of age for children deemed at risk.
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              Effects of oral habits' duration on dental characteristics in the primary dentition.

              Martin Nowak, Frederick Warren, S N Bishara … (2001)
              Studies dating to the 1870s have demonstrated that long-term nonnutritive sucking habits may lead to occlusal abnormalities, including open bite and posterior crossbite. However, little is known as to whether habits of shorter durations have lasting effects. The authors collected longitudinal data on nonnutritive sucking among children through a series of questionnaires regularly completed by parents. Researchers examined the children at ages 4 to 5 years and obtained study models. The models were measured for dental arch parameters (including arch width, arch length and arch depth) and assessed for overjet, overbite and posterior crossbite. The authors compared the dental arch and occlusal conditions among groups of children with nonnutritive sucking habits of different durations. Children with nonnutritive sucking habits that continued to 48 months of age or beyond demonstrated many significant differences from children with habits of shorter durations: narrower maxillary arch widths, greater overjet and greater prevalence of open bite and posterior crossbite. In addition, compared with those who ceased their habit by 12 months of age, those with habits at 36 months of age had significantly greater mandibular canine arch widths, maxillary canine arch depths and overjet, while those with habits at 24 months and 36 months had significantly smaller palatal depths. Prevalence of anterior open bite, posterior crossbite and excessive overjet (> 4 millimeters) increased with duration of habits. While continuous nonnutritive sucking habits of 48 months or longer produced the greatest changes in dental arch and occlusal characteristics, children with shorter sucking durations also had detectable differences from those with minimal habit durations. It may be prudent to revisit suggestions that sucking habits continued to as late as 5 to 8 years of age are of little concern.
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                Author and article information

                Contributors
                Alessandra Majorana: 00390303995687 , alessandra.majorana@unibs.it
                Journal
                Journal ID (nlm-ta): Prog Orthod
                Journal ID (iso-abbrev): Prog Orthod
                Title: Progress in Orthodontics
                Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )
                ISSN (Print): 1723-7785
                ISSN (Electronic): 2196-1042
                Publication date (Electronic): 2 November 2015
                Publication date PMC-release: 2 November 2015
                Publication date Collection: 2015
                Volume: 16
                Electronic Location Identifier: 39
                Affiliations
                [ ]Dental Clinic, School of Dentistry, University of Brescia, P.le Spedali Civili 1, 25123 Brescia, Italy
                [ ]Dental Clinic, IRCCS “Ca Granda-Ospedale Maggiore”, Department of Orthodontics, University of Milan, Milan, Italy
                [ ]Department of Oral and Maxillo-facial Sciences, Pediatric Dentistry Unit, “Sapienza” University of Rome, Rome, Italy
                Article
                Publisher ID: 107
                DOI: 10.1186/s40510-015-0107-8
                PMC ID: 4630315
                PubMed ID: 26525869
                SO-VID: 7995065e-6eeb-420a-98a3-2d2ef94be11a
                Copyright © © Majorana et al. 2015
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                Date received : 24 September 2015
                Date accepted : 9 October 2015
                Categories
                Subject: Research
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                issue-copyright-statement © The Author(s) 2015

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