Have you noticed Bruxism, Nail biting and Lip biting habits in your children ?

Today in this article we will explore about bruxism, nailbiting and lipbiting habits in children and explore various aspects to it.

Bruxism:

Bruxism is defined as habitual grinding of a teeth when an individual is not chewing or swallowing.

Classification:

It can be classified as follows:

- Day time : Diurnal Bruxism. It can be consious or sub-consious and may occur along with the parafunctional habits.

- Night time : Nocturnal Bruxism. It is a consious grinding of the tooth characterized by the rhythmic pattern of the masseter.

Clinical Features:

Signs and symtoms of the bruxism depends upon the frequency, intensity and the age of the patient. 

1. Occlusal trauma: Include toothache, mobility mainly in the morning. 
2. Tooth structure: Extreme sensitivity due to loss of enamel, wearing of the fecets, pulp may exposed, and many fracture teeth may occur.
3. Muscular: Tenderness of the jaw muscles on palpation, muscular fatigue, hypertrophy of the masseter.
4. Temporomandibular joint: Pain, crepitation, clicking in joints, restriction of the jaw movements.
5. Associated features: Headache

Treatment:

1. Occlusal adjustment of any premature contacts. 
2. Occlusal splints/night-guards.
3. Restorative treatment.
4. Relaxation training.
5. Physiotherapy.
6. Drugs - Local anesthetic injection, muscle relaxants, tranquilizers.
7. Biofeedback.
8. Acupuncture
9. Orthodontic correction.

Nailbiting:

Nailbiting is one of the most common habits in children. It is sign of internal tension. The main reason of the nailbiting in the children can be :

1. Insecurity
2. Psychosomatic successor of thumb sucking
3. Nervous
4. Tensions 

Effects:

1. Crowding, rotation and alteration in the edges of the anterior teeth.
2. Inflamation of the nail bed.

Management: 

1. Patient is made aware of the habits and the problem.
2. Scolding, nagging and frightening should not be used. 
3. Encouraging childrens to participate in outdoor activities helps in minimizing the tension.
4. Application of chemicals such as nail-polish, light cotton mittens as reminders in the nails.

Lip-biting:

It is defined as the habit that involves manipulation of lips and perioral structures.

Classification:

It can be classified as:

- Lip licking: Wetting of lips by the tongue.

- Lip sucking: Pulling the lips into the mouth between the teeth.

Etiology:

1. Malocclusion 
2. In association with other habits
3. Emotional stress

Clinical Features:

1. Protrusion of upper anterior teeth.
2. Retrusion of lower anterior teeth.
3. Lip trap 
4. Muscular imbalance
5. Redden and chapped lip area are present.
6. Mentolabial sulcus becomes accentuated. 

Treatement:

Appliance therapy is needed for treating lip-sucking habit such as :
- Lip protector
- Oral screen
- Lip bumper