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HABIT ( TONGUE THRUST HABIT)

   HABIT (  TONGUE THRUST HABIT) 

It is defined as condition in which the tongue makes contact with any teeth anterior to the molars during swallowing. 



ETIOLOGY

Fletcher has proposed the following factors being the cause for tongue thrusting. 


1) Learned behavior 

Tongue thrust can be acquired as a habit. The pre disposing factors are-

a) Tenderness of gum or teeth. 
b) Improper bottle feeding. 
c) Prolonged thumb sucking. 
d) Prolonged tonsillar and upper respiratory tract infections. 

2) Genetic factors

Some of the anatomic or neuromuscular variations in the oro -facial region that can precipitate tongue thrust. Ex- Hypertonic orbicularis oris activity. 


3) Maturational

Infantile swallow changes to maturational swallow, once the posterior deciduous teeth are erupting. 



4) Mechanical restrictions

Conditions such as Macroglosssia, constricted dental arches, enlarged adenoids predispose to tongue thrust habit. 

5) Neurological disturbance


Such as hyposensitive palate and motor disability can cause tongue thrust. 


6) Psychogenic factors


Tongue thrust sometimes occurs as a result of discontinuation of other habits like thumb sucking. 


Braner and Holt classification of Tongue thrust
  • Type 1-   Non deforming tongue thrust
  • Type 2-    Deforming anterior tongue thrust
              Subgroup 1 - Anterior open bite
              Subgroup 2- Anterior proclination
              Subgroup 3- Posterior crossbite
  • Type 3-  Deforming lateral tongue thrust
                Subgroup 1- Posterior open bite
                 Subgroup 2- Posterior cross bite
                 Subgroup 3- Deep over bite. 
              
Simple classification of Tongue thrust

1)  Simple tongue thrust-

 It is characterized by a normal tooth contact   during the swallowing   act. 

 Presence of an anterior open bite. 

 Abnormal mentalis  muscle activity is seen. 

 Exhibit good intercuspation of teeth. 

 2) Complex tongue thrust-
It is characterized by a teeth apart swallow. 

 Anterior open bite can be diffuse or absent.

Contraction of the circumoral muscles during swallowing.

Absence of temporal muscle constriction during swallowing.

Occlusion of teeth may be poor.



Clinical Features

 1) Bimaxillary protrusion

2) Anterior open bite

3) Proclination of anterior teeth

4) Posterior crossbite

5) Posterior open bite in case of lateral tongue thrust.

Management of Tongue Thrust


1) Habit Interception

2) Treatment of Malocclusion


1) Habit Interception-

a) Tongue thrust can be intercepted by the use       of habit breakers. 

b) Child is taught the correct method of                      swallowing. 
c) Exercise of the tongue to adapt to the new            swallowing pattern. 


2) Treatment of Malocclusion-

Removable orthodontic or fixed orthodontic appliances. 
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