Incompetent lip seal and nail biting as risk factors for malocclusion in Japanese preschool children aged 3-6 years.

BACKGROUND: Malocclusion is a multifactorial condition associated with genetic and environmental factors. The purpose of this study was to investigate the prevalence of occlusal traits, oral habits, and nose and throat conditions by age and to assess the association between malocclusion and its environmental factors in Japanese preschool children. METHODS: A total of 503 Japanese children (258 boys and 245 girls aged 3-6 years) were recruited. Occlusal traits were assessed visually to record sagittal, vertical, and transverse malocclusion, and space discrepancies. Lip seal was recorded by an examiner, and oral habits (finger sucking, lip sucking or lip biting, nail biting, chin resting on a hand) and nose and throat conditions (tendency for nasal obstruction, allergic rhinitis, palatine tonsil hypertrophy) were assessed by a questionnaire completed by the parents. The prevalence of each item was calculated, and binary logistic regression was used to examine the factors related to malocclusion. RESULTS: 62.0% of preschool children in the present study exhibited malocclusion, and 27.8% exhibited incompetent lip seal. Nail biting was the most frequent oral habit with a prevalence of 18.9%. Nasal obstruction was recorded in 30.4% of children. The results of binary logistic regression showed that incompetent lip seal was significantly related to malocclusion, and that nail biting was significantly negatively related. CONCLUSIONS: Incompetent lip seal is significantly associated with malocclusion, but nail biting may not necessarily be a deleterious habit for the occlusion in Japanese preschool children.

Onychophagia: detailed clinical characteristics.

BACKGROUND: Onychophagia is a common disorder affecting 20% to 30% of the general population. It is defined as habitual nail biting and can cause various changes in the nail units. However, to date, there has been a paucity of data focusing on nail deformities related to onychophagia. This study was performed to investigate the clinical characteristics of onychophagia in Korea. METHODS: This study included 53 patients with onychophagia who visited the Pusan National University Hospital (Busan and Yangsan) over a 10-year period (2011-2020). We retrospectively reviewed medical records and clinical and dermoscopic photographs. RESULTS: All 10 fingernails were affected in 37.7% of the patients. The left thumbnail was the most predominantly affected site (81.1%). Clinical findings showed that short nails with ragged distal borders were the most common presentation (100.0%), followed by generalized or patchy rough areas (50.9%), linear and pinpoint hemorrhage (32.1%), longitudinal melanonychia (30.2%), transverse groove (28.3%), brittleness (28.3%), macrolunula (24.5%), washboard nail (13.2%), and pterygium (3.8%). Of the patients, 88.7% had periungual complications, such as periungual exfoliation (77.4%), absent or ragged cuticle (52.8%), hyponychial hyperkeratosis (37.7%), and paronychia (15.1%). CONCLUSIONS: Although onychophagia is a common disorder, its clinical characteristics have not been reported in the literature. The results of this study may be helpful in managing patients with onychophagia.

Self-induced dermatoses: A great imitator.

The self-induced dermatoses represent about 2% of dermatology patient visits, and include the recurrent body-focused repetitive behaviors (BFRB) (skin-picking or excoriation disorder, trichotillomania, onychophagia and onychotillomania), dermatitis artefacta, and features of other psychiatric disorders, for example, secondary to excessive grooming in body dysmorphic disorder, skin picking in delusional infestation, or secondary to self-harm in depressive disease. Among the BFRBs, onychophagia and onychotillomania are most likely to be associated with lesions that mimic other dermatologic conditions (eg, nail psoriasis, lichen planus, vasculitis, onychomycosis, melanoma). Dermatitis artefacta (DA) describes lesions that are self-inflicted with the intention of assuming a sick role in the absence of obvious external rewards. DA lesions can be bizarre-appearing or may be created intentionally to mimic dermatologic disease (eg, Munchausen syndrome). The manipulation of the integument can have a focused obsessive-compulsive behavioral style which is more responsive to the standard behavior therapies, or an impulsive-dissociative style where patients have partial or no recollection of having self-induced their lesion; dissociative patients tend to have more severe BFRBs and DA, and greater psychopathology. Self-induced dermatoses may both imitate and co-occur with primary dermatologic disease, and may not be readily identified unless the clinician maintains an index of suspicion.

Granulomatous gastritis induced by onychophagia: First case report / Gastritis granulomatosa inducida por onicofagia: primer relato de caso

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Onychotillomania: Diagnosis and Management.

Onychotillomania, defined as self-induced trauma to the nail unit, either by picking or pulling at the nails, affects 0.9% of the population. It may lead to severe irreversible nail dystrophy, melanonychia, or infections. Although no large clinical trials have assessed the efficacy of treatments, cognitive-behavioral therapy, physical barrier methods, and pharmacological treatments have shown some benefits in case reports. The objective of this article is to review the prevalence, diagnostic criteria, etiology, historical and physical examination findings, pathological features, and current treatment methods. Onychotillomania remains a clinical challenge to dermatologists, pediatricians, internists, and psychiatrists in practice, as there are no evidence-based treatment methods.

Factores de riesgo asociados a hábitos bucales deformantes en niños / Risk Factors Associated with Deforming Oral Habits in Children

Introducción: los hábitos bucales deformantes tienen su origen dentro del sistema neuromuscular; constituyendo patrones reflejos de naturaleza compleja que se aprenden.Objetivo: identificar los factores de riesgo asociados a hábitos bucales deformantes en niños.Método: se realizó un estudio transversal en el período comprendido de septiembre de 2014 a febrero de 2015. Se escogieron 180 niños en las edades comprendidas entre 8 y 11 años, pertenecientes al área de salud del Policlínico Docente Pedro Díaz Coello de Holguín, que visitaron voluntariamente la consulta para participar en la investigación. Los resultados se presentaron en tablas estadísticas.Resultados: hubo predominio de niños con hábitos bucales deformantes en el sexo femenino (57,2 por ciento) y en la edad de 10 años (37,2 por ciento), predominó como hábito deformante la lengua protráctil (39,2 por ciento) y se consideran condiciones de riesgo en la presencia de hábitos bucales deformantes variables socio biológicas de las madres y los niños, la no experiencia de lactancia materna exclusiva (57,2 por ciento) y el mal funcionamiento familiar (61,1 por ciento). El nivel de escolaridad de la madre que predominó fue el preuniversitario o técnico medio (60,6 por ciento).Conclusiones: se identificaron como factores de riesgo asociados a los hábitos bucales deformantes el mal funcionamiento familiar y la no lactancia materna.(AU)

Introduction: the deforming oral habits have their origin in the neuromuscular system, constituting reflex patterns of a complex nature that are learned.Objective: to identify the risk factors associated to deforming oral habits in children.Method: a cross-sectional observational study was carried out between September 2014 and February 2015. For this 180 children between the ages of 8 and 11 from the Pedro Diaz Coello Teaching Polyclinic health area of the in Holguín were selected, who voluntarily visited the consultation to participate in the research. The results were presented in statistical tablesResults: the prevalence of children with deforming oral habits were from the female sex (57.2 percent) and in the age of 10 years (37.2 percent), prevailed as deforming habits the tongue thrusting (39.2 percent). Other risk conditions in the deforming oral habits were the socio biological variables of mothers and children as they do not have experience on breastfeeding (57.2 percent) and a wrong function of the family (61.1 percent). High school and technician were the mothers´ school level that prevailed (60.6 percent).Conclusions: family malfunction and non-breastfeeding were identified as risk factors associated with deforming oral habits.(AU)

Onychophagia: A nail-biting conundrum for physicians.

Onychophagia, defined as habitual nail biting, is a common disorder affecting 20-30% of the population and all age groups. It may lead to significant psychosocial problems, have a negative impact on quality of life, and cause complications involving both the nail unit and the oral cavity. The objective of this paper is to review the prevalence, etiology, history, physical examination, complications and management of nail biting. Since onychophagia is a challenging disorder to treat, a multi-disciplinary approach should be taken involving dermatologists, internists, pediatricians, psychiatrists and dentists.

[Failures and tongue rehabilitation]. / Échecs et rééducation linguale∗.

When confronted with difficult-to-eradicate dysfunctions and parafunctions, speech therapy most often proves a reliable ally to control the functional environment of the dental arches. However, a number of factors ranging from psychological issues to anatomical ENT obstructions, from genetic anomalies to iatrogenic procedures, account for the occasional mixed results achieved using this approach. In addition, our own treatment results can also be jeopardized or even obliterated by a recalcitrant tongue or one which has been inadequately provided for. The author will analyze the different factors involved through a series of clinical cases in order to outline her thinking regarding this organ, which can be either a driving force behind our treatments or a force for destruction.

Oral parafunctions, piercing and signs and symptoms of temporomandibular disorders in high school students.

OBJECTIVE: The use of chewing-gum and piercing has become common among adolescents and might result in increased oral muscle activity and overloading. Aim To investigate the frequency of oral piercing and parafunctions in relation to symptoms of temporomandibular disorders (TMD) among adolescents. MATERIALS AND METHODS: One hundred and twenty-four third level high school students, living either in a city or in a small town, enrolled in either science or media programmes, were included. The students completed a questionnaire regarding different parafunctions and symptoms of TMD. A clinical examination of the temporomandibular system and estimation of the tooth wear was performed in 116 students. RESULTS: Chewing-gum was used by 86% of the students (25% with a daily use) and 14% had an oral piercing. The science students used more chewing gum than the media students (p = 0.008), while the media students had more piercings (p < 0.001). Symptoms once a week or more were reported with 39% for headache, 18% for clicking, 7% for facial pain and 6% for difficulty to open wide. Girls reported more headaches (p = 0.007) and more severe symptoms (p = 0.003), had more medical consultations and used more analgesics (both p < 0.05) and had more clinical signs (p = 0.01) than boys. Girls had more oral piercings and used more chewing gum than boys (both p < 0.05). The media students had more sick leave (p < 0.01) than the science students. Chewing-gum use was associated with headache (p < 0.01), with difficulty to open wide (p < 0.05) and with tenderness of the temporomandibular joints and muscles (both p < 0.05). Oral piercing was associated with headache and muscle tenderness (both p < 0.05) and daily nail biting with headache (p < 0.05) and tooth wear (p = 0.004). CONCLUSIONS: There is an association between use of chewing gum, nail biting, oral piercing, and symptoms of TMD.

Hábito lesivo poco frecuente: presentación de un caso / An infrequent damaging habit: a case presentation

Fundamento: existen hábitos lesivos llamados neurosis, que se consideran factores importantes en el comienzo y evolución de la enfermedad periodontal. Ellos son capaces de influir tanto en su aparición y curso como en el resultado de su tratamiento.Objetivo: relatar un caso hábito poco frecuente en Estomatología.Caso clínico: se presenta el caso de una paciente de 27 años, con encías en el sector anteroinferior fuera de su posición debido a su hábito, desde la niñez, de morderse la uñas y empaquetarla en las encías de sus dientes anteroinferiores. Al examen físico se observó escasa placa dentobacteriana y presencia de sarro dentario, no caries dental, recesiones gingivales marcadas en sector anteroinferior con denudación de la superficie radicular. Se mostró un poco tímida, ansiosa, frustada. Se discutió el diagnóstico y manejo de esta enfermedad poco habitual. Se utilizó terapia sicológica y odontológica y se mantuvo una óptima higiene bucal por parte del paciente y vigilancia estricta del periodoncista. Conclusiones: la paciente está en tratamiento con una evolución satisfactoria(AU)

Background: there are damaging habits called neurosis which are considered important factors in the beginning and evolution of the periodontal disease. These habits can influence its appearance and course, as well as the result of its treatment.Objective: to present a case of an infrequent habit in Stomatology.Clinical case: the case of a twenty-seven-year-old patient is presented. The patients gums, in the anteroinferior region, were out of position because of her habit since childhood of biting her nails and packing them on the gums of her anteroinferior teeth. A scarce dentobacterial plaque and the presence of tartar, as well as dental caries, gingival resections in the anteroposterior area with denudation of the radicular surface were observed in the physical examination. The patient was a little shy, impatient, frustrated. The diagnosis and handling of this infrequent disease was discussed. Psychological and odontological therapy was applied and an optimum oral hygiene was carried out by the patient and the periodontist made a strict vigilance.Conclusions: the patient is under treatment with a satisfactory evolution(AU)

Hábito lesivo poco frecuente: presentación de un caso / An infrequent damaging habit: a case presentation

FUNDAMENTO: existen hábitos lesivos llamados neurosis, que se consideran factores importantes en el comienzo y evolución de la enfermedad periodontal. Ellos son capaces de influir tanto en su aparición y curso como en el resultado de su tratamiento. OBJETIVO: relatar un caso hábito poco frecuente en Estomatología. CASO CLÍNICO: se presenta el caso de una paciente de 27 años, con encías en el sector anteroinferior fuera de su posición debido a su hábito, desde la niñez, de morderse la uñas y empaquetarla en las encías de sus dientes anteroinferiores. Al examen físico se observó escasa placa dentobacteriana y presencia de sarro dentario, no caries dental, recesiones gingivales marcadas en sector anteroinferior con denudación de la superficie radicular. Se mostró un poco tímida, ansiosa, frustada. Se discutió el diagnóstico y manejo de esta enfermedad poco habitual. Se utilizó terapia sicológica y odontológica y se mantuvo una óptima higiene bucal por parte del paciente y vigilancia estricta del periodoncista. CONCLUSIONES: la paciente está en tratamiento con una evolución satisfactoria.

BACKGROUND: there are damaging habits called neurosis which are considered important factors in the beginning and evolution of the periodontal disease. These habits can influence its appearance and course, as well as the result of its treatment. OBJECTIVE: to present a case of an infrequent habit in Stomatology. CLINICAL CASE: the case of a twenty-seven-year-old patient is presented. The patient's gums, in the anteroinferior region, were out of position because of her habit since childhood of biting her nails and packing them on the gums of her anteroinferior teeth. A scarce dentobacterial plaque and the presence of tartar, as well as dental caries, gingival resections in the anteroposterior area with denudation of the radicular surface were observed in the physical examination. The patient was a little shy, impatient, frustrated. The diagnosis and handling of this infrequent disease was discussed. Psychological and odontological therapy was applied and an optimum oral hygiene was carried out by the patient and the periodontist made a strict vigilance. CONCLUSIONS: the patient is under treatment with a satisfactory evolution.

Risk factors associated with deforming oral habits in children aged 5 to 11: a case-control study.

INTRODUCTION: Dental and maxillofacial anomalies have multiple and complex causes. Most frequent among these are poor oral habits. A large number of children present with oral malocclusions, most of which are caused by deforming oral habits. It is important to learn about risk factors for this condition in order to institute preventive measures, early detection and treatment, and identification of low- and high-risk groups. OBJECTIVES: To identify risk factors associated with deforming oral habits, which, if maintained over time, are responsible for occlusion defects, speech disorders, and can affect physical and emotional child development. METHODS: A case-control study of children presenting with deforming oral habits in the municipality of Manzanillo in Granma province was conducted between January and August 2013. 540 children aged 5 to 11 were included of which 180 had deforming oral habits and were asked to fill out a survey to identify specific type of habits leading to malocclusion. The case group was composed of children with deforming habits, and the remaining 360 children without poor oral habits were the control group. Each case was randomly matched to two control cases. The children mothers were also surveyed to gather supplemental information. RESULTS: Children with deforming oral habits were mostly female. At age 10, onychophagia was the predominant oral deforming habit. Risk factors detected for these habits were sociobiological maternal and child variables such as low and high birth weight, maternal breastfeeding inexperience, and discord in the family. CONCLUSIONS: The study identified likely risk factors associated with deforming oral habits. These are discord in the family, birth weight, and lack of breastfeeding experience.

INTRODUCCIÓN: Las causas de las anomalías dentomaxilofaciales son múltiples y complejas. Los hábitos bucales incorrectos, deletéreos o deformantes son una de las más frecuentes. Debido a la cantidad de niños que acuden a consulta con maloclusiones, generadas en su mayoría por los hábitos bucales deformantes, se vuelve necesario el conocer los factores de riesgo para así reducirlos al máximo y evitar sus consecuencias. Este conocimiento puede ser muy útil para identificar los grupos de bajo y alto riesgo, así como para la prevención secundaria, cuando se cuenta con los medios de detección precoz y tratamiento. OBJETIVOS: Identificar los factores de riesgo asociados a hábitos bucales deformantes, los que producen alteraciones de la oclusión, trastornos en el lenguaje y en el desarrollo físico y emocional del niño, si es que se mantienen por largos períodos de tiempo. MÉTODO: Se realizó un estudio de tipo caso control de niños afectados por hábitos bucales deformantes del municipio de Manzanillo, provincia Granma, en el periodo comprendido entre enero y agosto de 2013. Del total de niños entre 5 y 11 años del área se seleccionaron 540 menores, de ellos 180 con hábitos bucales deformantes que se examinaron en consulta a los que se les aplicó una encuesta para determinar el tipo de hábitos que practicaban. Los niños con hábitos deformantes constituyeron los casos y los otros 360 sin hábitos bucales deformantes constituyeron los controles. Se tomó 1 caso por cada 2 controles estudiados a partir de un muestreo aleatorio. A todas las madres de estos niños se les realizó una encuesta para obtener las demás variables necesarias para el estudio. RESULTADOS: Hubo predominio de niños con hábitos bucales deformantes en el sexo femenino. En la edad de 10 años predominó como hábito deformante la onicofagia. Se consideran condiciones de riesgo en la presencia de hábitos bucales deformantes variables socio biológicas de las madres y los niños como el bajo y sobre peso del niño al nacer, la no experiencia de lactancia materna exclusiva y la no armonía familiar. CONCLUSIONES: Se identificaron como factores de riesgo asociados a los hábitos bucales deformantes la armonía familiar, el peso del niño al nacer y la experiencia de lactancia materna.

Onychophagia and subgingival foreign body embedment: a case report.

This paper describes a case of subgingival foreign body embedment in the form of a finger nail fragment, as a consequence of onychophagia (fingernail biting). The result was periodontal infection that was concurrent with apical pathology on an adjacent non-vital tooth. This finding complicated the diagnosis and management of this case. Although foreign body impactions are relatively rare, they should be considered in a differential diagnosis, especially when the clinician is presented with an unusual clinical picture.

Factores de riesgo asociados a hábitos bucales deformantes en niños de 5 a 11 años: estudio de casos y controles / Risk factors associated with deforming oral habits in children aged 5 to 11: a case-control study

Introducción Las causas de las anomalías dentomaxilofaciales son múltiples y complejas. Los hábitos bucales incorrectos, deletéreos o deformantes son una de las más frecuentes. Debido a la cantidad de niños que acuden a consulta con maloclusiones, generadas en su mayoría por los hábitos bucales deformantes, se vuelve necesario el conocer los factores de riesgo para así reducirlos al máximo y evitar sus consecuencias. Este conocimiento puede ser muy útil para identificar los grupos de bajo y alto riesgo, así como para la prevención secundaria, cuando se cuenta con los medios de detección precoz y tratamiento. Objetivos Identificar los factores de riesgo asociados a hábitos bucales deformantes, los que producen alteraciones de la oclusión, trastornos en el lenguaje y en el desarrollo físico y emocional del niño, si es que se mantienen por largos períodos de tiempo. Método Se realizó un estudio de tipo caso control de niños afectados por hábitos bucales deformantes del municipio de Manzanillo, provincia Granma, en el periodo comprendido entre enero y agosto de 2013. Del total de niños entre 5 y 11 años del área se seleccionaron 540 menores, de ellos 180 con hábitos bucales deformantes que se examinaron en consulta a los que se les aplicó una encuesta para determinar el tipo de hábitos que practicaban. Los niños con hábitos deformantes constituyeron los casos y los otros 360 sin hábitos bucales deformantes constituyeron los controles. Se tomó 1 caso por cada 2 controles estudiados a partir de un muestreo aleatorio. A todas las madres de estos niños se les realizó una encuesta para obtener las demás variables necesarias para el estudio. Resultados Hubo predominio de niños con hábitos bucales deformantes en el sexo femenino. En la edad de 10 años predominó como hábito deformante la onicofagia. Se consideran condiciones de riesgo en la presencia de hábitos bucales deformantes variables socio biológicas de las madres y los niños como el bajo y sobre peso del niño.

Introduction Dental and maxillofacial anomalies have multiple and complex causes. Most frequent among these are poor oral habits. A large number of children present with oral malocclusions, most of which are caused by deforming oral habits. It is important to learn about risk factors for this condition in order to institute preventive measures, early detection and treatment, and identification of low- and high-risk groups. Objectives To identify risk factors associated with deforming oral habits, which, if maintained over time, are responsible for occlusion defects, speech disorders, and can affect physical and emotional child development. Methods A case-control study of children presenting with deforming oral habits in the municipality of Manzanillo in Granma province was conducted between January and August 2013. 540 children aged 5 to 11 were included of which 180 had deforming oral habits and were asked to fill out a survey to identify specific type of habits leading to malocclusion. The case group was composed of children with deforming habits, and the remaining 360 children without poor oral habits were the control group. Each case was randomly matched to two control cases. The children’s mothers were also surveyed to gather supplemental information. Results Children with deforming oral habits were mostly female. At age 10, onychophagia was the predominant oral deforming habit. Risk factors detected for these habits were sociobiological maternal and child variables such as low and high birth weight, maternal breastfeeding inexperience, and discord in the family. Conclusions The study identified likely risk factors associated with deforming oral habits. These are discord in the family, birth weight, and lack of breastfeeding experience.

Clinical and cytologic features of antibiotic-resistant acute paronychia.

BACKGROUND: Acute paronychia usually is treated as a bacterial infection, but antibiotic-resistant acute paronychia may be caused by other infectious and noninfectious problems. OBJECTIVE: We sought to describe the clinical, etiologic, cytologic, and therapeutic features of antibiotic-resistant acute paronychia. METHODS: A retrospective review of medical records and cytology was performed in 58 patients (age, 1 month-91 years; 36 children and adolescents [62%] and 22 adults [38%]) who had antibiotic-resistant acute paronychias. RESULTS: Causes of paronychia included bacteria (25 patients [43%]), viruses (21 patients [36%]), fungi (5 patients [9%]), drugs (3 patients [5%]), pemphigus vulgaris (3 patients [5%]), and trauma (1 patient [2%]). Diagnostic cytologic findings were noted in 54 patients (93%); no diagnostic cytologic findings were present with drug-induced (3 patients) or traumatic (1 patient) paronychia. The most common predisposing factors were the habits of finger- or thumb-sucking (14 patients [24%]) and nail-biting (11 patients [19%]). Complications included id reaction with erythema multiforme in 3 patients (5%). LIMITATIONS: Limitations include retrospective study design from 1 treatment center. CONCLUSION: Antibiotic-resistant acute paronychia may be infectious or noninfectious. Cytologic examination with Tzanck smear may be useful diagnostically and may prevent unnecessary use of antibiotics and surgical drainage.

Association between parafunctional habits and signs and symptoms of temporomandibular dysfunction among adolescents.

PURPOSE: To determine associations between signs and symptoms of temporomandibular disorder (TMD) and harmful oral habits. MATERIALS AND METHODS: Two hundred forty-four adolescents from a public school in the city of São Roque, Brazil, were evaluated. A screening questionnaire for orofacial pain and TMD recommended by the American Academy of Orofacial Pain was used to determine signs and symptoms of TMD. Patient histories and clinical exams were used to determine harmful oral habits. RESULTS: Eighty-three participants (34%) displayed no signs or symptoms of TMD, 161 (66%) responded affirmatively to at least one item on the questionnaire and 49 (20.1%) gave at least three affirmative responses. Headache was the most frequently reported sign or symptom of TMD (40.6%; n = 99). There was no statistically significant association between gender and signs or symptoms of TMD (P = 0.281). Twenty-five percent (n = 61) of the patients had no harmful oral habits, while 16.4% (n = 40) had only one habit, the most common of which was nail biting. A total of 20.1% (n = 49) reported two harmful oral habits and 38.5% (n = 94) reported three or more such habits. There was a statistically significant association between signs and symptoms of TMD and three or more habits. CONCLUSION: A statistically significant association was found between signs and/or symptoms of TMD and harmful oral habits in adolescents.

Onychophagia and postorthodontic isolated gingival recession: diagnosis and treatment.

This clinical report describes the diagnosis and the management of isolated-type recession defects of complex etiology in 2 healthy postorthodontic patients. The lesions were confined to 1 mandibular incisor and were associated with an abnormal buccolingual inclination of the affected tooth despite a lingual retainer made with a round stainless steel twisted wire. After careful questioning, it was determined that the recession defects were indirect effects of habitual onychophagia. The concomitant fingernail-biting habit and the lingual bonded retainer led to the indirect development of bone dehiscence and, consequently, gingival recession.