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Classification
Obstructive mouth breathing Habitual mouth breathing Anatomical mouth breathing
3) When mouth breathing, brain thinks carbon dioxide is lost too quickly
Brain senses this Stimulation of goblet cells
4) Nostrils and sinuses filter and warm air going into the lungs
Sinus produces nitric oxide Acceleration of water loss leading to dehydration
5) Each nostril is innervated by 5 cranial nerves from a different side of the brain 6) Maintaining a keen sense of smell 7) Upper airway resistance syndrome
Also known as Snoring Social problems and other medical problems
8) Colds Mucous membrane lining Germs get caught and die in the mucous
Gingiva
Inflammed gingival tissue in upper anterior region
Gummy smile
Speech-nasal tone
Otitis media
Malocclusion
Other associated habits
Treatment considerations
Age of the child ENT examination: Rule out or eliminate nasal obstruction
MANAGEMENT
1) Treatment is required at an early age 2) Treatment considerations
Age of the child ENT examination
4) Treatment modalities
a) Elimination of the cause Surgery Local medication Rapid maxillary expansion
c) Interception of habit
Physical exercises
Deep breathes in the morning and at night
Lip exercises
Extending upper lip Lower lip exercise Playing a wind instrument Celluloid strip or metal disk
Maxillothoracic myotherapy
By Macaray in 1960 Macaray activator
Oral screen
d) Correction of malocclusion
Oral shield appliance Monobloc activator Chin cap
e) Surgery
Septoplasty Tonsillectomy Removal of adenoids
Appliance therapy
Oral screen Pre orthodontic trainer Correction of malocclusion
BRUXISM
Static or dynamic contact or occlusion of teeth at times other than for normal function such as mastication or swallowing Diurnal Nocturnal
BRUXISM
Etiology: Psychological stress, anger, aggression Local causes premature contacts Faulty restorations Deep bite Systemic causes GI disturbances, nutritional, allergic , endocrine disorders CNS disorders cerebral palsy, mental retardation Occupational factors
BRUXISM
Clinical features: Attrition facets Muscle tenderness, hypertrophy Injury to periodontal ligament Pulpal exposure Limited mouth opening Altered pattern of occlusion
BRUXISM
Clinical features Loss of vertical dimension TMJ problems Loss of alveolar bone - hyper mobility Hypersensitivity Gingival recession
BRUXISM
Management:
Occlusal adjustments, splints Restore vertical dimension Psychotherapy Electrical method Acupuncture Orthodontic therapy