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Open Bites and Oral Habits

December 1, 2023

Kids sometimes develop oral habits in their early years that can have serious ramifications on their dental health. As Dr. Bockow explains, pacifier use and thumb-sucking are primary examples of habits that can linger after early childhood and contribute to the development of poor tongue posture and lead to an open bite.

Dr. Rebecca Bockow is a dual-trained board-certified orthodontist and periodontist – one of only a handful in the country. She lectures nationally on periodontics, orthodontics, interdisciplinary orthodontics, airway, and skeletal growth and development.

”So oral habits... thinking about non-nutritive sucking, so pacifier use - usually restricted to the anterior region circular in nature. And if you look at the picture labeled A, we get sort of a chicken and egg situation as well with the tongue because now, once that open bite exists, that tongue is going to sneak into that space.

”Posterior cross-bite in the deciduous dentition period, its relation with sucking habits, irregular orofacial functions, and otolaryngological findings. There's a correlation between prolonged sucking, short lingual frenum small maxillary arch width, greater mandibular arch width, and unilateral cross-bite.

”There's a higher likelihood of developing a crossbite if pacifier use is extended beyond 18 months of age. Thumb sucking... we see a labial inclination of the upper incisors, a lingual inclination to lower incisors. It pushes the palate up, restricts mandibular growth, alters resting tongue posture, and creates an anterior dental open bite.

”So we have this ideal situation on the left and on the right once we introduce a pacifier or a digit we start to train a low tongue posture. We don't get that tongue to move up into the palette. We start to get lack of muscle memory, muscle strength.

”And so, not only do we see a high vaulted palette, possibly a cross-bite, but we don't have the functionality of the tongue when the habit goes away too... we don't often resume that that proper swallow. And we get excessive pressure from the cheeks not enough pressure from the tongue.”

Dr. Bockow loves to create beautiful smiles for her patients, setting them up for a lifetime of dental and airway health.

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