Characteristics of primary dentition occlusion in preschool children: an epidemiological study

Associations between nonnutritive sucking habits, developing malocclusion, and various feeding practices in 3-6-year-old Indian urban children: A case-control study

BACKGROUND

Nutritive sucking and nonnutritive sucking (NNS) may affect the craniofacial development, differently.

AIM AND OBJECTIVES

We investigated associations between NNS habits (NNSHs), developing malocclusion, and various feeding practices in 3-6-year-old children.

METHODOLOGY

A sample of 350 children 3-6-year-old from various preschools were selected for this case-control study (94 with NNSH and 256 without NNSH). NNSH (outcome) and feeding practices and developing malocclusions (exposures) were assessed using a structured study tool.

RESULTS

The prevalence of NNSH in 3-6-year-old children was 26.8%. The odds (95% [confidence interval (CI)]) of boys compared to girls having NNSH were 0.66 (0.4121-1.706) (P = 0.0290). The overall prevalence of developing malocclusion in 3-6-year-old children was 34.01% out of which open bite was most commonly reported with 12.57% followed by spacing 8.5%, increased overjet 6.8%, crowding 2.2%, posterior crossbite and rotation 1.4%, and overbite 1.14%. Breastfeeding was found to be the most commonly used mode of feeding reported by 53.42% of mothers. It was found that the odds (95% [CI]) of subjects having NNSH were 0.66 (0.4694-0.9460) (P < 0.0001) who were not breastfed as compared to those who were breastfed. Among developing malocclusions, increased overjet with P = 0.0019, open bite with P = 0.0416, and spacing with P = 0.0243 were found to be associated with feeding practices.

CONCLUSION

The prevalence of NNSH and developing malocclusions (increased overjet, open bite, and spacing) was 26.8% and 34.01%, respectively. Breastfeeding played a protective role against developing NNSH.

Evolution of the Terminal Plane from Deciduous to Mixed Dentition

(1) Introduction: Correct development and growth of the dental arches and occlusion in the deciduous dentition is crucial for physiological occlusion in the permanent dentition. The present study evaluates the evolution of the terminal plane and canine occlusion class in the same children from deciduous to mixed dentition. (2) Materials and methods: The study included 257 children (164 girls and 93 boys) aged 3-5 years in the first phase and 8-10 years in the second phase. The chi-square test was used for the comparison of qualitative variables, while analysis of variance (ANOVA) or the Mann-Whitney U-test, Kruskal-Wallis test, and Wilcoxon test were used in the case of quantitative variables, as applicable. Statistical significance was considered for p < 0.05. (3) Results: The most common terminal plane in the first phase of the study was a bilateral flush plane (70%), followed by distal and mesial, with few differences between them. In the second phase, the most common terminal plane was mesial, followed by bilateral flush and distal. There were no statistically significant differences according to gender. Canine occlusion in the first phase was predominantly bilateral class I, followed by class II and class III. Similar results were recorded in the permanent dentition, except for a lesser percentage of children with canine class II. Molar occlusion in the second phase was predominantly class I, followed by half cusp class II and full cusp class II and class III. (4) Conclusions: The present study shows that knowing the age range in which maximum dental development and growth in both arches occurs may contribute to avoiding malocclusions and the possible need for orthodontic-orthopedic treatment, resulting in improved outcomes and greater stability.

Prevalence and Associated Factors of Malocclusion among Preschool Children in Huizhou, China: A Cross-Sectional Study

This survey examined the prevalence of malocclusion and its associated factors in 3- to 5-year-old children in Huizhou, China. Children were recruited from 21 kindergartens using a multistage sampling method. Two examiners performed oral examinations on the children, assessing occlusal traits, including primary molar and canine relationship, overjet, crossbite, overbite, anterior open bite, scissor bite, midline deviation, crowding, and spacing. Caries experience was recorded. Self-administered questionnaires were distributed to collect background information and oral health-related habits. Chi-square test, Mann-Whitney U test, and binary logistic regression were conducted. The study invited 1485 children and eventually recruited 1454 (52.9% boys; response rate: 97.9%). The prevalence of malocclusion was 68.3%, and deep overbite was found in 48.6% of the children. Children who had lip-biting habits had a higher prevalence of deep overbite than those who did not (OR = 2.36, p < 0.05). Children who had digit-sucking habits and dental caries in anterior maxillary teeth had a lower prevalence of deep overbite than those who did not (OR = 0.73 and 0.70, respectively, p < 0.05). In conclusion, over half of the children in Huizhou who participated in the study had malocclusion. Dental caries in anterior maxillary teeth, digit-sucking, and lip-biting were the associated factors of deep overbite.

Oral manifestations of congenital Zika virus infection in children with microcephaly: 18-month follow-up case series

AIMS

To describe oral manifestations in children born with microcephaly attributed to congenital Zika virus syndrome (CZS).

METHODS

Data was collected in semiannual intervals from 2017 to 2019, by oral exams of the children and interview with caregivers at a Public Dental Center in Rio de Janeiro, Brazil. A single calibrated examiner performed clinical examinations.

RESULTS

Of 38 eligible children, 34 were followed-up from 12 to 30 months of age, 20 boys and 14 girls. The mean age of emergence of their first primary tooth was 12.4 months (SD = 2.9). By 30 months of age only 14.7% (n = 5) had complete primary dentition. Alteration in the sequence of tooth emergence was observed in 41.1% (n = 14). Radiographic examination demonstrated dental agenesis (14.7% n = 5). Dental developmental alterations (38.2%, n = 13), enamel defects (14.7%, n = 5), eruption cysts/hematoma (23.5%, n = 8), gingival bleeding (55.8%, n = 19), narrow palate, and bruxism (64.7%, n = 22) were also observed. No child had dental caries.

CONCLUSION

Children with microcephaly attributed to CZS presented oral manifestations early in life.

A Four-Year Follow-Up Case Report of Hypomineralized Primary Second Molars Rehabilitated with Stainless Steel Crowns

Hypomineralized primary second molars (HPSM) are characterized by enamel opacities accompanied by hypersensitivity and atypical caries lesion, on one to four primary second molars. The correct treatment and follow-ups of those teeth have an important impact on a correct eruption of the first permanent molars and future occlusion. Hence, this report aims to describes a case of a severe HPSM in all second molars of a four-year-old girl and subsequent four-year follow-ups. The rehabilitation involved the placement of four stainless steel crowns on all four second primary molars under general anesthesia. Concerning the available literature and the case severity of HPSM, the treatment approach proposed for the case provided good functional outcome.

Distribution of School Children Based on the Type of Terminal Plane in Primary Dentition: A Study among 3- to 5-year-old Children in Chennai, Tamil Nadu, India

Background

This study was aimed to investigate the prevalence of primary malocclusion among school children under 5 years of age in Chennai, Tamil Nadu.

Materials and methods

A total of 814 school children under 5 years were selected from 5 government and 5 private schools in Chennai city, Tamil Nadu, India, and their occlusion was recorded based on the terminal planes. Data were analyzed using SPSS version 16 software. Frequency distribution and Chi-square test were carried out.

Results

The most common occlusion seen in the present study was flush terminal plane (54.05%). Of them, 43.73% had mesial step and 2.08% had distal step. There was no significant difference between males and females.

Conclusion

The signs of future malocclusion are found to be high. Hence, early preventive and interceptive measures are necessary to reduce the prevalence of future developing malocclusion and further adverse effects.

How to cite this article

Anu V, Pavani B, Pavani D, et al. Distribution of School Children Based on the Type of Terminal Plane in Primary Dentition: A Study among 3- to 5-year-old Children in Chennai, Tamil Nadu, India. Int J Clin Pediatr Dent 2020;13(2):136–137.

The association between nutritive, non-nutritive sucking habits and primary dental occlusion

Background

The development of primary dentition can be affected by oral sucking habits. Therefore, this study aims to investigate the association of nutritive and non-nutritive sucking habits with primary dentition development.

Methods

One thousand one hundred and fourteen children aged 2 to 5 years old in Hong Kong were recruited in a cross-sectional study. Information on their nutritive (e.g. breastfeeding and bottle feeding) and non-nutritive sucking habits (e.g. pacifier use and thumb/digit sucking) was collected via questionnaires. The children’s primary occlusions were examined in three dimensions.

Results

Children who were breastfed for more than 6 months had a lower proportion of daily pacifier use (p < 0.05). Children who used pacifiers daily had a higher proportion of thumb/digit sucking (p < 0.05). Children who used pacifiers daily for more than one year had higher chances of developing an anterior open bite (p < 0.05) and a reduced overbite (p < 0.05). Those exhibiting daily thumb/digit sucking for more than one year had higher chances of developing Class II incisor and Class II canine relationships, an increased overjet and anterior open bite (p < 0.05).

Conclusion

Pure breastfeeding for more than 6 months is inversely associated with daily pacifier use and daily pacifier use is positively associated with daily thumb/digit sucking. Children with more than one year of daily pacifier use and thumb/digit sucking have higher chances of developing abnormal dental relationships in the sagittal (i.e. Class II incisor and Class II canine relationships and increased overjet) and vertical (i.e. anterior open bite) dimensions, respectively.

An Evaluation of Occlusal Relationship and Primate Space in Deciduous Dentition in Kancheepuram District, Tamil Nadu, India

Aim:

The objective of the study was to evaluate the occlusal characteristics of primary dentition in 3–5-year-old children in Kancheepuram district.

Materials and Methods:

A cross-sectional survey was carried out on children aged 3–5 year old in the Kancheepuram district. A total of 603 children were examined. Occlusal relationship was assessed separately on both right and left side and was classified as a flush terminal plane, mesial step, or distal step. Similarly, occlusal relationship of primary canine was examined and classified as Class I, II, or III. Primate space was measured in both the arches using digital Vernier caliper.

Results:

Pearson Chi-square test was used. Statistical significance was noted on both right and left side primary molar occlusion as well as in the canine occlusion across the three age groups. Primate spaces in both arches have been found to be significant across the three age groups. Mann–Whitney test between gender and occlusal relationship was found to be not significant.

Conclusion:

Flush terminal plane is the most common primary molar occlusion found in the present study which is statistically significant. Most of the children had primate space present in upper and lower teeth which is statistically significant.

Occlusal Features and Caries Experience of Hong Kong Chinese Preschool Children: A Cross-Sectional Study

Objective: To study occlusal features and their relation to caries experience in Hong Kong Chinese preschool children. Methods: Seven kindergarten classes in Hong Kong were selected using a stratified random sampling method, and the 4- and 5-year-old Chinese kindergarten children were invited to join the survey. Two calibrated dentists performed the clinical examinations in the kindergartens. Occlusion features, including incisal overjet; canine and molar relationship; median diastema; and primate space as well as malocclusion features, including crossbite; anterior open bite; and scissor bite, were recorded. Caries experience was recorded with the dmft index. Results: A total of 538 children were invited to participate in the study, and finally 495 children were examined (92%). Approximately half (52%) had a normal incisor relationship. Most children had a class I canine relationship (left-79%; right-75%). Approximately two-thirds had a flush terminal plane (left-64%; right-65%). Most children (76%) had a maxillary primate space, and 47% had a mandibular primate space. The prevalence of median diastema, anterior crossbite, and unilateral posterior crossbite was 30%, 12% and 1%, respectively. No bilateral posterior crossbite or scissor bite was found. Approximately half (49%) had caries experience. The mean dmft score was 2.1. Gender and age were not associated with either the studied occlusal features or the mean dmft score (p > 0.05). Conclusion: Approximately half of the Hong Kong preschool children studied had a normal occlusion, and two-thirds of them had a flush terminal plane. About three-quarters of them had a maxillary primate space, and half of them had a mandibular primate space. Their occlusal traits were not associated with caries experience and prevalence.

Prevalence of Malocclusion in 3- to 5-Year-Old Children in Shanghai, China

The aim of the present study was to obtain the prevalence of malocclusions in preschool children in Shanghai, China. A cross-sectional survey was conducted among 2335 children aged 3-5 years from kindergartens. Several occlusal parameters were clinically assessed, including second deciduous molar terminal plane, canine relationship, degree of overjet and overbite, anterior and posterior crossbite, and the presence or absence of physiologic spaces and crowding. All parents of subjects were asked to fill in the oral health knowledge questionnaires. The prevalence of malocclusion in primary dentition in Shanghai was 83.9%, and no significant differences were found in genders. Data showed that the prevalence of deep overbite (63.7%) was the highest in children with malocclusion, followed by deep overjet (33.9%), midline deviation (26.6%), anterior crossbite (8.0%) and anterior crowding (6.5%). The results revealed a high prevalence of malocclusion in primary dentition in children aged 3-5 years old of Shanghai, especially in vertical anomalies. The need for preventive orthodontic therapy is extremely desired and oral health education about malocclusion should be strengthened.

Occlusal Traits of Primary Dentition among Pre-School Children of Mehsana District, North Gujarat, India

INTRODUCTION

Aesthetic and functional problems in the dentofacial complex among children are often attributed to the disturbances in the dentofacial growth and development. This can be recognized during routine dental visits. This study pursued to assess the occlusion of the primary dentition in three to five-year-old children.

AIM

To study the occlusal traits of the primary dentition in a group of three to five-year-old North Gujarat children of Mehsana district and the variation in their occlusion relative to age and gender in the same group.

MATERIALS AND METHODS

The study was a cross-sectional survey based on clinical examination and photographic evaluation of the primary dentition, 383 preschool children aged three to five years who were randomly selected from preschools in Mehsana district, Gujarat, India, using a multistage sampling technique. The study group was evaluated for the several occlusal parameters that include primary molar relation based on Baume classification and canine relation, overjet, overbite were assessed using Foster and Hamilton criteria. Chi-square test was performed to carry out statistical analysis. The p-value<0.05 was taken as statistically significant.

RESULTS

Out of 383 participants, 55.35% had flush terminal plane; 43.34% mesial step molar relationship and 1.31% distal step molar relationship, 63.2% had straight profile, 95.8% had Class I canine relationship, 71.3% primate spaces, 56.7% physiologic spaces. Flush terminal plane was common at three years while, mesial step at four to five years, and Class I canine relationship was prevalent in both age groups. Flush terminal plane was more common in female participants than the males. Amongst other occlusal characteristics, increased overbite and open bite were prevalent.

CONCLUSION

It was found that the flush terminal plane molar relationship, straight profile, Class I canine relationship, primate spacing, increased overbite and open bite predominated.

Malocclusion in the primary dentition in children with and without deformational plagiocephaly

OBJECTIVES

Asymmetries of the jaw and orthodontic abnormalities are suspected as long-term consequences of positional cranial deformity. But only few data exist on this issue. As plagiocephaly is a common problem in infancy, potential functional impairments should be investigated to initiate appropriate measures if necessary. The aim of our study was to compare the orthodontic situation in primary dentition of children with positional plagiocephaly and children without cranial deformities.

MATERIAL AND METHODS

Fifty children treated by helmet therapy for plagiocephaly and 50 non-affected children (age 1.98-5.69 years) were examined in a cross-sectional study. Orthodontic parameters of all dimensions were assessed and analyzed.

RESULTS

Children of the plagiocephalic group showed more often orthodontic alterations compared to the others. Especially the frequencies of a class II malocclusion (36 vs. 14 %), an edge-to edge bite (28 vs. 12 %), and deviations of the midline (38 vs. 16 %) were conspicuous. However, none of the differences was significant (p > 0.003). Of all observed mandibular asymmetries, 69 % appeared as a shift to the contralateral side of the former flattened occipital region.

CONCLUSION

Positional head deformity might be associated in some cases with a higher prevalence of occlusal abnormalities in primary dentition.

CLINICAL RELEVANCE

Positional plagiocephaly interfaces medicine and dentistry. As it is a common disorder, this etiology has to be considered in the prevention and therapy of malocclusion.

Exploring the association between feeding habits, non-nutritive sucking habits, and malocclusions in the deciduous dentition

Background

This study aimed to explore the association between feeding habits, non-nutritive sucking habits, and malocclusions in deciduous dentition.

Methods

A cross-sectional observational survey was carried out in 275 children aged 3 to 6 years and included clinical evaluations of malocclusions and structured interviews. Statistical significance for the association between feeding habits and the development of malocclusion was determined using chi-square and Fisher’s exact tests. In addition, odds ratio (OR) calculations were used for intergroup comparisons. Controlling for confounders was adjusted by excluding children with non-nutritive sucking habits.

Results

The results indicated that there were no significant relationships between exclusive breastfeeding or bottlefeeding and the presence of any type of malocclusion (p > 0.05). There was also no significant association between breastfeeding or bottlefeeding duration and malocclusion (p > 0.05). In addition, it was observed that exclusive breastfeeding had a protective effect and diminished the risk of acquiring non-nutritive sucking habits (p = 0.001).

Conclusions

There was no association between feeding habits and malocclusions in the deciduous dentition in this sample of children. Exclusive breastfeeding reduced the risk of acquiring non-nutritive sucking habits.

Effects of breast-feeding duration, bottle-feeding duration and non-nutritive sucking habits on the occlusal characteristics of primary dentition

BACKGROUND

Early transition from breastfeeding and non-nutritive sucking habits may be related to occlusofacial abnormalities as environmental factors. Previous studies have not taken into account the potential for interactions between feeding practice, non-nutritive sucking habits and occlusal traits. This study assessed the effects of breast-feeding duration, bottle-feeding duration and non-nutritive sucking habits on the occlusal characteristics of primary dentition in 3-6-year-old children in Peking city.

METHODS

This cross sectional study was conducted via an examination of the occlusal characteristics of 734 children combined with a questionnaire completed by their parents/guardians. The examination was performed by a single, previously calibrated examiner and the following variables were evaluated: presence or absence of deep overbite, open bite, anterior crossbite, posterior crossbite, deep overjet, terminal plane relationship of the second primary molar, primary canine relationship, crowding and spacing. Univariate analysis and multiple logistic regressions were applied to analyze the associations.

RESULTS

It was found that a short duration of breast-feeding (never or ≤ 6 months) was directly associated with posterior cross bite (OR = 3.13; 95% CI = 1.11-8.82; P = 0.031) and no maxillary space (OR = 1.63; 95% CI = 1.23-2.98; P = 0.038). In children breast-fed for ≤ 6 months, the probability of developing pacifier-sucking habits was 4 times that for those breast-fed for >6 months (OR = 4.21; 95% CI = 1.85-9.60; P = 0.0002). Children who were bottle-fed for over 18 months had a 1.45-fold higher risk of nonmesial step occlusion and a 1.43-fold higher risk of a class II canine relationship compared with those who were bottle-fed for up to 18 months. Non-nutritive sucking habits were also found to affect occlusion: A prolonged digit-sucking habit increased the probability of an anterior open bite, while a pacifier-sucking habit associated with excessive overjet and absence of lower arch developmental space.

CONCLUSION

Breastfeeding duration was shown to be associated with the prevalence of posterior crossbite, no maxillary space in the deciduous dentition and development of a pacifier-sucking habit. Children who had a digit-sucking habit were more likely to develop an open bite.

Association of breastfeeding and three-dimensional dental arch relationships in primary dentition

BACKGROUND

The benefits of breastfeeding on oral health are still inconclusive, especially the association on occlusion. This study aimed to investigate the association of breastfeeding and the development of primary dentition.

METHODS

A cross-sectional study was conducted with 851 Asian children aged 2-5 years old in Hong Kong. Questionnaires were completed by the parents to collect information on breastfeeding and the non-nutritive sucking habits. The children's dental arch relationships were examined in the sagittal, vertical, and transverse dimensions by an experienced examiner.

RESULTS

Children who experienced pure breastfeeding for more than 6 months had a lower chance of developing a class II incisal relationship (P < 0.05) or an increased overjet (P < 0.05), and had wider intercanine (P < 0.05) and intermolar widths (P < 0.05). Vertically, no association on the extent of overbite or openbite was found (P > 0.05).

CONCLUSIONS

Pure breastfeeding for more than 6 months is positively associated with primary dental arch development in the anterior sagittal dental segment and on the horizontal arch width in primary dentition. Therefore, pure breastfeeding for more than 6 months is recommended, as it is associated with lower chance of the development of abnormal dental relationships. The results will be valuable for education and promotion of maternal breastfeeding.