Knowledge and Attitudes of Parents about Oral Health in the Primary Dentition Stage in a Peruvian High Andean City

Children's oral health depends on parents' knowledge and attitudes. The primary dentition stage, in particular, plays a crucial role in the comprehensive development of children. Therefore, the objective was to evaluate parents' knowledge and attitudes about oral health in the primary dentition stage in Chachapoyas (Amazonas, NW Peru). A questionnaire was administered to 409 parents from 15 educational institutions, and the data were analyzed using multinomial logistic regression. Among the surveyed parents, 75.3% could identify at least one habit harmful to their children's teeth (such as excessive sugar consumption) and one of its effects (such as dental caries). Additionally, 77.5% reported that their children presented some dental problem, more frequent in the peripheral areas than in the city's center. Gender (odd ratio, OR = 0.484; p = 0.037), educational level (OR = 2.144; p = 0.043), and type of health insurance (OR = 2.627; p = 0.044) of the parents influenced awareness of taking care of their children's primary dental health. The geographic location of the school (1.729 < OR < 2.079; p ≤ 0.011) and family income (OR = 3.504; p = 0.028) influenced parents' identification of the different harmful effects of children's habits. Factors such as low socioeconomic status and never taking the child to the dentist increased the risk of dental problems (p < 0.05). It is suggested that peripheral areas, like rural areas, lack the same oral health programs and access to treatment as central urban areas, leading to disparities in parental knowledge and attitudes.

Adjustable tongue crib

Thumb sucking and tongue thrusting habits are mostly counteracted and rehabilitated using a tongue crib. Most patients find the conventional crib difficult (due to its position and length) in the initial days of treatment and become uncooperative. Hence, few modifications are made to the traditional design of the tongue crib for easy adjustment of the crib height and angulation, which provides comfort to the patient.

Oral ulcers in a finger-sucking child after cutaneous wart therapy

Common skin warts frequently appear on the fingers of children, a patient population in whom finger-sucking is a prevalent habit. Despite overlap between these two pediatric conditions, there are no well-reported specific precautions against the use of topical blistering wart treatments, such as trichloroacetic acid and cantharidin, in finger-sucking children with warts. We report the case of oral ulcers in a pediatric patient secondary to thumb-sucking after receiving treatment for multiple finger warts with combination cryotherapy, trichloroacetic acid, and cantharidin.

Thumb sucking or nail biting in childhood and adolescence is associated with an increased risk of Crohn's disease: results from a large case-control study

BACKGROUND

The hygiene hypothesis suggests that a reduction in microbial exposure contributes to an impaired immune response later in life and increases the incidence of immune-mediated diseases such as inflammatory bowel diseases (IBD). Thumb sucking and nail biting are two early habits that modulate the oral microbiota composition and antigen load.

OBJECTIVE

We hypothesized a lower risk of Crohn's disease (CD) and ulcerative colitis (UC) in adults with prior thumb sucking and nail biting.

METHODS

918 IBD cases and their 918 siblings without IBD were asked to fill out a survey containing 32 questions on environmental factors in childhood and early adulthood. Prevalence of thumb sucking and/or nail biting at the usually well-remembered time of (1) school enrollment and (2) coming-of-age ceremonies was the predefined combined risk factor of this study.

RESULTS

65% of the patients were female and 57% suffered from CD. About 49% of IBD patients but only 44% of their siblings reported thumb sucking/nail biting at the time of school enrollment or coming-of-age (p = .007). Sensitivity analysis revealed that this difference was observed in patients with CD (50% versus 41%; RR= 1.22; 95% CI 1.09-1.37, p = .001) but not in patients with UC (49% versus 48%; RR= 1.02; 95% CI 0.90-1.17; p = .83).

CONCLUSION

Contrary to our expectation and challenging the hygiene hypothesis, we found that common oral habits are not protective against IBD. Instead, nail biting at the time of school enrollment and coming-of-age was a statistically significant risk factor for CD in our cohort. Key summary Evidence available before this study: The hygiene hypothesis suggests that a reduction in microbial exposure due to improved health activities has contributed to an immunological imbalance in the intestine and an increased incidence of allergic and autoimmune diseases. A population-based birth cohort study has demonstrated that thumb-sucking and nail biting in children lead to a reduction of the risk of atopic sensitization, asthma, and hay fever. Added value of this study: Contrary to the hypothesis, thumb sucking and nail biting were not associated with a reduced risk of IBD. Instead, thumb sucking and/or nail biting at the usually well-remembered points in time of school enrollment and of religious or secular coming-of-age ceremonies was associated with a higher risk of Crohn's disease but not of ulcerative colitis. Our data did not support the hygiene hypothesis, one pathogenic concept in the context of IBD.

Evaluation of the efficacy of the modified bluegrass appliance in cessation of thumb-sucking habit: an in vivo study with 12 months follow-up

Background and aims

Blue grass appliance, also known as habit correction roller has gained universal attention and acceptance to correct thumb sucking habit. The present study utilizes the modified bluegrass appliance that was fabricated with an inexpensive acrylic roller to lower the cost of treatment and make it more affordable for the patients in developing countries. The purpose of this study was to evaluate the efficacy of the modified bluegrass appliance in cessation of thumb-sucking habit.

Methods

Forty children aged 4–14 years visiting our department for the treatment of thumb sucking habit were selected. A modified bluegrass appliance having an acrylic roller was used along with the positive reinforcement. The patients were followed-up after two weeks of appliance placement and then monthly for twelve months. The various factors like need of reinsertion, discomfort caused due to improper placement or distortion, and/or breakages of the appliance following insertion were evaluated. The cessation of the thumb sucking habit was determined by the patient and/or parental/legal guardian confirmation and disappearance of the callous formation on the thumb. However, the total treatment time was determined when the appliance was removed.

Results

Of the total 33 patients included in the final analysis, the treatment was successful in 32 (97%) of the patients. The treatment time for the cessation of habit was ≤ 4 weeks in 13 (40.6 %) patients and 5–20 weeks in 50% of the subjects. Conversely, in 2 (6.3%) of the patients the habit ceased after 21–24 weeks and in 1 (3.1%) patients it took 25–28 weeks for the habit to cease. The appliance had to be reinserted during the treatment in 5 (15.7%) out of the total 32 patients. The total treatment time for the cessation of thumb-sucking habit with modified bluegrass appliance was ≤24 weeks in 17 (53.1%) patients, 25–36 weeks in 34.4% and 37–48 weeks for the 12.5% subjects.

Conclusion

The modified bluegrass appliance was found to be highly comfortable and cost saving for the patients and very much successful in eliminating the habit within a short period of time without any complications.

Evaluation of knowledge and attitude of parents about the importance of maintaining primary dentition - A cross-sectional study

Introduction:

Dental caries is very common in primary dentition because of improper oral hygiene and increased intake of sucrose. Grossly decayed primary teeth require extraction. The space created by extracted teeth should be replaced by primary dentition to avoid migration of adjacent teeth into the space and to prevent the eruption of permanent tooth. Different appliances are used to maintain the space post extraction of the primary tooth to preserve the space for the eruption of the permanent tooth in a sequential manner.

Aim:

Evaluate the attitude and knowledge of parents toward the importance of maintaining primary dentition in their children.

Methods:

A survey was conducted among randomly selected 100 parents having children between the ages of 2 and 16 years from the general population of Chennai, India. A questionnaire was created was distributed. The data were later collected and statistical analysis was performed.

Results:

Hundred percent awareness was seen among parents regarding maintenance of oral hygiene in children. Only 65% parents reported visiting dentists only when the child complains of pain. Eighty-nine percent of the parents were aware of the harmful effects of thumb sucking habits. However, only a minimum percent parents thought that treating primary teeth was not very important as it would shed off.

Conclusion:

Even though parents were aware that primary teeth have to be managed properly, they were not aware of the various treatment modalities available for treating spaces after extraction of primary teeth and caries management. An increase in the knowledge will encourage parents to provide better oral health to their children.

Influence of nail biting and finger sucking habits on the oral carriage of Enterobacteriaceae

BACKGROUND

Oral habits like thumb sucking and nail biting are pernicious habits that act as an adaptive function in obtaining pleasure and subduing anxiety. These habits may also act as carriers of numerous microorganisms into the oral cavity, of which, Enterobacteriaceae members are transient pathogens, which might result in debilitating systemic conditions.

AIM

To study the oral carriage of Enterobacteriaceae in children having habit of nail biting and thumb sucking. And to study the association of the organism with the individual's respective plaque indices.

SUBJECTS AND METHODS

Totally, 40 chronic nail biters, 40 chronic thumb suckers, and 20 controls (no habit) (8-15 years old) were enrolled in the study. Appropriate history and their plaque indices recorded. Sterile containers were used to collect the salivary samples and later cultured on Agar plates. Biochemical tests categorized the organisms into subspecies.

STATISTICAL ANALYSIS USED

ANNOVA, Student's t-test.

RESULTS

Presence of a nail biting habit indicated a higher plaque index, which in turn showed a higher carriage of Enterobacteria spps, predominantly Escherichia coli.

CONCLUSIONS

Oral surgical intervention in individuals with pernicious oral habits need to be counseled and educated on the possible complications, which might otherwise provide an environment that disseminates these microorganisms resulting in a broad range of local and systemic infections.

A Scottish cost analysis of interceptive orthodontics for thumb sucking habits

OBJECTIVE

There is a potential cost saving to be made within the NHS by providing simple interceptive treatment rather than comprehensive treatment at a later date. The focus of this study is to determine the size of this potential cost by looking at the cost to NHS Tayside for the provision of interceptive treatment for cessation of thumb sucking and where this has been unsuccessful (or not provided) the costs of correction of the associated malocclusion.

DESIGN

A cost analysis is described, investigating the costs of treatment solely to the NHS, both in the primary and secondary setting.

METHODS

Three potential treatment pathways are identified with the costs calculated for each pathway. The actual cost of providing this treatment in NHS Tayside, and the potential cost saving in Tayside if there was a change in clinical practice are calculated. Both discounting of costs and a sensitivity analysis are performed.

RESULTS

The cost to NHS Tayside of current practice was calculated to be between £123,710 and £124,930 per annum. Change in practice to replace use of a removable with a fixed habit breaker for the interceptive treatment of thumb sucking reduced the calculated cost to between £99,581 and £105,017.

CONCLUSION

A saving could be made to the NHS, both locally and nationally, if the provision of a removable habit breaker was changed to a fixed habit breaker. In addition, increasing the proportion receiving active treatment, in the form of a fixed habit breaker, rather than monitoring, would appear to further reduce the cost to the NHS considerably.