Association between occlusal features and masticatory function in Hong Kong preschool children: a survey with one-year longitudinal follow-up

BACKGROUND

Mastication is important for breaking down food, aiding swallowing and nutrients absorption, and is therefore fundamental to a child's development. Studies have shown poor masticatory function to be associated with younger age and presence of caries. However, studies of the association between masticatory function and malocclusion yielded contradictory results. The aim of this study is therefore to investigate the association between three-dimensional occlusal features with masticatory function, among preschool children in Hong Kong.

METHODS

Self-administered questionnaires on masticatory function in three domains, namely general chewing difficulty, requiring help when eating different food types and increased preference for soft food were completed by parents. Information on non-nutritive sucking habits and basic demographics were also collected in the questionnaire. Clinical examinations were conducted to record three-dimensional occlusal features and presence of caries. Baseline investigations and one-year follow-ups were undertaken for 1,566 and 996 preschool children. Association of poor masticatory function with occlusal features, sucking habits and caries was investigated using chi-squared tests. Binomial logistic regressions were then carried out incorporating any significant factors identified. Longitudinal analysis of the one-year follow-up data was carried out to investigate whether improved occlusal features, sucking habits and caries resulted in better masticatory function.

RESULTS

In the cross-sectional study, the first domain of general chewing difficulty was associated with caries and thumb/digit sucking. The second domain of requiring help when eating different food types was associated with the male sex, younger age, caries and pacifier use. The last domain of increased preference for soft foods was associated with caries and thumb/digit sucking. Occlusal features, including abnormal overjet and unilateral permanent molars not in contact, were significantly associated with poor masticatory function in the bivariate analyses, but were not significant in the logistic regressions. In the longitudinal analysis, general chewing difficulty was found to improve in those of older age and those with resolved anterior crossbite. Less help was required to eat meat in those with fewer caries. Similarly, less help was required to eat food containing bones in those with reduced pacifier use. Preferences for eating soft foods was reduced in those who developed a normal overjet.

CONCLUSIONS

The study identified significant relationships between masticatory difficulties and factors associated with age, gender, active caries, and non-nutritive oral habits such as thumb/digit sucking and pacifier use. Younger children and males required more assistance with certain food types. Active caries and thumb/digit sucking habits contributed to general masticatory difficulties and preference for soft foods. The one-year follow-up indicated that improvement in masticatory function varies across age cohorts and were associated with improved occlusal features, such as resolution of anterior crossbite and normalized overjet, reduced pacifier use, and a decrease in the number of decayed teeth.

[Early interventions of oral habits]

Oral habits, such as mouth breathing, sucking, and lip and tongue habits, are important factors that lead to malocclusion. The abnormal pressure will disrupt the muscle balance of the oral and maxillofacial complex and interfere with the normal development of the maxillofacial complex. Therefore, early diagnosis and successful treatment of oral habits are pivotal to the early treatment of malocclusion. This paper discusses the malocclusion caused by children's oral habits and the corresponding intervention methods.

Morphological and functional abnormalities of the orofacial sphere associated with thumb sucking in children aged 3 to 10 years old in Yaounde, Cameroon

Introduction

thumb sucking is one of the most common oral habits in infants and children. In our context, little is known about the effects of prolonged thumb sucking on the orofacial sphere. Objective: determine the prevalence of thumb sucking and, identify the morphologic and functional abnormalities of the orofacial sphere associated with the duration and frequency of thumb sucking in children aged 3 to 10 years.

Methods

a cross-sectional and analytical study was carried out in the pediatric units of the District Hospitals of Biyem-assi and Efoulan from February to June 2020 in children aged 3 to 10 years. Recruitment was consecutive, not probabilistic. After obtaining informed parental consent, a clinical examination was performed and the criteria retained were based on the ANGLE classification of the malocclusions. Socio-demographic, socio-economic, clinical characteristics were collected and morphological and functional abnormalities were observed. Statistical analysis was performed using SPSS software version 23.0. The significance threshold was set at 5%.

Results

of the 116 enrolled children; 74 girls (63.79%) and 42 boys (36.21%) with a mean age of 4.80 ± 0.5 years. The highest proportion of thumb sucking was found in firstborn children (n=46, 39.65%), and in those who breastfed for less than 6 months (n=99, 85.62%). The prevalence of thumb sucking was 17.4%. Using the multivariate analysis, class II division 1 canine occlusion [OR=1.52 (1.27-2.68), p=0.03] and decreased overbite [OR=4.5 (2.5-9.3), p=0.001] while class II division 1 canine occlusion [OR=2.59 (1.3-10.1), p=0.009] and increased overjet [OR=1.89 (1.06-6.75), p=0.005] were independent morphologic abnormalities significantly associated with the frequency and the duration of thumb sucking respectively. There was no association between the duration and frequency of thumb sucking and the functional abnormalities.

Conclusion

thumb sucking is more common in girls and the likelihood of thumb sucking decreases with age. The prevalence of thumb sucking was 17.4%. The malocclusions observed in our population are class II division 1 canine relationship, decreased overbite and increased overjet.

Prevalence of Oral Habits of Schoolchildren in the Mixed Dentition in Dharan, Nepal

Purpose: To determine the prevalence of oral habits in the mixed dentition of schoolchildren in Dharan, Nepal and compare this prevalence between sexes, races, and age.<br/> Methods: A cross-sectional study was conducted among 830 schoolchildren of 10 randomly selected schools in Dharan. The presence or absence of oral habits was determined using a structured questionnaire, and an oral examination of the children was carried out under natural light. A chi-square test was used to compare the association of oral habits with age, sex and race.<br/> Results: The most prevalent oral habit was tongue thrusting (39.6 percent), while the habit of biting objects was the least prevalent (0.8 percent). Mouth-breathing was statistically significant for sex (P = 0.010), whereas biting objects (P = 0.035) and self-inflicting habits (P = 0.005) were statistically significant for race. Lip sucking (P ≤0.001) and lip-biting habits (P = 0.001) were statistically significant for age.<br/> Conclusion: These findings highlight the importance of periodic screenings and timely referral for the early detection of oral habits and its associated effect on the developing occlusion.

Evaluation of Crossbites in Relation with Dental Arch Widths, Occlusion Type, Nutritive and Non-nutritive Sucking Habits and Respiratory Factors in the Early Mixed Dentition

PURPOSE

The purpose of this study was to analyse the connection between dental arch widths, malocclusion type, nutritive sucking habits and non-nutritive sucking habits, and respiratory factors with the presence of crossbites (CB) in the early mixed dentition.

MATERIALS AND METHODS

Data were collected from 72 children with and without CB. A questionnaire was applied to parents/carers to obtain information about nutritive and non-nutritive sucking habits. The posterior and anterior crossbites were diagnosed in a centric relationship. Dental arch widths were measured directly from the models by two calibrated examiners. The data were analysed statistically using chi-square and Fisher's exact tests.

RESULTS

The incidence of Class III malocclusion and the presence of ear, nose and throat problems in the study group were significantly higher than in the control subjects (p = 0.01, p = 0.047). The mean breastfeeding duration for children in the CB group was found significantly shorter than in the control subjects (p = 0.043). The number of children with mouth breathing in sleep was significantly higher in the CB group than the control subjects (p = 0.046). The children with CB demonstrated a statistically significant increase in mandibular intercanine width (ICW) than the control group (p = 0.044).

CONCLUSION

The results demonstrated that an insufficient duration of breastfeeding, mouth breathing, ear-nose-throat problems and Class III malocclusion were associated with the presence of CB in the early mixed dentition.

Anterior open-bite and sucking habits in Italian preschool children

AIM

To evaluate the consequences of prolonged sucking habits on the development of the orofacial complex in deciduous dentition.

MATERIALS AND METHODS

A cross-sectional study was carried out involving 235 preschool children. A questionnaire for children parents and clinical examinations were carried out by calibrated blinded examiners. The chi-square test and the T-Student test were used for statistical analysis.

RESULTS

The prevalence of non-nutritive sucking habits (NNSH) in the sample was 74%. Anterior open-bite (AOB) was detected in 18%, and it was significantly related to non-nutritive sucking habits, bottle-feeding (only in the 3-year-old group) and persistent use of pacifier (p<0.05).

CONCLUSIONS

NNSH and type of feeding were important contributing factors in the development of anterior open-bite in deciduous dentition.

[From digit-sucking-cum-deglutition to deglutition in dentate subjects]

Failure to manage function-related problems can lead to failures in the conduct of orthodontic treatment and to poor stability. However, even if the dysfunctions have been diagnosed by the practitioner, he/she will still be dependent on the quality of the rehabilitation. Traditionally, rehabilitation requires intensive participation on the part of patients in order to ensure stimulation to their cortical neural networks. Eric Kandel, winner of the Nobel Prize for Medicine in 2000, has shown that this approach stimulates information transmission by boosting the activity of the neurotransmittors. Likewise, he demonstrated that when rehabilitation is aimed at the sub-cortical pathway, there is no longer augmentation of the neurotransmission but rather the build-up of new circuits involving the creation of new synapses. Today, it is possible to rehabilitate swallowing and breathing by the sub-cortical pathway.

Comparison of the upper airways from cephalometric radiographs of children with and without finger-sucking habit

AIM

Finger-sucking in early childhood can induce morphologic changes in the oropharynx and upper airways, which could arise even in children without reported oral breathing. The aim of this study was to compare cephalometric findings in children with and without finger sucking habit with respect to oral breathing.

MATERIALS AND METHODS

Fifty-six children aged 4 to 12 years (28 with diagnosis of finger sucking and 28 controls) treated at the Port Colombia Dental Clinic underwent cephalometric radiographs, from which morphologic (n=11, whole skull), upper airways (n=10), hyoid bone (n=3) and postural (n=5) measurements were performed. The unpaired t-test was used for comparison between groups.

RESULTS

Both groups had similar age and gender distribution (7.9 yrs ± 2.9; M/F: 14/14). Patients with finger-sucking habit had a higher hard palate length from the anterior nasal spine to the posterior nasal spine (finger-sucking subjects: 50.18 mm; controls: 46.91 mm; p = 0.0001) and distance from the epiglottic vallecula to the posterior pharyngeal wall (finger-sucking subjects: 15.55 mm; controls: 13.36 mm; p = 0.0231) than control subjects. Patients with finger-sucking habits also had a shorter distance from the posterior nasal spine to the adenoids (14.91 mm vs. 17.82 mm; p = 0.0173), wider cranial-cervical angles (105.64 mm vs. 101.6 mm; p = 0.05) and lower hyoid bone positioning (14.55 mm vs. 11.82 mm; p = 0.0125) than controls.

CONCLUSION

Finger-sucking habit is associated with characteristic cephalometric changes even in children without oral breathing, especially at the hyoid bone and postural measurements.

Metric analysis of the hard palate in children with digit sucking habits

BACKGROUND

The effects of digit sucking on dentofacial structures has been widely studied, but its relationship with the function and/or shape of the palate has been negleted. A clinical observation of high palatal vault has been reportedly associated with digit sucking. However, the description has been made on the basis of subjective clinical observation rather than actual measurements. The aim of this study is to assess the effects of digit sucking habits on palatal dimensions of children with digit sucking habit; and compare the findings obtained to a control population.

METHOD

Cross-sectional sucking behaviour data was collected on 250 school children aged 3 to 5 years using questionnaires completed by parents. Parameters including palatal widths, depth and heights were measured directly from the maxillary casts obtained from the children and palatal index was calculated. All values were compared using t-test.

RESULTS

Significant differences were seen in palatal depth, palatal width, palatal height and palatal index at the level of the maxillary primary first and second molars. No significant difference was observed for palatal index at the level of the maxillary primary canine.

CONCLUSIONS

It was concluded that digit sucking may cause changes in palatal dimensions.

[Quantitative analysis of the palatal features affected by digit-sucking habit using a laser scanning system]

OBJECTIVE

To investigate the influence of digit-sucking habit on palatal features in pre-school children by using a laser scanning system.

METHODS

Forty pre-school children were chosen according to the results of questionnaires, among which 20 with digit-sucking habit(digit-sucking group) and 20 without any oral habits(control group). Impression of the upper jaw was taken from each child. After laser scanning the plaster casts, and three-dimensional reconstruction by the computer, parameters of anterior and posterior palatal length, width and height were measured, ratios of height/width, length/width and width ratio of anterior and posterior palatal were analyzed. The differences of palatal features between two groups were analyzed by t test.

RESULTS

There was statistical significance between digit-sucking group and control group in posterior palatal width, anterior palatal length and anterior palatal height. The ratios of height/width and length/width in both posterior and anterior areas were statistically significant (P < 0.05). Compared to the control group, the results indicated that palatal features were relatively deeper, narrower and more protrusive in digit-sucking group.

CONCLUSION

The digit-sucking habit may have some deleterious impacts on the palatal features in pre-school children with primary dentition. And it is practical to measure the spacial palatal features by using laser scanning system to some extent.

Malocclusion in preschool children: prevalence and determinant factors

PURPOSE

To evaluate the prevalence of malocclusion and associated factors in the primary dentition of preschoolers in the city of Diamantina, Brazil.

METHODS

A cross-sectional study was carried out with 381 children aged 3-5 years treated at the 10 basic health care units in the city during immunisation campaigns. The dependent variables (presence of malocclusion, open bite, crossbite and crowding) were evaluated through a clinical oral exam. The independent variables (gender, age, health problems, breastfeeding, bottle feeding, harmful oral habits, mother's schooling, household income and number of children in the home) were collected through interviews. Statistical analysis involved descriptive analysis, Chi square test and Poisson regression.

RESULTS

The prevalence of malocclusion was 32.5%. Open bite was the most frequent type of malocclusion. Children with a history of bottle feeding (PR 1.74; 95% CI 1.24-2.44) and those with harmful oral habits (PR 1.49; 95% CI 1.23-1.99) had greater prevalence rates of malocclusion. Greater prevalence rates of open bite were also found in children with a history of bottle feeding (PR 5.00; 95% CI 1.99-12.5) and those with harmful oral habits (PR 2.90; 95% CI 1.59-5.29), whereas greater prevalence rates of crossbite were found in boys (PR 1.79; 95% CI 1.10-2.91) and were associated with mother's schooling (PR 1.91; 95% CI 1.20-3.06).

CONCLUSION

A history of bottle feeding and the presence of harmful oral habits were identified as determinants for the occurrence of malocclusion in preschoolers.

Cessation age of breast-feeding and pacifier use is associated with persistent finger-sucking

PURPOSE

Although some studies have reported that breast-feeding and pacifier use influence finger-sucking, few have demonstrated whether the age at cessation of breast-feeding or pacifier use and persistent finger-sucking are related. Therefore, the purpose of this study was to examine whether the age at cessation of breast-feeding and pacifier use influenced persistent finger-sucking.

METHODS

A cross-sectional study of 555 36- to 47-month-olds was conducted in Nagasaki, Japan, using a questionnaire. Using the optimal cutoff point in a receiver-operating characteristic curve, the age was estimated at which cessation of pacifier use and breast-feeding had the most significant effect on persistent finger-sucking, and the estimated ages were assessed by multiple logistic regression analysis, incorporating all the questions in the questionnaire as independent variables.

RESULTS

The odds ratios for persistent finger-sucking when breast-feeding was stopped at an age younger than 12 months old or when pacifier use was stopped at an age younger than 14 months old were 3.77 (95 percent confidence interval (CI)=1.97-7.22) and 8.62 (95 percent CI=2.56-29.04), respectively.

CONCLUSIONS

Cessation of breast-feeding before 12 months old or pacifier use before 14 months old was associated with persistent finger-sucking.

Sample of a client intake information protocol: a synopsis and rationale

The utilization of standardized comprehensive forms in the field of orofacial myology is crucial as this profession continues to grow and establish assessment and treatment protocols. This article formally presents a comprehensive health history intake form currently in use, and highlights the rationale for each particular question within this form in an effort to explore the evidence-based theory behind each question utilized. Highlighting the importance of obtaining a thorough health history as it pertains to our profession, personally allows the clinician to ultimately best plan a therapeutic strategy and assess the individual criteria necessary for successful orofacial myofunctional habituation.

The oral health environment and the equal environment assumption (EEA) among 1-8-year-old twins

AIM

The purpose of the present study was to describe the oral health environment in preschool children and to examine the extent to which paired twins experience the same oral health environment.

MATERIALS AND METHODS

In collaboration with The Medical Birth Registry of Norway (MBRN) 100 twin families who participated in the Norwegian Mother and Child Cohort, were invited to take part in ongoing studies on oral health. Participating twin families lived in Oslo and the surrounding counties of the capital. The age range of the participating twins was 1-8 years. A clinical examination took place at The Institute of Clinical Dentistry, University of Oslo in 2008. The oral health environment was measured in two ways: 1) Interview. Mothers were interviewed by trained interviewers about oral health related habits of each of the twins. 2) Weekend diet log. Parents listed 84 different deserts, ice cream, sweets, cakes, cookies, fruits, snacks, and biscuits for each twin that were consumed on during the weekend. The statistical analyses comprised frequency distributions of the environmental variables and correlations between the variables within the pair of twins.

RESULTS

The results showed a parental involvement in early tooth brushing and also an indication of tooth brushing not always being easy. Use of fluoride toothpaste started early, and two thirds of the children also used fluoride tablets. Use of pacifier was prevalent; the duration of use of pacifier and feeding bottle was relatively long. Nearly 75% of the parents indicated that they had no problems relatively to the twins' meals, and 53% mentioned that the twin pairs were different with regard to meals. Nearly 70% of the kindergartens had a clear health profile. The correlations varied between r = 0.45 and 1.00.

CONCLUSION

The children in the present work were young, and the detailed information in this paper therefore adds to the knowledge of parental involvement in children's oral health. Generally the findings indicate a high level of involvement from the parents in the oral health environment at home. Altogether the results showed that the assumption of identical oral health environment cannot be supported by these data.

Oral habits among pre-elementary children in Bitola

AIM

The purpose of this study was to determine the prevalence of oral habits (nail biting, finger sucking) among the pre-elementary children in Bitola.

METHODS

In the observational average, (cross-sectional) study were covered 890 children 3 and 5 years old, who came to regular medical checkups during the period from January to December 2009, in the Health Centre in Bitola. During the research the following methods were applied: psychological testing (Chuturik Test), clinical paediatric examination, interview with the parents and applying the Questionnaire on Children's Behaviour, Child Behaviour Checklist-Achenbach, 1981, in Hill R., and Castrol E. (2002): Getting rid of Ritalin, Hampton Roads Publishing Company, Inc.

RESULTS

The research included 890 children, of whom 401 were three yeas old and 489 five years old, and 51.6% male and 48.4% female. The prevalence of oral habits among the subjects was 35.39%. Statistical analyses showed that these habits can be found (p<0.05) among 3-year-old children, but the tested difference concerning the gender was statistically insignificant (p>0.05). Children who live in a rural environment, who do not have their own room and do not use a computer, statistically significantly manifested oral habits more often (p<0.05). Tested differences in the frequency of oral habits according to the number of family members were statistically insignificant (p>0.05). Children whose parents have primary education and whose mothers are working and have minimal incomes manifested a significantly more frequent presence of oral habits for the level of p<0.01 and p<0.05.

CONCLUSION

These oral habits have a prevalence of 35.39% among the pre-elementary children in Bitola and should be viewed as a major public health problem. Because of their influence on the development of the orofacial system, the responsibility primarily of paediatrist and children's dentists is great for their prevention, early diagnosis and treatment in collaboration with other specialists, the child and parents.

Orofacial dysfunction in individuals with Prader-Willi syndrome assessed with NOT-S

OBJECTIVE

The objective of the study was to evaluate orofacial dysfunction in individuals with Prader-Willi syndrome (PWS) and compare it with a healthy reference group.

METHODS AND MATERIALS

The Nordic Orofacial Test-Screening (NOT-S) protocol was used for evaluation of orofacial function in 45 (23 Male, 22 Female) individuals with PWS, aged 19.8 ± 9.5 years, and a reference group of 40 (18 M, 22 F) healthy individuals, aged 24.0 ± 16.3 years.

RESULTS

The NOT-S score was markedly higher for the individuals with PWS than for the healthy reference group (3.9 ± 2.1 vs 0.3 ± 0.5, p < 0.001). The most common domains of dysfunction in individuals with PWS were Oral motor function (60.0%), Habits (55.6%), Face at rest (53.3%), Speech (44.4%), Drooling (44.4%) and Breathing (42.2%).

CONCLUSIONS

Eighty-seven per cent of the participants with PWS demonstrated dysfunction in two or more domains, particularly in the domains Oral motor function, Habits and Face at rest.

Use of a structural equation model for prediction of pain symptoms in patients with orofacial pain and temporomandibular disorders

AIMS

To develop and test a biopsychosocial model using structural equation modeling for predicting orofacial pain symptoms in a sample of patients with masticatory muscle pain (MMP).

METHODS

Data were collected from clinic records of 251 adult patients who presented for initial evaluation to the Orofacial Pain Center at the University of Kentucky College of Dentistry and were subsequently diagnosed with MMP. Data were used to fit a model relating stressors, psychological distress, arousal, sleep problems, oral parafunction, and pain symptoms. Items from the Multidimensional Pain Inventory (MPI) and the IMPATH:TMJ, a comprehensive biopsychosocial assessment of patients with temporomandibular disorders (TMD), were used to construct a measurement model of five latent variables.

RESULTS

Estimation of the model indicated a good fit to the data and significant associations between stressors, psychological distress, arousal, sleep problems, and pain symptoms. Sleep problems partially mediated the relation between arousal and pain symptoms. Contrary to hypotheses, no association occurred between oral parafunction and pain symptoms, possibly indicating that any relationship between oral parafunction and pain symptoms may not exist.

CONCLUSION

Results from the model tested in the present study are an additional step toward developing a more comprehensive biopsychosocial model explaining the nature and etiology of MMP in orofacial pain and TMD. With additional development and testing, it may also serve as an aid to planning interventions, especially psychosocial interventions targeting stress management, psychophysiological regulation, psychological distress, and sleep problems.

Relationship between breast- and bottle-feeding and non-nutritive sucking habits

PURPOSE

The objective of the present study was to assess the persistence of non-nutritive sucking habits and its relationship with breastfeeding, as well as to establish the influence of sociodemographic factors on these habits among children aged 3 to 5 years.

MATERIALS AND METHODS

A case-control study was conducted with 1107 children from public and private daycare centres in Natal, Brazil: 450 in the case group (312 pacifier suckers and 138 thumb suckers) and 657 in the control group (habit-free). Data regarding sociodemographic conditions and duration of breastfeeding were obtained using a structured questionnaire.

RESULTS

Breastfeeding for a duration of > 6 months (adjusted odds ratio = 0.311; 95% confidence interval = 0.226 to 0.428) was an independent protective factor against persistent pacifier sucking. The use of pacifiers was more frequent among 3-year-old children and among those from a higher income family and a higher level of schooling of parents. The relation between duration of breastfeeding and thumb sucking was not statistically significant (P = 0.087). There was an association between the thumb sucking habit with sex (female), low level of schooling of father and the child being born as the last male child in the birth order. No relation was found between breastfeeding and habit frequency (day/night and night) (P = 0.301). An association with habit frequency was found with the age of 3 years, female, the family income group that ranged between US $176 and US $875, and those attending private institutions.

CONCLUSIONS

Breastfeeding for a duration of > 6 months was a protective factor against the persistence of pacifier sucking, but the subjectivity of the mother-child relationship must be investigated further.

Association between breastfeeding duration and non-nutritive sucking habits

OBJECTIVE

To evaluate the relationship between breastfeeding duration and the prevalence of non-nutritive sucking habits in children with deciduous dentition.

METHOD

A cross-sectional survey was conducted on the mothers of 551 children aged 3 to 6 years, randomly selected from public pre-schools in São Paulo, Brazil. Mothers were asked to complete a questionnaire that included items regarding their children's age, gender, race, method and duration of infant feeding, as well as pacifier use and/or digit-sucking habits. According to the answers pertinent to the method and duration of infant feeding, children were assigned to five groups: 1--never breastfed, 2--breastfed for a period shorter than 3 months of life, 3--breastfed for 3 to 6 months, 4--breastfed for 6 to 9 months, and 5--breastfed for 9 months or longer. Data were submitted to the Fisher's exact test with Bonferroni correction for multiple comparisons to analyse possible associations between breastfeeding duration period categories and non-nutritive sucking behaviours.

RESULTS

Pacifier use frequency was high in groups 1, 2, 3 and 4 (85%, 87.6%, 78% and 70%, respectively), in comparison with that in group 5 (38.6%). The prevalence of non-nutritive sucking habits was significantly reduced in children who were breastfed for nine months or longer (p = 0.000). There were no statistically significant differences in the frequencies of pacifier use and/or digit-sucking habits between genders, regardless of the breastfeeding duration period.

CONCLUSION

Children aged 3-6 years who were breastfed for nine months or longer had a lower prevalence of non-nutritive sucking habits.

Prevalence of posterior crossbite among pacifier users: a study in the deciduous dentition

The aim of this study was to evaluate the prevalence of posterior crossbite among children whose pacifier-sucking habit persisted until different ages. Children aged 3 to 6 years were randomly selected from public preschools in São Paulo, SP, Brazil. Their mothers were asked to complete a questionnaire on non-nutritive sucking behaviors. The sample consisted of 366 children assigned to 2 groups: control (n = 96) and pacifier users (n = 270). Pacifier users were further assigned to 3 subgroups, according to the age of habit persistence: P1 - until 2 years of age; P2 - between 2 and 4 years of age; and P3 - between 4 and 6 years of age. One dentist assessed the children for occlusal relationships through clinical examination. Associations between the age interval of habit discontinuation and the prevalence of posterior crossbite were analyzed using the chi-square test (p < 0.05). The prevalence of posterior crossbite was significantly higher among pacifier users (20.4%), compared to control children (5.2%), p < 0.01. Unilateral posterior crossbite was more prevalent than bilateral crossbite among pacifier users (9.8% versus 3.6%). Functional posterior crossbites were diagnosed in 3.1% of the control children and 7% of the pacifier users. The frequencies of posterior crossbite were notably high for children in the 3 pacifier subgroups, P1, P2, and P3, corresponding to 17.2%, 16.9%, and 27.3%, respectively. The high prevalence of posterior crossbite may be associated with pacifier-sucking habits that persisted after 2 years of age.

Social and biological early life influences on the prevalence of open bite in Brazilian 6-year-olds

OBJECTIVE

Little is known about the effects of social and biological risk factors for open bite on the primary dentition. The aim of this study was to assess the early-life risk factors affecting anterior open bite.

METHODS

A cross-sectional study using a birth cohort was carried out in Pelotas, Brazil. A sample of 400, 6-year-old children was employed. The Foster and Hamilton criteria were used to classify open bite. Data concerning social conditions, and perinatal and childhood health and behaviour were obtained from birth to 12 months of age and during the fifth year of the children's lives. Unconditional bivariate and multiple logistic regression analysis were performed.

RESULTS

The prevalence of anterior open bite was 46.3%. Risk factors included: a maternal age of between 30 and 39 years, as compared with children whose mothers were younger; breast-feeding for < 9 months; dental caries experience; pacifier sucking between 12 months and 5 years, as compared to no sucking or a shorter duration of sucking; and the presence of finger-sucking at 6 years of age.

CONCLUSION

Open bite in the primary dentition was associated with older mothers, early weaning, dental caries occurrence, long-term use of a pacifier and finger-sucking at 6 years of age. These findings support the common risk approach for intervention to prevent open bite in the primary dentition.

Unusual allergic reaction to orthodontic wire: report of a case in a Nigerian patient and implications for clinical management

Material reactions of both an irritant and hypersensitivity nature are not uncommon in contemporary orthodontic practices. The most common hypersensitivity reactions in orthodontic patients are due to alloy components of metal-based orthodontic appliances. This article reports a case of an unusual reaction to the component of an orthodontic appliance in a 6-year-old girl. There was associated trauma with local irritation. The implications and suggestions for management in the orthodontic clinic are reviewed.

Signs and symptoms of temporomandibular disorders and oral parafunctions in urban Saudi Arabian adolescents: a research report

BACKGROUND

The aim of this study was to evaluate the prevalence of signs and symptoms of temporomandibular disorders (TMD) and oral parafunction habits among Saudi adolescents in the permanent dentition stage.

METHODS

A total of 385 (230 females and 155 males) school children age 12-16, completed a questionnaire and were examined clinically. A stratified selection technique was used for schools allocation.

RESULTS

The results showed that 21.3% of the subjects exhibited at least one sign of TMD and females were generally more affected than males. Joint sounds were the most prevalent sign (13.5%) followed by restricted opening (4.7%) and opening deviation (3.9%). The amplitude of mouth opening, overbite taken into consideration, was 46.5 mm and 50.2 mm in females and males respectively. TMJ pain and muscle tenderness were rare (0.5%). Reported symptoms were 33%, headache being the most frequent symptom 22%, followed by pain during chewing 14% and hearing TMJ noises 8.7%. Difficulty during jaw opening and jaw locking were rare. Lip/cheek biting was the most common parafunction habit (41%) with females significantly more than males, followed by nail biting (29%). Bruxism and thumb sucking were only 7.4% and 7.8% respectively.

CONCLUSION

The prevalence of TMD signs were 21.3% with joint sounds being the most prevalent sign. While TMD symptoms were found to be 33% as, with headache being the most prevalent. Among the oral parafunctions, lip/cheek biting was the most prevalent 41% followed by nail biting 29%.

Dental arch diameters and relationships to oral habits

The objective was to analyze variations in dental arch width in relation to oral habits. Maxillary and mandibular intercanine and intermolar distance were determined in relation to certain oral habits in 1297 children (ages 3 to 6 years). After an oral examination, the parents of each child completed a questionnaire about oral habits, including the use of a dummy or a bottle (or both), finger sucking, mouth breathing, breast- or bottle-feeding, and duration of these habits. Data were subjected to statistical analysis by the chi-square test for qualitative variables and analysis of variance for quantitative variables with homogeneous variances. Statistical significance was P < .05. In general, the maxillary arch was larger than the mandibular arch with regard to both the intercanine and the intermolar distances and more significantly so in boys. In relation to age, a significant increase was found only for the mandibular intercanine distance (P = .001). When arch width was analyzed in relation to various oral habits, the maxillary intercanine distance was less in children who used a dummy, especially one of a round design (P = .003). The maxillary intercanine distance was also less in children who breathed through their mouth (P = .002). In most cases, dummy use and mouth breathing were associated with a reduction in the intercanine distance in the maxillary arch. A dummy habit leads to a reduction in maxillary arch width, and mouth breathing causes a reduction in the size of both arches.

Limiting factors in orthodontic treatment: 1. Factors related to patient, operator and orthodontic appliances

Owing to a shortage in the orthodontic work force in the United Kingdom, many general dental practitioners carry out orthodontic treatment in selected cases. Orthodontic treatment may not always be successful as a result of various factors. Some of these limiting factors are related to the practitioner, others to the patient, the orthodontic appliances used and sometimes to the underlying biology. It is essential that practitioners are aware of these limitations. The aim of this two part article is to describe some of the practical aspects that need to be considered.

CLINICAL RELEVANCE

General dental practitioners and novice orthodontic practitioners may get into difficulties by embarking upon an orthodontic treatment which may not be feasible owing to various limitations of orthodontic treatment.

Class II malocclusion with maxillary protrusion from the deciduous through the mixed dentition: a longitudinal study

The aim of this study was to analyze the skeletal characteristics of Class II malocclusion with maxillary protrusion in the deciduous dentition and to describe the growth features of this type of skeletal imbalance during the transition from the deciduous through the mixed dentition. A group of 17 subjects having skeletal Class II malocclusions in the deciduous dentition due to maxillary protrusion was compared with a control group of 30 untreated subjects with ideal occlusion at the same stage of development. Both groups were observed for the first time in the deciduous dentition (T(1)) and followed during the transition from the deciduous to the mixed dentition (T(2)). During this time no orthodontic treatment was provided. Lateral cephalograms were taken for all subjects at T(1) and T(2). A cephalometric analysis was performed based on a reference system that consisted of two perpendicular lines traced through stable basicranical structures. The results indicate that a Class II skeletal pattern due to a maxillary protrusion is established early in the deciduous dentition and remains unmodified in the transition to the mixed dentition. The maxilla appeared to be displaced forward in Class II subjects, whereas the mandibles of the Class I and Class II subjects did not show any significant differences at this stage of growth. In the passage from the deciduous through the mixed dentition, Class I and Class II subjects showed growth increments that were not significantly different from each other. Sucking habits appeared to be correlated with the skeletal maxillary protrusion.

Associations between a history of breast feeding, malocclusion and parafunctional habits in Puerto Rican children

Studies relating breast-feeding, malocclusion and parafunctional habits in young children are scarce.

PURPOSE

The purpose of this study is to evaluate the associations of a history of breast-feeding, incidence of malocclusion and parafunctional habits.

METHODS

The dental records of a sample of 540 children aged 6 to 72 months screened for oral conditions and behavioral risk factors were evaluated for variables such as a history of breastfeeding, malocclusion and parafunctional habits. Descriptive statistics using the EPI-INFO Program and Chi-square test at the 0.05 level of probability were performed.

RESULTS

The results showed that the mean age of the children was 28 months +/- 14. The mothers' mean age was 26.4 years +/- 6. The prevalence of breast-feeding was 34% with a mean breast-feeding time period of 3 m +/- 3.7. About 95% of the children had a history of bottle-feeding and 90% showed some evidence of malocclusion at the time of dental examination. The main malocclusion problems were space deficiency (closed contacts among incisors) (31%), open bites (6%) and crossbites (5%). A habit of thumb sucking was reported in 32% of the cases and pacifier use in 21%. there were significant differences for the following variables: mother's age and breast-feeding time period; number of children in family and breast-feeding time period; breast-feeding history and breast-feeding time with bottle use, malocclusion and thumb sucking habit; and gender and thumb-sucking habit.

CONCLUSION

It is concluded that breast-feeding practices and time period are behavioral factors that contribute in the prevention of malocclusion in addition to decreasing the practice of parafunctional habits in preschool children.

Aspectos etiológicos da mordida aberta anterior e suas implicações nas funções orofaciais

TEMA: a mordida aberta é uma anomalia complexa e de difícil tratamento. Comumente são vistos resultados insatisfatórios e a recidiva de tratamento na clínica ortodôntica. OBJETIVO: associar disfunções orofaciais e hábitos orais deletérios à mordida aberta anterior, reunindo evidências que colaborem para o melhor entendimento da etiologia e do desenvolvimento da mordida aberta anterior e sua potencial associação a alterações miofuncionais na amostra estudada. MÉTODO: estudo exploratório, derivando medidas de associação entre as condições clínicas, hábitos de sucção e alterações miofuncionais de 130 escolares. Estudo realizado em duas etapas, sendo a primeira a devolução de um questionário remetido ao responsável sobre hábitos bucais e a segunda caracterizada pelo exame clínico odontológico e fonoaudiológico dos menores autorizados. RESULTADOS: na amostra, o padrão de má-oclusão mais prevalente foi a mordida aberta anterior, que se associou com o padrão de crescimento vertical da face (risco relativo 3,12; intervalo de confiança 1,20 - 9,90) e com a classe II de Angle (p-valor = 0,01). Associação entre a mordida aberta anterior e interposição lingual (RR 2,44; IC 1,13 - 5,27). O mesmo não foi verificado para as deficiências na fonoarticulação (RR = 0,80; IC 0,20 - 2,30). CONCLUSÃO: há uma correlação etiológica da mordida aberta anterior com hábitos orais deletérios e algumas alterações das funções orofaciais. Foi identificada associação entre o histórico de hábitos parafuncionais e a ocorrência de interposição lingual em deglutição e a deficiência fonoarticulatória. É notória a necessidade da interação entre ortodontistas e fonoaudiólogos no atendimento integral do paciente portador de mordida aberta. Ressalta-se o papel reabilitador da terapia fonoaudiológica, através da terapia miofuncional oral, enfatizando o posicionamento da língua durante a deglutição, a fala e quando em posição habitual.

Genetic and environmental influences on finger-sucking and nail-biting in Japanese twin children

The purpose of this study was to clarify the genetic contribution to finger-sucking and nail-biting in childhood using the largest databases available on Japanese twins. The subjects were 1131 pairs of 12-year-old twin children, consisting of 1057 males and 1205 females. All data were gathered by maternal questionnaire, and responses to the questionnaire were checked in the medical interview. The prevalence of finger-sucking between 0 to 2 years was 40% in males and 43% in females (p = .0053). The prevalence of nail-biting up until the age of 12 years was 28% in males and 26% in females (nonsignificant). Concordance rates and polychoric correlations were all higher in monozygotic pairs than in dizygotic pairs, irrespective of the sex combination. Univariate and bivariate genetic analyses using structural equation modeling was performed. The results showed that the proportion of total phenotypic variance attributable to genetic influences was 66% in males and 50% in females for finger-sucking, and 50% in both males and females for nail-biting. A co-occurrence of finger-sucking and nail-biting was observed in 17.7% of males (tetrachoric correlation: r = .40) and 15.7% of females (r = .32), which was attributed partly to common genetic or environmental factors. The proportion of total shared variance explained by genetic factors was 67%.

Prenatal thumb sucking is related to postnatal handedness

This study followed-up 75 individuals who were observed sucking their thumb as fetuses and examined their handedness, assessed by a modified version of the Edinburgh Handedness Inventory, at 10-12 years of age. Of 60 right-handed fetuses, all were right-handed postnatally; 10 of 15 left-handed fetuses were left-handed and five right-handed. Male left thumb sucking fetuses were more likely to be right-handed children than females. The study indicates that the prenatal exhibition of lateralised motor behaviour, in this case thumb sucking, is indeed related to postnatal handedness, perhaps more strongly for right 'handed' fetuses than left 'handed' fetuses.

Feeding, artificial sucking habits, and malocclusions in 3-year-old girls in different regions of the world

PURPOSE

The way babies and young children are reared is important to their health and development. Extensive breast-feeding has also been shown to reduce the development of artificial sucking habits like digit or pacifier-sucking. The aim of this study was to determine feeding methods, artificial sucking habits, and the presence of malocclusions in 3-year-old girls living in different regions of the world.

METHODS

Children from the following countries were involved in the present study: (1) Brazil (Porto Alegre); (2) Japan (Niigata); (3) Mexico (Mexico City); (4) Norway (Oslo); (5) Sweden (Falköping); (6) Turkey (Istanbul); (7) and the United States (Iowa City, Iowa). During the interview and examination, the following variables were evaluated and registered: (1) breastfeeding and bottle-feeding; (2) duration and frequency; (3) sucking habits; (4) posterior and anterior crossbites; and (5) other malocclusions/normal occlusion.

RESULTS

The prevalence of breast-feeding was very high in all groups, ranging between 78% and 98%. The prevalence of bottle-feeding in the different areas was also high. Except for Iowa City, the prevalence of digit-sucking was relatively low. Pacifier-sucking is fairly popular in most areas, with the exception of Niigata. The prevalence of normal occlusion in different cities ranged from 38% to 98%.

CONCLUSIONS

There are considerable differences in feeding, as well as artificial sucking habits, in different areas of the world and at different periods.

[The relationship between oral habits, oronasopharyngeal alterations, and malocclusion in preschool children in Vitória, Espírito Santo, Brazil]

The objective of this study was to estimate the prevalence of malocclusion and associated variables such as deleterious habits (DH) and oronasopharyngeal alterations (OA), mouth breathing, atypical phonation, and atypical swallowing in three-year-old children in Vitória, Espírito Santo State, Brazil. The sample included 291 children of both sexes enrolled in a Children's Educational Center and selected through probability sampling by conglomerates. Logistic regression indicated a high relative risk (RR) in children with altered overjet, open bite, and cross-bite to present mouth breathing (RR = 1.89; CI: 1.56-2.03), (RR = 2.46; CI: 2.00-3.02), (RR = 1.45; CI: 1.23-1.72); atypical swallowing (RR = 2.57; CI: 1.87-3.52), (RR = 3.49; CI: 2.53-4.81), (RR = 1.86; CI: 1.46-2.39); and atypical phonation (RR = 2.25; CI: 1.66-3.05), (RR = 3.18; CI: 2.38-4.25), (RR = 1.71; CI: 1.32-2.22), respectively. An association was shown between finger or pacifier sucking and altered overjet (p < 0.001), and between pacifier sucking and open bite (p < 0.001). Such results indicate that the prevalence of malocclusions is associated with DH and OA.

[Early recognition of orthodontic problems by the general dentist during oral examination: signs which should attract attention]

The last decennia more and more patients are aware of the advantages of a good dental health. Dental minded parents in their children visit the dentist (general practitioner, GP) on a regular basis for a routine check up. During this check up, signs of possible future orthodontic problems can be encountered by the GP. In this article guidelines are handed to the GP by means of a flow chart which can be used at the end of the dental examination. Anterior/posterior relation, cross-bites, deep and open bite, habits and crowding shall be briefly discussed. Heaving knowledge of these, the GP can decide referring the patient to the orthodontist for further orthodontic evaluation.

Symptoms and signs of temporomandibular disorders and oral parafunctions among Saudi children

This study aimed to record the prevalence of signs and symptoms of temporomandibular disorders (TMD) and oral parafunctions among Saudi children. A questionnaire and a clinical examination of signs and symptoms of TMD were performed on 1940 stratified randomly selected schoolchildren. The sample was divided into three groups, 505 with primary, 737 with mixed and 734 with permanent dentition. The prevalence of TMD signs was found to be 20.7% and the most common sign of TMD was joint sounds (11.8%). The second most common sign was restricted mouth opening (5.3%). Muscle and temporomandibular joint (TMJ) pain as well as deviation upon jaw opening appeared infrequently. TMJ sounds were significantly increasing with age (P < 0.05). TMD symptoms as reported by the parents were evident in 24.2% of the returned questionnaires (1113). The most common symptoms were headache (13.6%) and pain on chewing (11.1%). The incidence of headache was found to be significantly increasing from primary to permanent dentition (P < 0.01). No sex difference in the prevalence of any symptom was reported. Nail biting was the most common oral parafunction (27.7%) while bruxism was the least common (8.4%). All parafunctions except bruxism were significantly related to age. Cheek biting and thumb sucking were reported more in females than in males. The importance of a screening examination for symptoms and signs of TMD should not be overlooked in the clinical assessment of the pediatric patient.

Dead cattle, lead and child health

This study was carried out as part of a larger interagency investigation in response to concerns about human health following the death of three cattle from lead poisoning in an old lead mining area in Silvermines, Tipperary. Its aim was to screen for lead toxicity in the local child population. Screening consisted of measurement of blood lead concentrations and the completion of questionnaires regarding exposure to lead and general health. Pre-school and primary school children resident in four surrounding district electoral divisions (DEDs) were specifically targeted. One out of 334 (0.3%) children screened had an elevated blood lead concentration. The geometric mean lead concentration was 2.6 microg/dl which is below the intervention lead concentration of 10 microg/dl recommended by the CDC. The mean lead concentration in those aged under three years was statistically significantly higher than in those aged three years and over (3.4 microg/dl vs 2.5 microg/dl; p=0.000581). No specific health problems were identified by the questionnaires. This study concluded that the elevated environmental lead levels which were demonstrated by other agencies involved in this investigation are not currently being transferred to children. It recommends further blood screening of children in the area and ongoing education to minimise the risk of lead toxicity in the area in the future.

Oral habits in school going children of Delhi: a prevalence study

This study was conducted on 5554 children aged 5-13 years old with the objectives of recording the prevalence of oral habits among North Indian children according to sex. These children were selected from the schools of Delhi. The sample represented the entire school-going population of Delhi in the age group of 5-13 years. Statistical analysis was carried out using BMDP software and sex differences were calculated by using Fisher's exact test. The results showed that the prevalence of oral habits in Delhi school going children was 25.5%. Tongue thrust was the commonest habit (18.1%) followed by mouth breathing (6.6%). Thumb sucking was relatively less common habit and seen in only 0.7% of children. There were no significant differences between boys and girls for the prevalence of oral habits. However, for the specific habit types there was a sex difference. Thumb sucking was more common in girls (1.0%) when compared with boys (0.4%) and this difference was statistically significant (P < 0.001). There was a reverse trend for the mouth breathing, which was more common (P < 0.001) in boys (7.8%) than girls (5.3%). There were no differences for tongue thrust habit between boys (17.5%) and girls (18.6%).

The effects of infant feeding patterns on the occlusion of the primary dentition

The purpose of this study was to investigate the effects of different methods of infant feeding on the development of the occlusion in the primary dentition. The study included 126 children. Parents completed questionnaires regarding feeding and health history, and the primary dental occlusion was recorded for each child. The authors found that: (1) predominant bottle-feeding between 0 and 6 months of age was associated with the development of a pacifier habit; (2) children who used a pacifier were more likely to develop a nonmesial step occlusion, an overjet >3 mm, and an open bite; (3) children who sucked their thumb were more likely to develop an overjet >3 mm; and (4) in the absence ofnonnutritive oral habits, children who were predominantly bottle-fed between 0 and 6 months of age were more likely to develop an overbite >75%, although just shy of nominal statistical significance.

Incidence of oral habits in children with mixed dentition

Recognition and elimination of an oral habit is of utmost importance in the treatment of periodontal disease. It is not probable that the influence of such a factor can lead to the alteration of gingival dimension, but a cofactor role of oral habits in the development of gingival recession has been acclaimed. The purpose of this study was to present cross-sectional data from an epidemiological study performed in two urban settlements in Zagreb, Croatia. The study was performed in 1025 children, in an attempt to try and discover the incidence of oral habits in children with mixed dentition, aged from 6 to 11 years. About 33.37% of the screened population exhibited oral habits, such as nail and object biting, non-nutritive sucking, simple tongue thrusting and lip or cheek biting. Chi-square test analysis showed no statistically significant differences between sex and age groups, a result that does not exclude the oral habits from aetiology of the periodontal pathology. We can conclude that oral habits are a frequent finding, although the cause relation to periodontitis has yet to be cleared completely.

[Significance of bad habits in orthodontics]

The author is concerned with the etiological role of bad habits in the development. Disturbances caused by pacifier habits, finger sucking, various forms of swallowing habits and their therapeutical possibilities are discussed. The role of mouth breathing, nail biting, bruxism and self-mutilation in development of anomalies and their therapy are also mentioned. The attention is called to the fact that dentists have responsibility and task to diagnose as early as can be the oral bad habits and that the adequate therapy in time in co-operation with other specialists helping the child get out of bad habits, preventing the development of severe anomaly.

Associations of pacifier use, digit sucking, and child care attendance with cessation of breastfeeding

OBJECTIVE

Breast milk is the recommended method of nutrition for newborns and infants. Several studies have investigated factors associated with the cessation of breast-feeding. This study assessed the associations between pacifier use, digit sucking, childcare attendance, and breastfeeding cessation among 1387 infants in the Iowa Fluoride Study.

STUDY DESIGN

This was a longitudinal questionnaire survey. Mothers completed mailed questionnaires sent at infant ages 6 weeks, 3 months, and 6 months.

POPULATION

Parents were recruited postpartum at 8 Iowa hospitals.

OUTCOMES MEASURED

Survival analysis (using Cox proportional hazards model) assessed the time covariate effects of pacifier use, digit sucking, and child care attendance on cessation of breastfeeding, while adjusting for other possible confounding variables (not planning to breastfeed, maternal smoking, infants' sex and antibiotic use, maternal and paternal age and education, and income group).

RESULTS

Percentages of women who did any breastfeeding were 46%, 36%, and 27%, at 6 weeks, 3 months, and 6 months, respectively. Percentages using pacifiers were 81%, 71%, and 59%. Combinations of pacifier use and digit sucking for various levels of child care had statistically significant associations with cessation of breastfeeding, with the effect being strongest for pacifier users and digit suckers with no child care days (hazard ratio = 1.88; 95% CI, 1.36-2.62).

CONCLUSIONS

Pacifier use and digit sucking were associated with cessation of breastfeeding, with results dependent on the level of childcare attendance. The strongest associations were found for those not attending childcare and for combined use of pacifier with digit sucking.

Duration of nutritive and nonnutritive sucking behaviors and their effects on the dental arches in the primary dentition

The purpose of this study was to determine the association between the duration of nutritive and nonnutritive sucking behaviors and various occlusal characteristics in the primary dentition. Sucking behavior data were collected on 372 children followed longitudinally from birth by using periodic questionnaires completed by parents. Study models were obtained from the children at 4 to 5 years of age and assessed for posterior crossbite, anterior open bite, and overjet. Dental arch parameters including arch widths, arch lengths, and arch depths were measured directly from the models. The subjects were grouped according to type of habit (pacifier or digit) and duration of nonnutritive sucking behaviors (less than 12, 12 to 24, 24 to 36, 36 to 48, and more than 48 months). Children with nonnutritive sucking of less than 12 months were further grouped according to the duration of breast-feeding. The dental arch and the occlusal characteristics were then compared among these groups. The results indicated no relationship between duration of breast-feeding during the first year of life and any dental arch or occlusal parameters. The study found that prolonged pacifier habits resulted in changes to the dental arches and the occlusal parameters that were different from the effects of digit sucking. In addition, some changes in the dental arch parameters and occlusal characteristics (eg, prevalence of posterior crossbite and increased amount of overjet) persisted well beyond the cessation of the pacifier or digit habit. Although further study is needed to determine the effects of nonnutritive sucking behavior in the mixed dentition, the results suggest that current recommendations for discontinuing these habits may not be optimal in preventing habit-related malocclusions.

Seroprevalence of toxocariasis in schoolchildren in Trinidad

The seroprevalence of toxocariasis was investigated in 1997/98 in 1009 schoolchildren (aged 5-12 years) throughout Trinidad. Infection, as measured by titre, was found to be high compared to values obtained from children in other countries. Using an excretory-secretory antigen and performing an ELISA test, it was found that 62.3% of children had an IgG antibody titre of > or = 1:100, indicating exposure to the parasite, while 27.2% had a titre of > or = 1:800, indicating a current or recent infection. Relationships were explored between seroprevalence and host factors including age, sex, school location, and other risk factors including geophagia, thumb-sucking, presence of other gastrointestinal-tract parasitism and pet ownership. There was no significant relationship between age and the presence of current or recent infection (P = 0.746). Boys were significantly more commonly infected than girls as were the attendees of rural schools versus urban schools (P < 0.001). The percentage of seropositivity among children varied widely from school to school. Pet ownership and the absence of pipe-borne water in the household were found to be significantly associated with positive serology (P < 0.05). Clinical symptoms mostly associated with positive serology were eczema, seizures and chronic cough. Recommendations derived from this study include health education in order to increase the public awareness on the transmission of the disease, de-worming all dogs and cats periodically and the curbing of stray dogs and cats. Environmental sanitation measures should include keeping children away from contaminated areas and practising proper hygiene after play.

Fetal handedness and head position preference: a developmental study

Hand-head contacts were observed by means of serial ultrasound recordings in 10 healthy fetuses from 12 to 38 weeks of gestational age. Contacts were distinguished as being unimanual or bimanual, and if unimanual, whether they were made with the right or left hand. Both types of contact and ones made unimanually with the right or left hand were identified at each age as to whether they were associated with a preferential head position. A strong unimanual bias was evident at each age except for Week 36. At this age, there was a bimanual bias. Unimanual contacts did not develop a lateralized preference, and neither type of contact established a stable relationship with head position. Furthermore, there was no evidence to support the suggestion that hand contact and head position codevelop to form a preferred ipsilateral synergy. Findings are discussed relative to contradictory evidence from other fetal and neonatal studies.