Dentofacial morphology of mouth breathing children

The relationship between dentofacial morphology and respiration has been debated and investigated from various approaches. The aim of this study was to verify the skeletal and dental relationship of mouth and nose breathing children. Thirty-five children, 7 to 10 years of age, were submitted to orthodontic and otorhinolaryngologic evaluations and were separated into 2 groups: 15 nose breathers and 20 mouth breathers. Each subject underwent a cephalometric radiograph analysis. Statistical analysis (Mann-Whitney U test) indicated that changed mode of breathing was associated with 1) maxillo-mandibular retrusion in relation to the cranial base in the mouth breathers; 2) the SNGoGn and NSGn angles were greater in the mouth breathing group; 3) incisor inclination in both jaws and the interincisal angle were not different between groups. There was no statistically significant difference in the maxillary and mandibular molar heights between the nose breathers and mouth breathers.     

儿童口呼吸的诊断与处理

儿童口呼吸问题日益受到医学界和社会的关注,口呼吸可分为习惯性和病理性口呼吸。其中由于腺样体和(或)扁桃体肥大导致的病理性口呼吸往往是儿童阻塞性睡眠呼吸暂停低通气综合征的病因,可能导致颅颌面畸形等后果。目前关于口呼吸的定义和诊治方面尚存在不少问题,需要澄清。     

Salivary clearance from different regions of the mouth in children.

The aim of this study was to evaluate the rates of salivary clearance at seven different locations in children. The diffusant was 1 mol/l KCl in a 1.0% agarose matrix, placed in small acrylic devices which could be fastened to the teeth with dental floss. The diffusion chambers were taken from the mouth at selected time intervals and the gels transferred quantitatively to flasks containing 400 ml of 100 ppm NaCl. The fluid was agitated intermittently for 1 h and analyzed for potassium by atomic absorption spectrophotometry. For 12 subjects (5 years of age), the clearance halftimes (the time for the initial potassium concentration to decrease by half) were lowest in the lower anterior lingual regions and were highest in the upper anterior buccal regions. When the salivary flow was stimulated, the clearance halftimes for the lower and upper anterior buccal sites in the 6 subjects without spaces between their anterior teeth were significantly higher than in the 6 subjects with spaces. The results show that the clearance halftime is longest for the upper anterior buccal site which is the site most prone to nursing bottle caries in the deciduous dentition.     

Head motion may help mouth opening in children

Concomitant head and mandibular movement during jaw function is well known in adults; however, its importance in children has not been studied. The brain attains 85–90% of its adult weight at 5 years of age, though the maximum rate of condylar growth is attained at approximately 14 years of age. These findings suggest that the coordination of the head and mandible may differ between children and adults. This study investigated head and mandibular movements of 19 children with complete primary dentition (average age: 5 years 5 months) and compared their functional integration of jaw and head movements to those of 16 female adults (average age: 20 years 3 months) with permanent dentition. Although the mandibular opening distance was significantly greater in the adults, the magnitude of concomitant head motion was greater in children. The results suggest that head extension in children helps increase the magnitude of mouth opening more than in adult women.     

Clinical measurement of normal maximum mouth opening in children

This study was designed to find a method of assessing maximum mouth opening (MMO), using a tool that is proportional to the body size. One hundred two (102) children were selected to participate in the study. MMO, the width of three fingers (index, middle and ring fingers), four fingers (index, middle, ring and little fingers), body height, weight and age of each child were recorded, and the ability of each subject to position the fingers, vertically aligned between the upper and lower central incisors with the mouth maximally open, was documented. All subjects were able to position three fingers between the upper and lower central incisors, while only 37 (36.3%) were able to position four fingers. MMO was significantly different from the width of three and four fingers and was positively correlated with both weight and height and with age. Height, weight, and age showed a moderate to strong correlation with all finger measurements; no gender significant difference was observed for MMO. The findings of this study suggest that the ability to position three fingers between the upper and lower incisors with the mouth wide open can be considered a simple method to quickly evaluate MMO, but that it is not highly reliable.     

Restricted opening of the mouth with an extra-articular cause in children.

Restricted opening of the mouth with an extra-articular cause (ROMEC) can have very different aetiologies. A series of 6 children, who have been operated on under 4 different diagnoses, are presented. Excluded are common problems such as recent trauma and posttraumatic scarring, craniomandibular dysfunction or elongated coronoid process, and also tumours. Problems of establishing the diagnosis, surgical treatment, postoperative physiotherapy and timing are discussed. It is shown that none of the cases is a perfect result, some outcomes are even very disappointing. It is therefore concluded that absolute trismus should be treated independently of age. The result expected will be mediocre. For final correction it is suggested that the operator should wait preferably until the second growth spurt has passed. The same goes for children presenting primarily with a mouth opening greater than 20 mm.     

Fluoride mouth rinsing proficiency of Japanese preschool-aged children

AIM: To determine whether Japanese preschool-aged children swallow fluoride solution while rinsing and how much fluoride was retained in the mouth after rinsing. METHODS: The subjects were 769 children who participated in a school-based fluoride mouth rinse programme (FMR) using 0.05% sodium fluoride solution daily. The group of younger, mean age of 4 years and 10 months, experienced the FMR for two months, and the group of older children, mean age of 5 years and 4 months, did it for at least 8 months, rinsing for a minute using 7 ml of the solution. The amount of fluoride retained in the mouth was estimated as the amount present in the net rinsing solution prepared minus what returned to the solution expectorated. RESULTS: No child swallowed all the solution. The rate of fluoride retained was 12.0% (mean = 0.19 mg) in the younger group and 10.7% (mean = 0.17 mg) in the older. Only six children retained over 0.5 mg of fluoride. With the extra survey using weekly intervals, the amount retained was below 0.5 mg in all children. CONCLUSION: That Japanese preschoolaged children could perform fluoride mouth rinsing safely and efficiently.     

Prevalence of oral malodor and the relationship with habitual mouth breathing in children

The prevalence of oral malodor and association of habitual mouth breathing with oral malodor were investigated in children residing in rural areas. One hundred and nineteen children participated in this study. A sulfide monitor and organoleptic method were used to evaluate oral malodor. About 8% of children had a sulfide level in mouth air above the socially acceptable limit (75 ppb). Habitual mouth breathing was a factor contributing to oral malodor. Oral malodor was not significantly correlated with plaque index, history of caries or frequency of toothbrushing.     

Electromyographic muscle EMG activity in mouth and nasal breathing children

Mouth breathing may cause changes in muscle activity, because an upper airway obstruction leads may cause a person to extend his/her head forward, demanding a higher inspiratory effort on the accessory muscles (sternocleidomastoids). This purpose of this study is to compare, using electromyography (EMG), the activity pattern the sternocleidomastoid and upper trapezius muscles in mouth breathing children and nasal breathing children. Forty-six children, ages 8-12 years, 33 male and 13 female were included. The selected children were divided into two groups: Group I consisted of 26 mouth breathing children, and Group II, 20 nasal breathing children. EMG recordings were made using surface electrodes bilaterally in the areas of the sternocleidomastoideus and upper trapezius muscles, while relaxed and during maximal voluntary contraction. The data were analyzed using the Kruskall-Wallis statistical test. The results indicated higher activity during relaxation and lower activity during maximal voluntary contraction in mouth breathers when compared to the nasal breathers. It is suggested that the activity pattern of the sternocleidomastoid and upper trapezius muscles differs between mouth breathing children and nasal breathing children. This may be attributed to changes in body posture which causes muscular imbalance. Because of the limitations of surface EMG, the results need to be confirmed by adding force measurements and repeating the experiments with matched subjects.     

The influence of fluoride mouth rinsing on the incidence of gingivitis in Norwegian children

ABSTRACT The prevalence of plaque and gingivitis in 154 children 11–13 years of age was assessed at intervals of 2 and 6 months after an initial examination. The children were divided into four groups, each receiving weekly mouth rinses with fluoride or a placebo solution. Two of the groups carried out supervised toothbrushing immediately before the rinses. Judged from 48 Pl I and G I scores in each child, the baseline data indicated no sex differences, but slight differences in moderate gingivitis, i.e. score 2, between the groups. Paired comparisons of the score 2 frequencies during the experiment indicated no effect on the incidence of gingivitis caused by the fluoride treatments or the supervised toothbrushing. Thus, the weekly fluoride rinses commonly used in the school dental service do not appear to have a detrimental effect on the gingiva of children. The weekly supervised brushing instruction used in the present program was not able to improve significantly the level of oral hygiene in succeeding periods.     

Presence of biotypes of "Streptococcus mutans group" in the mouth of Belgrade children

Strains of "Streptococcus mutans group" were tested in order to determine their belonging to the biotype according to the scheme suggested by Shklair. Biochemical testing of the strains was performed by API 20 Strep system. All the strains tested in this experiment showed biochemical activity characteristic for Streptococcus mutans, Biotype I, Genetic group I, and serological groups (c, e, f). The results of this research are in accordance with the results of similar works performed in various geographical areas.     

An exploratory study of the factors related to mouth breathing syndrome in primary school children

ObjectiveMouth breathing syndrome (MBS) is defined as a set of signs and symptoms that may be completely or incompletely present in subjects who, for various reasons, replace the correct pattern of nasal breathing with an oral or mixed pattern. It is important to identify the relevant factors affecting MBS in order to diagnose its cause since breathing obstructions can result from multiple factors. The purpose of this study is to clarify the relevant factors and the interrelationships between factors affecting MBS among children.DesignWe surveyed 380 elementary school children from 6 to 12 years in age. The questionnaire consisted of 44 questions regarding their daily health conditions and lifestyle habits and was completed by the children’s guardians. A factor analysis was performed to classify closely related questions into their respective factors and to examine the strength of the correlation between the newly revealed factors.ResultsTwenty-six out of the 44 questions were selected, and they were classified into seven factors. Factors 1–7 were defined as “Incompetent lip seal”, “Diseases of the nose and throat”, “Eating and drinking habits”, “Bad breath”, “Problems with swallowing and chewing”, “Condition of teeth and gums”, and “Dry lips”, respectively. There were also correlations between these factors themselves.ConclusionMBS was categorized according to 7 major factors. Because Factor 1 was defined as “Incompetent lip seal”, which was representative of the physical appearance of mouth breathers and correlated with other factors, we suggested that MBS should consist of 7 factors in total.