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Updated: Jan 20, 2026
Toddler and Preschool Child Exam
Published on: April 30, 2023
Association between oral habits, mouth breathing and malocclusion in Italian preschoolers
E G Paolantonio1, N Ludovici1, S Saccomanno1
1Dental and Maxillofacial Institute, Head and Neck Department, Fondazione Policlinico Gemelli IRCCS, Catholic University of Sacred Heart, Rome, Italy.
Insights
Bad habits and mouth breathing are significant risk factors for malocclusion in preschoolers. Early intervention is crucial for preventing and managing these orthodontic issues.
Area of Science:
- Pediatric Dentistry
- Orthodontics
- Craniofacial Growth
Background:
- Malocclusion prevalence and risk factors in preschoolers require investigation.
- Understanding associations between habits and malocclusion aids early intervention.
Purpose of the Study:
- Evaluate malocclusion prevalence in preschoolers.
- Assess the link between detrimental habits (e.g., thumb sucking) and mouth breathing with severe malocclusions.
Main Methods:
- Cross-sectional study of 1616 children aged 3-6 years.
- Utilized the Baby ROMA index to assess orthodontic treatment needs.
- Analyzed associations using Chi-square and Fischer tests.
Main Results:
- 38% of children require orthodontic treatment; 46% need monitoring and risk factor elimination.
- Prevalence of detrimental habits and mouth breathing increases with malocclusion severity.
- Oral habits and mouth breathing strongly correlate with anterior open bite, posterior crossbite, and increased overjet.
Conclusions:
- Detrimental habits and mouth breathing are identified risk factors for malocclusion.
- Early interception and correction of these habits are vital for preventing malocclusion development or progression.
- A multidisciplinary approach is recommended for optimal patient management.
Aim:
This cross-sectional study was carried out to evaluate the prevalence of malocclusion and associated factors in preschoolers with the aim of assessing the existence of an association between bad habits and mouth breathing with the most severe malocclusions.
Materials And Methods:
A sample of 1616 children aged 3-6 years was visited by applying the Baby ROMA index, an orthodontic treatment need index for preschool age. The following were searched: the prevalence of malocclusion, the association of bad habits and mouth breathing with malocclusion, how often are found in association and how this association is statistically significant. Chi-square and Fischer test were applied to verify the statistical significance of the association between the variables.
Results:
The data show that 38% of the sample need orthodontic treatment and 46% have signs of malocclusion of less severe degree that require a close monitoring and the elimination of risk factors so that they can improve spontaneously with growth. Moreover the prevalence of bad habits and oral breathing increases with increasing severity of the malocclusion, and sucking habits and oral breathing are both closely related to anterior open bite, posterior crossbite and increased overjet.
Conclusions:
In the context of prevention and early treatment of disorders of the craniofacial growth, bad habits and mouth breathing, being risk factors of malocclusion, should be intercepted and corrected early on to prevent the development of malocclusion, or the worsening of existing ones. From this point of view it is important to follow the patients with a multidisciplinary approach.
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