An atypical Lingual Lesion Resulting from the Unhealthy Habit of Sucking the Lower Lip: Clinical Case Study

Unhealthy oral habits may be involved in the etiology of a malocclusion, since they may affect development of the oro-facial region. There is little information on the habit of sucking the lower lip, to which practitioners attribute less clini-cal consequences. However, lower lip sucking is a harmful habit which appears frequently in children, especially dur-ing situations requiring increased attention and mental concentration. In patients presenting lower lip sucking, strong contractions of the lower lip’s orbicular’s muscle and the mentalis muscle, associated with hypertonicity of the upper

lip caused by sucking, has to be balanced by lingual thrusting during the act of deglutition. A case is presented in which failure to identify the habit of lower lip sucking led to an atypical lesion on the tongue, caused by the tongue’s impaction against the orthodontic appliance prescribed to correct a malocclusion. The recognition and elimination of an unhealthy habit is of great importance in diagnosis and the establishment of a treatment plan, so that undesirable complications can be avoided.

1. Moyers RE. Manual de Ortodoncia. 4ta ed. Buenos Aires: Editorial Médica Panamericana; 1992.

2. Josell SD. Habits affecting dental and maxillofacial growth and devel opment. Dent Clin North Am. 39:851-60. 1995

3. Turgeon-O’Brien H, Lachapelle D, Gagnon PF, Larocque I, Maheu-Robert LF. Nutritive and non-nutritive sucking habits:A review. ASDC J Dent Child. 63:321-7. 1996

4. Proffit WR. Equilibrium theory revisited: Factors influencing position of the teeth. Angle Orthod. 48:175-86. 1978;

5. Garliner D. Recognition and diagnosis of orofacial muscle imbalance. In: Garliner D. Myofunctional therapy. 1ra ed. Philadelphia:Saunders; 1981.

6. Nilner M, Kopp S. Distribution by age and sex of functional distur-bances and diseases of the stomatognathic system in 7-18 year olds. Swed Dent J. 7:191-8. 1983

7. Bosnjak A, Vucicevic-Boras V, Miletic I. Incidence of oral habits in children with mixed dentition. J Oral Rehabil. 29:902-5. 2002

8. Bessa CF, Santos PJ, Aguiar MC, do Carmo MA. Prevalence of oral mucosal alterations in children from 0 to 12 years old. J Oral Pathol Med. 33:17-22. 2004

9. Schneider PE, Peterson J. Oral habits: considerations in management. Ped Clin North Am. 29:523-46. 1982

10. Graber TM. Análisis funcional. In: Graber TM, Rakosi T, Petrovic AG. Ortopedia dentofacial con aparatos funcionales. 2da ed. Madrid: Harcourt Brace de España; 1998.

11. Graber LW. Orthodontics. In: Garliner D. Myofunctional therapy. 1ra ed. Philadelphia:Saunders; 1981.

12. Subtelny JD, Subtelny JD. Oral habits - Studies in form, function and therapy. Am J Orthod. 43:347-831973

13. Wildman AJ, Fletcher SG. Patterns of deglutition. Angle Orthod 34:271-91. 1964

14. Peng CL, Jost-Brinkmann PG, Yoshida N, Miethke RR, Lin CT. Differential diagnosis between infantile and mature swallowing with ultrasonography. Eur J Orthod. 25:451-6. 2003

15. Peng CL, Jost-Brinkmann PG, Yoshida N, Chou HH, Lin CT. Comparison of tongue functions between mature and tongue-thrust swallowing - an ultrasound investigation. Am J Orthod Dentofac Orthop. 125:562-70. 2004

16. Proffit WR, Chastain B, Norton LA. Linguopalatal pressure in children. Am J Orthod. 55:154-66. 1969

17. Bradley RM. Fisiología Oral. Buenos Aires: Editorial Médica Panamericana; 1984.

18. Thüer U, Sieber R, Ingervall B. Cheek and tongue pressures in the molar areas and the atmospheric pressure in the palatal vault in young adults. Eur J Orthod. 21:299-309. 1999

19. Chiba Y, Motoyoshi M, Namura S. Tongue pressure on loop of transpalatal arch during deglutition. Am J Orthod Dentofac Orthop. 123:29-34. 2003

20. Ichida T, Takiguchi R, Yamada K. Relationship between the lingual-palatal contact duration associated with swallowing and maxillofacial morphology with the use of electropalatography. Am J Orthod Dentofac Orthop. 116:146-51. 1999

21. Tosello DO, Vitti M, Berzin F. EMG activity of the orbicularis oris and mentalis muscles in children with malocclusion, incompetent lips and atypical swallowing - Part I. J Oral Rehabil. 25:838-46. 1998

22. Tosello DO, Vitti M, Berzin F. EMG activity of the orbicularis oris and mentalis muscles in children with malocclusion, incompetent lips and atypical swallowing - Part II. J Oral Rehabil. 26:644-9. 1999