The impact of oral habits and parafunctions on dental and skeletal development in pediatric populations: a literature review
Authors
Federica Macrì, Giovanni Cattaneo, Maria Assunta Mauri, Francesco Carlo Tartaglia, Franceska Vinjolli, Edit Xhajanka, Alessandra Laforgia, Grazia Marinelli, Francesca Calo, Antonio Rizzo, Antonio Musciacchio
Abstract
Objective: Harmful oral habits and parafunctions (e.g., thumb/finger sucking, prolonged pacifier use, atypical swallowing, onychophagia, bruxism, and oral/oronasal breathing) are common in pediatric populations and may interfere with dentoskeletal development when they persist beyond the expected developmental period. This review summarizes their associations with malocclusion traits and functional alterations during growth.
Materials and Methods: A structured literature search was conducted in PubMed/MEDLINE, Scopus, and Embase for articles published between January 1990 and December 2024. The search combined terms related to oral habits/parafunctions and malocclusion and was limited to English or Italian. A total of 790 records were identified (PubMed: 50; Scopus: 240; Embase: 500). After title/abstract screening and full-text assessment, 23 studies were included and narratively synthesized.
Results: The evidence most consistently links prolonged non-nutritive sucking habits with anterior open bite, increased overjet, maxillary arch constriction, and a higher risk of posterior crossbite. Altered swallowing patterns and oral/oronasal breathing are frequently reported as co-factors contributing to vertical and transverse discrepancies. Pediatric bruxism is commonly reported and has been associated with muscle symptoms and temporomandibular complaints, potentially complicating the clinical picture. Across studies, designs, diagnostic criteria, and outcome reporting were heterogeneous, limiting comparability.
Conclusion: Harmful oral habits and parafunctions are modifiable risk factors for the development or worsening of malocclusion during growth. Early identification, counseling, and multidisciplinary interceptive approaches may reduce the likelihood of stable dentoskeletal discrepancies. Future studies should adopt standardized definitions and outcomes and better quantify habit-related biomechanical effects to improve comparability and clinical guidance.
PDF
