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Muchos de los problemas que llevan a necesitar una ortodoncia son de origen genético o hereditario, pero también hay determinados hábitos bucales que pueden acabar creando problemas en el desarrollo orofacial. 

Los hábitos son acciones involuntarias, repetitivas y duraderas en el tiempo que pueden ser suprimidas por mecanismos de reeducación. No cumplen ninguna función, y, en cambio, ejercen fuerzas perjudiciales sobre los dientes, hueso, encías y tejidos blandos de la boca, produciendo así alteraciones en el desarrollo oral y deformaciones dentoesqueléticas. 

En la actualidad, los hábitos orales parafuncionales en niños son una de las causas principales del desarrollo de las maloclusiones. Cabe destacar que, a día de hoy, es una de las patologías con mayor prevalencia; y ortodoncistas y logopedas jugamos un papel fundamental en su detección y corrección. 

La SEDO recomienda llevar a los 6 años a los niños a su primera revisión ortodoncica para el diagnóstico temprano de las maloclusiones. También es importante la detección precoz de los hábitos orales perjudiciales para evaluar la repercusión que pueda tener sobre el desarrollo oral del niño, y la conveniencia de realizar un tratamiento con el fin de corregirlo en la mayor brevedad posible.

Entre ellos, los hábitos orales más habituales son: 

1- Deglución atípica e interposición lingual

Es un tipo de deglución fisiológica desde la vida intrauterina hasta la erupción de los incisivos y consiste en la interposición de la lengua entre los dientes superiores e inferiores al tragar. Si este hábito persiste más allá de los 4 años de edad del niño, puede producir deformación del paladar, mordida abierta anterior (se produce la imposibilidad de juntar los dientes al cerrar la boca), proyección hacia delante de los dientes anteriores superiores e inferiores y por tanto, falta de sellado labial, lo que origina problemas en la pronunciación.

2- Respiración oral

La respiración correcta es la nasal, si se respira por la boca de manera habitual de día y de noche puede deberse a la presencia de un obstáculo que impide el paso correcto del aire por la nariz (alergias, amígdalas, vegetaciones, pólipos, tabique nasal desviado...).

La respiración oral impide el crecimiento adecuado de los maxilares y favorece el desarrollo de gingivitis y sequedad bucal, además como la lengua se sitúa en una posición baja en la boca para permitir el paso del aire, no estimula el crecimiento en anchura del paladar, y esta posición mantenida en el tiempo provoca que la mandíbula crezca hacia abajo y no hacia delante, lo que produce alargamiento facial. 

3- Succión digital y labial

Que un niño se chupe el dedo es relativamente habitual. Si estos hábitos se eliminan antes de los 3 años de vida, las repercusiones suelen ser reversibles y mínimas. Sin embargo, si perdura en el tiempo, suele deformar la mordida del niño (creando sobre todo mordidas abiertas y compresiones del maxilar). 

A veces la deglución atípica se acompaña de una interposición del labio entre los incisivos superiores y los inferiores. Estos pacientes colocan el labio inferior por detrás de los dientes superiores (como si se mordiesen el labio inferior). El labio inferior acaba con el paso del tiempo inclinando los incisivos superiores hacia fuera de la boca y apiñando los inferiores hacia dentro. Esto hace que los dientes se desplacen para crear su propio hueco y crea la sensación de que los incisivos centrales superiores ("las paletas") quedan fuera de la boca. 

4- Uso prolongado de chupete y biberón

El hábito de succión es normal en la vida intrauterina y en los primeros meses de vida, pero a medida que erupcionan los dientes de leche, los niños deben abandonar este hábito y comenzar a masticar. Se recomienda retirar el chupete a los 12 o 18 meses de edad ( y en ningún caso superar los 2 años), ya que si este hábito continúa en el tiempo puede producir deformación del paladar y mordida abierta.

Un uso prolongado del chupete podría causar efectos totalmente indeseables tales como mordida abierta anterior, compresión maxilar o incisivos protuidos. 

De esta manera respetamos la necesidad inicial fisiológica de succión, sin interferir en la posterior erupción dentaria y desarrollo de los maxilares. 

Un uso prolongado del biberón produce los mismos efectos adversos. También conviene alternar a partir del primer año este, hasta el uso del mismo. 

5- Dieta excesivamente blanda

El tipo de alimentación que se da en los primeros años de vida, tiende a ser cada vez más blanda, durante un periodo de tiempo más prolongado: pan de molde sin corteza en vez de bocadillos de pan crujiente, bebidas de fruta triturada, purés y cremas, yogures...

Este tipo de alimentos son más fáciles de tragar y digerir, ejercitando menos la musculatura masticatoria y produciendo un menor desarrollo de los maxilares. Al existir una alteración de estos maxilares, suele existir una discrepancia entre el tamaño de estos y el de los dientes. Esto puede causar falta de espacio y apiñamiento entre otras causas. 

Además, la dieta blanda tiene un efecto cariogénico. Estos alimentos, se adhieren con facilidad a los surcos, fisuras y diferentes regiones de la anatomía dentaria. Esto dificulta el correcto cepillado.

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