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VOLUME 14 , ISSUE S2 ( Special Issue (Behaviour Management), 2021 ) > List of Articles

CASE REPORT

Separation Anxiety—An Unseen Cause for Development of Abnormal Oral and Paraoral Habits and Malocclusion: A Review of Literature and Report of Two Cases

Vijaya S Dhote, Priyanti M Dharmadhikari, Rakesh N Bahadure, Nilima R Thosar, Aniket V Dhote

Citation Information :

DOI: 10.5005/jp-journals-10005-2091

License: CC BY-NC 4.0

Published Online: 01-02-2022

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

A child's overall well-being depends on its mutual relationship with the caregiver and social environment. Its attachment with the caregiver forms an emotional bond at six months to two years of age. Separation anxiety refers to fear of separation from the attachment figure. In some neglected children in early age of attachment formation, symptoms of separation anxiety persist and they may show debilitating nervous behaviors during growth. It thus becomes an unseen cause of psychological problem and development of abnormal oral habits occlusal dysfunctions and further psychological problems. Oral habits being learnt patterns of muscle contraction are displayed for release of mental tension due to fear and anxiety often associated with anger, hunger, sleep, tooth eruption and fear. Pediatric dentist plays an important role in patient education through anticipatory guidance. Proper diagnosis and early interception of oral habits as a result of separation anxiety disorder can prevent occlusal disturbances in children. The present paper includes review of literature along with the management of two cases of separation anxiety as an unseen cause of development of unique socially unacceptable abnormal oral and paraoral habits and resultant malocclusion.


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  1. Stone LL, Otten R, Soenens B, et al. Relations between parental and child separation anxiety: the role of dependency-oriented psychological control. J Child Fam Stud 2015;24(11):3192–3199. DOI: 10.1007/s10826-015-0122-x
  2. Justus R. Correction of anterior open bite with spurs: long-termstability. World J Orthod 2001;2(3).
  3. Moss E, Cyr C, Bureau JF, et al. Stability of attachment during the preschool period. Dev Psychol 2005;41(5):773–783. DOI: 10.1037/0012-1649.41.5.773
  4. Crawford TN, Cohen PR, Chen H, et al. Early maternal separation and the trajectory of borderline personality disorder symptoms. Dev Psychopathol 2009;21(3):1013–1030. DOI: 10.1017/s0954579409000546
  5. Ehrenreich JT, Santucci LC, Weiner CL. Separation anxiety disorder in youth: phenomenology, assessment, and treatment. Psicol Conductual 2008;16(3):389–412. DOI: 10.1901/jaba.2008.16-389
  6. Svensson J, Barclay L, Cooke M. The concerns and interests of expectant and new parents: assessing learning needs. J Perinat Educ 2006;15(4):18–27. DOI: 10.1624/105812406x151385
  7. Ainsworth MDS, Blehar MC, Waters E, et al. Patterns of Attachment: A Psychological Study of the Strange Situation: Psychology Press; 1978:116–136.
  8. Main M, Solomon J. Procedures for Identifying Infants as Disorganized/Disoriented During the Ainsworth Strange Situation. Attachment in the Preschool Years: Theory, Research, and Intervention. 1990;1:121–160.
  9. Bowlby J. The nature of the child's tie to his mother. Int J Psychoanal 1958;39(5):350–373.
  10. Ruffin NJ. Understanding Growth and Development Patterns of Infants. Virginia: Virginia Dept. of Education Licensed School Psychologist and NCSP Publication; 2009:350–355.
  11. Settlage CF, Bemesderfer S, Rosenthal J, et al. The appeal cycle in early mother-child interaction: nature and implications of a finding from developmental research. J Am Psychoanal Assoc 1991;39(4):987–1014. DOI: 10.1177/000306519103900406
  12. Bowly J. A Secure Base: Clinical Applications of Attachment Theory. New York, Brunner-Routledge. 1988.
  13. Ainsworth MDS. Some considerations regarding theory and assessment relevant to attachments beyond infancy. In: Greenberg MT, Cicchetti D, Cummings EM, editors. Attachment in the Preschool Years: Theory, Research, and Intervention. Chicago: University of Chicago Press; 1990:463–488.
  14. Kobak R, Cassidy J, Lyons-Ruth K, et al. Attachment, stress, and psychopathology: a developmental pathways model. In: Cicchetti D, Cohen D, editors. Handbook of Developmental Psychopathology. 1. Cambridge: Cambridge University Press; 2006:333–369.
  15. Kobak R, Madsen S. Disruptions in attachment bonds: implications for theory, research, and clinical intervention. In: Cassidy J., Shaver P, editors. Handbook of Attachment: Theory, Research and Clinical Applications. 2 ed. New York: Guilford Press; 2008:23–47.
  16. Bowlby J. Attachment and loss. Separation New York: Basic Books 1973;vol 2.
  17. Bowlby J. Attachment and loss. Loss, Sadness and Depression New York: Basic Books 1980;vol 3.
  18. Rutter M. Psychosocial resilience and protective mechanisms. Am J Orthopsychiatry 1987;57(3):316–331. DOI: 10.1111/j.1939-0025.1987.tb03541.x
  19. Zeanah CH, Smyke AT, Koga SF, et al. Attachment in institutionalized and community children in Romania. Child Dev 2005;76(5):1015–1028. DOI: 10.1111/j.1467-8624.2005.00894.x
  20. Leventhal T, Brooks-Gunn J. The neighborhoods they live in: the effects of neighborhood residence on child and adolescent outcomes. Psychol Bull 2000;126(2):309–337. DOI: 10.1037/0033-2909.126.2.309
  21. Howard K, Martin A, Berlin LJ, et al. Early mother-child separation, parenting, and child well-being in Early Head Start families. Attach Hum Dev 2011;13(1):5–26. DOI: 10.1080/14616734.2010.488119
  22. Zeanah CH, Egger HL, Smyke AT, et al. Institutional rearing and psychiatric disorders in Romanian preschool children. Am J Psychiatry 2009;166(7):777–785. DOI: 10.1176/appi.ajp.2009.08091438
  23. Smyke AT, Zeanah Jr. CH, Fox NA, et al. A new model of foster care for young children: the Bucharest early intervention project. Child and adolescent psychiatric clinics of North America 2009;18(3):721–734. DOI: 10.1016/j.chc.2009.03.003
  24. Kearney CA. Dealing with school refusal behavior: a primer for family physicians: workable solutions for unhappy youth and frustrated parents. J Fam Pract 2006;55(8):685–693.
  25. Albano AM, Barlow DH. Breaking the vicious cycle: cognitive-behavioral group treatment for socially anxious youth. In: Hibbs E, Jensen P, editors. Psychosocial Treatment Research and Adolescent Disorders Washington, DC: APA Press; 1996:43–62.
  26. Tonge B. Separation anxiety disorder. In: Ollendick TH, King NJ, Yule W, editors. International Handbook of Phobic and Anxiety Disorders in Children and Adolescents New York: Plenum Press; 1994. 145–167.
  27. Black B. Separation anxiety disorder and panic disorder. Anxiety disorders in children and adolescents 1995:212–234.
  28. Biederman J, Petty C, Faraone SV, et al. Childhood antecedents to panic disorder in referred and nonreferred adults. J Child Adolesc Psychopharmacol 2005;15(4):549–561. DOI: 10.1089/cap.2005.15.549
  29. Silove D, Manicavasagar V. Adults who feared school: is early separation anxiety specific to the pathogenesis of panic disorder? Acta Psychiatr Scand 1993;88(6):385–390. DOI: 10.1111/j.1600-0447.1993.tb03478.x
  30. Fischer D, Himle J, Thyer B. Separation anxiety disorder. In: Ammerman R, Hersen M, Last C, editors. Handbook of prescriptive treatments for children and adolescents Boston: Allyn & Bacon 1999;vol 2:141–154.
  31. Bernstein GA, Borchardt CM. School refusal: family constellation and family functioning. J Anxiety Disord 1996;10(1):1–19. DOI: 10.1016/0887-6185(95)00031-3
  32. Schaefer C. Evidence supporting the benefit of play for mild to moderate behavior problems of preschool children. In: Nash J, Schaefer C, editors. Play therapy for preschool children Washington, DC: American Psychological Assoc; 2010:31–45.
  33. Shah AF, Batra M , Sudeep CB, et al. Oral habits and their implications. Ann Med 2014; 1(4).
  34. Rani M. Synopsis of orthodontics. India: Laxman Chand Arya, AITBS Publishers and Distributors. 1998:179–200.
  35. Baer PN, Lester M. The thumb, the pacifier, the erupting tooth and a beautiful smile. J Pedod 1987;11(2):113–119.
  36. Shahraki N, Yassaei S, Moghadam MG. Abnormal oral habits: a review. J Dent Oral Hyg 2012;4(2):12–15. DOI:10.5897/JDOH12.001
  37. Guideline on management of the developing dentition and occlusion in paediatric dentistry. Am Acad Pediatric Dent 2014;36(6):251–261.
  38. Proffit WR, Fields Jr. HW, Sarver DM. The etiology of orthodontic problems. Contemporary Orthodontics 5th ed. St. Louis: Mosby; 2012:114–146.
  39. Warren JJ, Bishara SE, Steinbock KL, et al. Effects of oral habits duration on dental characteristics in the primary dentition. J Am Dent Assoc 2001; 132(12):1685–1693. DOI: 10.14219/jada.archive.2001.0121
  40. Campus G, Condò SG, Di Renzo G, et al. National Italian guidelines for caries prevention in 0 to 12 years-old children. Eur J Paediatr Dent 2007;8(3):153–159.
  41. Salute M, dellepolitichesociali L. Lineeguidanazionali per la promozionedella salute orale e la prevenzionedelle patologieorali in etàevolutiva. 2008. http://www.salute.gov.it/portale/temi/p2_6.jsp?lingua=italiano&id=732&area=Sorriso%20salute&menu=vuoto [Accessed on 2008].
  42. Ford K, Brocklehurst P, Hughes K, et al. Understanding the association b/w self reported poor health and exposure to adverse childhood experiences A retrospective study. BMC Oral Health 2020;20(1):51. DOI: 10.1186/s12903-020-1028-6
  43. Guideline on management of the developing dentition and occlusion in pediatric dentistry reference manual. Am Acad Pediatric Dent 1990;32(6):10–11.
  44. Majorana A, Bardellini E, Amadori F, et al. Timetable for oral prevention in childhood— developing dentition and oral habits: a current opinion. Prog Orthod 2015;16:39. DOI: 10.1186/s40510-015-0107-8
  45. Dhimole A, Bhasin N, Pandya D, et al. Psychosomatic disorders affecting the mouth: a critical review . Br J Med Med Res 2016;14(5):1–9. DOI: 10.9734/BJMMR/2016/24743
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