Oral habits

Many parents express concern over their child's thumb sucking or use of a pacifier. Often worried about effects on teeth, parents sometimes try to prevent their children from sucking their thumb or using a pacifier. In fact, it has been shown that many children begin thumb sucking in utero. The truth is that sucking is a natural reflex. Thumb sucking and pacifier both help children become comfortable with their environment, as well as offer children a sense of security. Parents should not be upset over their child's need to suck their thumb or use a pacifier since most kids forego these habits naturally.

Thumb, finger and pacifier sucking all affect the teeth essentially the same way. However, a pacifier habit is often easier to break long before any damage can be done to the jaw and teeth. There are some things that parents should be aware of when allowing their children to use a pacifier. To reduce choking danger, always purchase pacifiers that come in one-piece design. Separate pieces can come apart and be swallowed by the baby or cause chocking. Never tie a pacifier around your child's neck as this can create a strangulation danger. Always check the pacifier, especially the nipple end, to make sure that it is still in good condition. Brittle nipples can break and choke your child. Also, never dip a pacifier in sugar, honey, or juice before giving it to your baby. It can lead to tooth decay.

Most children outgrow thumb sucking and pacifier use by age 4. However, thumb sucking that persists beyond the eruption of the permanent front teeth can cause changes in the appearance and positioning of teeth, shape and growth of the jaws, and affect speech development. The amount of change that may occur is dependent on the frequency, duration and intensity of the habit.

If your child is having trouble giving up the pacifier or thumb sucking, we suggest gradually weaning your child. The most effective way to accomplish this is to simply explain to your child that they must do so in order for their teeth to come in straight. You would be surprised at how effective simply explaining this to your child can be. When they do suck their thumb or use a pacifier give them a gentle verbal reminder. Under no circumstances should you give negative reinforcement or punish a child for this behavior as this often causes the child to further embrace the habit. Many professionals urge parents to tape their children's fingers or apply bitter tasting solutions to the fingers to prevent thumb sucking. We would advise against this. It is somewhat not as effective as providing positive reinforcement when children don't suck their thumb.

What should you do? First start by NOT allowing them to suck their thumb or use a pacifier during certain hours of the day.Offer them rewards when they successfully do this. Also, since thumb sucking and pacifier use are often security mechanisms, consider giving them a teddy bear or lots of hugs to, in effect, replace the pacifier or thumb sucking. Gradually increase the number of hours in which they are not allowed to use the pacifier or suck their thumb until they no longer need these habits. Remember, the time they need the pacifier the most (during bed) should be the last time period phased out. If a child’s habit is persisting after age 5, a “habit breaker appliance” may be needed to assist the child in ceasing the habit. Our doctors will be happy to answer any questions you may have in this regard. You may also refer to the section on “Early Orthodontic Treatment”.

Some helpful hints on breaking thumb sucking habit include:

• Wait until the time is right (low stress).
• Praise them when they are not sucking (positive reinforcement).
• Use a reward system like a calendar with stickers followed by reward at the end of the week/month
• Read helpful books such as:
• "The Little Bear who sucked his thumb" by Dr. Dragan Antolos
• "Harold’s Hideway Thumb" by Harriet Sonnenschein
• "David Decides About Thumb sucking" by Susan Heitler, PhD