Thumb Sucking and Pacifiers “Non-nutritive Sucking Habits”

Thumb sucking and pacifiers “non-nutritive sucking habits” is a natural reflex for babies, which begins around the 29th week of gestation. Non-nutritive sucking includes oral habits developed by babies other than breast or bottle-feeding. In fact, it is reported that nearly 100% of infants partake in some sort of non-nutritive sucking, most commonly thumb sucking, using a pacifier, or both. Other non-nutritive sucking habits include but are not limited to sucking on toys, blankets, other fingers, toes, etc. Babies usually form these habits as a way to self-soothe, which is regarded as totally normal for kids 3 years old and younger. Non-nutritive sucking habits usually do not start causing problems unless they persist as the child becomes older. Dr Jeff Holt from Kids Dental in Plano and Carrollton provides information about baby dental topics for infant oral hygiene care.

Benefits of Non-Nutritive Sucking Habits

There are several benefits for infants who engage in non-nutritive sucking habit, such as using a pacifier or sucking a finger or thumb. Forming an oral habit such as these demonstrates an infant’s early ability to self-manage his or her emotions. Using a pacifier or allowing thumb sucking can also help an infant relax and center his or her attention. Non-nutritive sucking typically occurs more when a baby is tired, distressed, apprehensive, or bored, and consequently, can help in providing the baby with comfort and a feeling of safety.

Pacifiers Recommendations

Negative Effects of Pacifiers and Thumb Sucking

The American Academy of Pediatrics (AAP) actually recommends parents put their infants to bed with a pacifier. For reasons not completely known, this practice is proven to reduce the risk of Sudden Infant Death Syndrome (SIDS), which can occur until a child reaches their first birthday. Offering an infant a pacifier at nap or bedtime is considered a healthy habit, but if used for too many years, pacifiers can cause dental complications later. According to the following guidelines, however, pacifier use is highly recommended for the first year of a baby’s life:

  • Use a pacifier when placing an infant down to sleep, but do not force an infant to use a pacifier or reinsert the pacifier into a sleeping baby’s mouth if it falls out.
  • Never coat a pacifier in any sweet solution.
  • Sanitize and replace pacifiers often.
  • If an infant is breastfeeding, do not introduce a pacifier until the baby is 1 month of age to make sure breastfeeding is solidly and successfully established.
  • Never use a pacifier in place of or as a way to delay meals. Only offer a pacifier when you are sure the baby is not hungry.
  • Pacifiers should include ventilation holes and have a shield that is wider than the baby’s mouth.
  • Pacifiers should be made of durable material and only consist of a single piece.
  • Always replace a pacifier when it starts to look worn.
  • Never tie a pacifier by a string to a crib or around a baby’s hand or neck. This highly increases the risk for strangulation.

Dental Effects of Non-Nutritive Sucking Habits

The detrimental effects of non-nutritive sucking habits are insignificant on infants and children under the age of three. Sometimes, upper incisors become tipped towards the lips, which is commonly known as “buck teeth,” while other times these teeth are inhibited and may not erupt. Some controversy subsists over whether the effects of pacifier use and thumb sucking differ, but overall, research at this time shows differences to be more related to the intensity of the sucking habit.

How much teeth change due to non-nutritive sucking depends on the intensity, frequency, and duration of the habit, as well as how the thumb or finger is positioned in the baby’s mouth. The most commonly identified dental signs of an active non-nutritive sucking habit include:

  • open bite child kidsdental from Thumb Sucking and Pacifiers “Non-nutritive Sucking Habits”
    Anterior Open Bite

    Anterior open bite: the upper and lower incisors do not overlap correctly when the teeth bite together.

  • Movement of the incisors: the incisors shift out of their correct and ideal position in the mouth.
  • Maxillary (Upper Jaw) constriction: the hard palate narrows due to the internal pressures caused by the sucking and the pressing of the tongue away from the hard palate into the floor of the mouth.

When To Stop Pacifier Use And Thumb Sucking

Usually children stop sucking their thumb or using a pacifier between 2 and 4 years old, and over 20% of toddlers still partake in these habits at 3 years old. Typically, pacifier users stop non-nutritive sucking before thumb suckers, and older children who still suck their thumb most often discontinue the habit due to peer pressure at school.

The official recommendation of the American Academy of Pediatric Dentistry (AAPD) is children stop their non-nutritive sucking habits by 3 years of age. Discontinuing these habits earlier rather than later allows the mouth a better opportunity to re-align itself before permanent teeth begin to emerge. If the child stops early enough, many of the issues with his or her bite may fix themselves. If the habits, however, continue as the permanent teeth begin to surface through the gums, many of the adult teeth will display the same effects of the non-nutritive sucking as the primary teeth. This may lead to orthodontic issues in the future.

Intervention Techniques For Non-Nutritive Sucking Habits

At around 3 years of age, there are several ways to approach intervening in a child’s non-nutritive sucking habit/s.  These are a few ways to start encouraging a child to give up non-nutritive sucking in the order that they should be tried:

  • Have a conversation with the child: Talk to the child about the problems their habit will cause in a way that is easy for them to understand. Sometimes this is enough to stop the sucking.
  • Remind the child: This can work for a child who has expressed they want to stop sucking but just needs help remembering. Also, keeping a waterproof adhesive bandage around the thumb or finger that the child sucks can serve as a good reminder for the child to stop. Placing a mitten or sock over the child’s hand at bedtime can also help. Make sure the child understands this is a reminder, not a punishment.
  • Implement a reward system: When employing this system, typically the child, parent, and health professional all agree that the child with quit their sucking habit in a certain amount of time, and then the child will be rewarded. The reward must be something that motivates the child to truly stop.
  • Interrupt the habit physically: If none of these techniques are successful, and the child really wants to quit the habit, there are two other methods that may work. 1. Gently and loosely wrap the child’s arm in and elastic bandage at night to prevent the child from inserting their hand into their mouth. The bandage should not be wrapped tightly. 2. A dentist can place an appliance in the child’s mouth that keeps the child from being able to successfully suck.

source: “Bad Breath in Children” Kids Dental Web, Jan. 25th 2018.

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