A Common Habit With A Common Ending

"My daughter just loves her binky!"

"We can't get my son to stop sucking his thumb"

Thumb, finger and pacifier habits are normal and common behaviors during early childhood. In the dental world we refer to these behaviors as "nonnutritive sucking" behaviors. Not all children will develop these habits, but for those who do, parents often wonder about the effects it might have on the teeth and jaws.

There are several dental effects that result from these behaviors. We often see an "open bite", which means that when the child bites down, his or her back teeth are in contact, while the front teeth are not. The front teeth may also be pushed forward. The combination of these effects can make the front teeth appear to be arched rather than straight across. Children can also develop a narrow upper jaw as a result of prolonged digit sucking or pacifier use. In extreme cases, it may look like all of the upper teeth are tucked inside the lower teeth. It is generally thought that the duration of sucking (i.e. the amount of time during the day a child either sucks his thumb or uses the pacifier) contributes more to these effects than how strongly a child sucks.

If the habit is stopped while all of the primary teeth are still present, parents will often notice the primary teeth begin to migrate back into their proper position. If the habit persists as the permanent teeth are erupting, more lasting effects on a child's bite may be seen that require correction with an appliance or braces.

The pacifier can be taken away gradually, or taken away "cold turkey". Both methods are effective, although can be rough on parents. Talking to your child about becoming a "big girl" or big boy" is helpful when approaching this juncture. Studies have shown that neither method has detrimental effects on emotional development. Some parents invent the "pacifier fairy". This fictional figure collects binkies and gives them to babies who still need them. Other parents have put the pacifiers on a plate for Santa at Christmas time so he can take them to small children who need them.

Children who suck a thumb or finger generally stop by the preschool years. Encouraging a child to stop sucking will generally only work when the child is capable of understanding why it should be stopped. We encourage parents not to be overly anxious about these habits and their possible effects. Nagging or punishment may result in the behavior increasing. For a child who needs help with stopping a thumb or finger habit, we suggest several alternatives to punishment.

First, a simple discussion between the child and the dentist can be very effective. Many children will take an adult other than their parent more seriously, and often want to show the dentist they can "do a good job". Second, rewards can be effective. Some dentists will design contracts or certificates for their patients, with a final prize to work towards. Parents can place calendars up with gold sticker stars, or place loose change in a jar for every day a child goes without sucking their thumb. Thirdly, some children just need a simple reminder, such as a piece of tape or a bandage on the offending finger. There are fingernail polishes specifically designed to help stop these habits as well; they come with a very bitter taste. Finally, for those children who cannot break the habit, and the permanent teeth have fully erupted, an appliance may be necessary. Talking to your child's dentist about with methods may work for your child is the first step to getting control over these habits.