Non-nutritive oral habits such as thumb sucking and pacifier use are very common for young children and these habits can often be challenging to break. Prolonged sucking can potentially lead to an "open bite" where the...
Non-nutritive oral habits such as thumb sucking and pacifier use are very common for young children and these habits can often be challenging to break. Prolonged sucking can potentially lead to an “open bite” where there is a clear space between the upper front and lower front teeth even when the child bites together in the back.
Open Bite: Clear space between upper and lower front teeth even when back teeth are biting and closed tightly
From the age of two months to a year, my daughter was attached to her pacifier 24/7. She started out as a thumb sucker then after weeks of trying I finally switched her over to a pacifier. Even though both habits can lead to the same results of palate and teeth distortion, a pacifier habit is much easier to break later than the thumb. That is why I often advise parents of infants who have thumb habits to try to replace it with pacifier.
The severity of palate distortion depends on the frequency and the amount of force of the habit. This means that a child who sucks lightly for 30 minutes a day might not have any distortion at all. Whereas someone who sucks very hard throughout the day may have 15mm of anterior space between upper and lower arch.
Fortunately, most palate distortions in the front teeth usually spontaneously correct itself after the habit breaks, as long as this happens before the permanent teeth start coming in around the age of 6-7. For this reason, we pediatric dentist will often just monitor habits and palate distortions between birth to 4.5 years of age. When patients are 5 years old or older we start making habit breaking appliances for our patients so that when permanent teeth come in we don’t have to worry about permanent changes in the alignment of the dental arches.
Bianca attached to her binky. We kept it strapped on wherever she goes
Here is how I broke my daughter’s pacifier habit which can be applied to any infant or young toddler. When she turned one I started cutting her pacifier short with scissors. I only cut about 3mm each time (about 1/4 inch.) and do it once a week. She can still use her pacifier but after a few weeks of cutting it became so short that there is nothing for her to suck on. Because the change is very gradual (I cut just a little bit each time over a total period of 6 weeks), towards the end she didn’t really mind not being able to suck on it. She continued to hold it on her hand and play with it for weeks when it became a short little nub. As long as she was unable to put it in her mouth, there is no worry that having it present was going to cause any harm to her teeth or palate.
After Four Weeks of Cutting
Older children are much smarter and more observant. I often advised parents to make up a story about the “Binky Fairy” who leaves a little present under the pillow when the child is emotionally ready to give up his or her binky. Another good story to tell is the “Binky Donation” program where the pacifier is mailed out to the poor kids across the world whose families are too poor to buy them binkies. In this scenario it’s often helpful to have the child write a little card, draw a picture, put a stamp on the envelope with the pacifier in it and mail out the little package. In addition to giving up the habit, one can also learn to not take everything for granted and develop sympathy for others who are less fortunate.
Stay tuned for Part II where I will discuss thumb habits in depth.