What Is It?

There are two types of sucking: nutritive and non- nutritive (NNS). Non-nutritive sucking is a habit which may involve sucking of pacifiers, toys, blankets or digits. Thumb and finger sucking is normal in infancy and early childhood. Many children do this the first few years of life and stop naturally on their own. At a young age, it is unnecessary to create undue attention to these habits. Sucking habits become a concern when the child is three to four years of age. Prolonged NNS has been associated with a variety of negative effects on dental and oral development.

What Is The Problem?

Non-nutritive sucking for a prolonged period in childhood has been shown to change the growth pattern of teeth and the oral muscle function. The front teeth are the most noticeable change from NNS. A dental “open bite” may form as well as a cross bite and over-jet.

• This “buck tooth” appearance is due to continual force and pressure of the thumb on the front teeth.

• The upper jaw is also affected with often times narrow and high palate being formed from this constant pressure. This narrow and high upper jaw reduces the space for the nasal sinuses which often affects the airway and breathing. The tongue can no longer rest in the proper position at the roof of the mouth and teeth no longer have adequate space to grow. Orthodontic expansion is most likely needed, with possible airway evaluation.

• The lower jaw develops smaller and less prominent which creates the appearance of a “small chin”.

• The tongue no longer is able to rest in the proper position and finds itself with a low and forward posture. This in turn creates a tongue thrust which creates problems with eating, drinking, breathing, speech, appearance and rest posture of the face.

• Low lip tone and mouth breathing are direct results of NSS. The lips are now used to being apart due to the thumb, digits or toy being in the way. The lips begin to rest in an open posture, resulting in no support for the teeth. Normally, the lips and face muscles help act as a retainer for the teeth.

• Generally, a longer narrow and flattened face is common with NSS. All structures have grown down and forward, creating a long or drooping face.

• Speech is also effected with poor articulation, sound and lack of muscle control. This is hard due to palate changes from the thumb/digit habit, resulting in improper tongue position.

Ask Yourself:

• Intensity: is the thumb/finger being sucked forcefully enough that it has developed callouses or changed shape? Can you see strong contraction of the cheeks during sucking?

• Frequency: Does the sucking occur all the time? Day and night? Does it occur only at night or when the child is alone?

• Duration: How many years has the habit persisted? If the child is now getting their adult dentition, this is a concern.