Sucking Habits & Teeth

Thumbs up or thumbs down?

by Denise Baillet

Babies often find comfort in sucking a soother, thumb, blanket or fingers. It is an instinctive behaviour that is pleasurable for infants, helps them relax, and focuses their attention. Some ultrasound images have even shown babies sucking their thumbs before they are born!

The most common time for babies to need comfort is in stressful situations or when they are going to sleep. When children continue with this behaviour past the point when it is beneficial, it becomes a sucking habit that can affect positioning of the teeth and jaw development.

Some studies have shown a decrease in the incidence of Sudden Infant Death Syndrome (SIDS) among babies who use a soother. However, soothers are not recommended in the first 6-8 weeks, when babies are learning to breastfeed. Additionally, soothers should not be introduced until breastfeeding is well established. Before offering a soother, it is important to check if the baby is hungry, tired or bored to ensure the appropriate need is being met. Remember that if you choose to give a soother, it is not a replacement for the comfort that children get from being held.

Choosing a Soother
• Soother packages are often marked with a recommended age. Most babies prefer a larger soother than what is stated on the package. You may have to try a few soothers before you find one your baby likes.

• Consider how many pieces make up the soother; multiple pieces can separate, creating a choking hazard.

• Look for a soother with a large mouth shield that has at least two vent holes in it for breathing.

• There is little difference between the effect of regular and orthodontic soothers on tooth positioning and jaw development. What does make a difference is how a child holds the soother in their mouth and how often and for how long a child continues to use a soother.

Soother Safety
• Do not attach a string or anything to the soother that can choke the baby.

• Remove the soother when children are running and playing.

• Check the soother daily for wear and make sure the nipple is firmly attached. Replace discoloured or cracked soothers.

• Clean soothers frequently with soap and warm water. Avoid using your mouth to clean the soother. This may spread infections, including thrush and the germs that can cause tooth decay (cavities).

• Avoid dipping soothers in honey (in case of botulism) or anything containing sugar as this may lead to cavities.

As previously mentioned, soothers are not the only things children use for comfort. Children can become very attached to their soothers, thumbs, fingers, blankets or other objects. If the sucking habit is prolonged, it may affect how the teeth come into the mouth or how the roof of the mouth is shaped.

Parents can start discouraging sucking habits around one year of age. Some studies have found an increase in ear infections with soother use past the age of one. Fortunately, very few children continue this habit past the age of three, and usually their peer group will help influence children to stop if the habit continues into school. Teeth that have been moved due to a sucking habit may reposition themselves if the habit is stopped by age three. If the habit continues until adult teeth start to come in, around ages five to six, a dentist may suggest that a dental appliance be placed in the mouth to help stop the habit.

Stopping a sucking habit is easier when children are using a soother because, unlike thumbs, soothers can be taken away! Usually, a thumb-sucking habit will last longer than a soother habit. Gently guiding children away from a habit is often most effective. First, try to reduce the habit to sleep time only. As soon as the child is asleep, remove the object from the mouth.

Tips From Parents on Stopping the Sucking Habit
• Stay firm with your decision to get rid of a soother or other object of comfort and do not give in.

• Help children find other ways to seek comfort.

• Explain that the child is too grown up to be using a soother.

• “Forget” the soother when you go out.

• Tie a soother to a helium balloon and let children release it in the park.

• Create a story like the Tooth Fairy and make a secret trade when they are sleeping.

• Make a reward chart to positively reinforce not using the soother and to track the child’s progress. For example, reward with a sticker if a soother is not used in the car, or for an hour. Small accomplishments are easier to start with. Even a small reward can motivate.

• Give gentle reminders throughout the day.

• Limit when the fingers or thumb can be used, for example, in bed only.

• Distract children with something to keep their hands busy when they might be tempted to suck, for instance on car rides.

• When you are walking, hold the child’s hand that is preferred for sucking.

As they mature, most babies will find other means of comfort instead of sucking, and their natural tendency will not turn into a habit. Others may require assistance from their parents to help break a sucking habit when it becomes harmful to their mouth development. If you have concerns about the dental effects of your child’s prolonged sucking habit, talk to your dentist.

Denise Baillet, RDH, is a dental hygienist with the VIHA Children, Youth and Family Dental Program in Victoria.