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Nonnutritive Sucking, continued
Dental Effects
The dental effects of
Nonnutritive Sucking: Sucking not relating to or providing nutrition.
nonnutritive sucking directly correlate with the frequency, intensity, duration, and nature of the habit. The most common effect is movement of the central incisors upward and anteriorly, which may result in an
Anterior Open Bite: Vertical space between the upper and lower incisors resulting from opposing teeth failing to establish occlusal contact when the jaws are closed.
anterior open bite. Other possible effects include
Maxillary Constriction: A narrowed hard palate.
maxillary constriction and
Posterior Crossbite: Malocclusion in which the posterior maxillary molars or premolars are lingually displaced inside of the mandibular teeth.
posterior crossbite. (Refer to the Chapter 8 Photo Gallery for examples.)

Dental effects are generally reversible and unlikely to cause any long-term problems if the habit is discontinued by the age of 5. It is important to counsel families to help a child break the habit before the permanent teeth erupt, preferably beginning intervention by age 4. Many families successfully decrease pacifier use earlier by limiting it to naps and bedtime.

The success of any intervention depends on a child’s willingness to participate. For the child who persists with a sucking habit, consider these treatment options:
Discussion. Tell the child in basic terms why you want them to stop and that you believe they can do so. Plan a quitting strategy together.
Reminder therapy. This includes rubber bands, string, and band-aids, all of which help the child to interrupt the habit for themselves. These aids should be reserved for older children, as they pose a choking hazard in young children.
Reward system. This could include a star chart, stickers, or a habit calendar.
A stuffed animal or other comfort object.
Physical Intervention. The child must be ready and agreeable for the intervention to work. Techniques include covering hands at night with mittens or socks, dressing the child in a special shirt with the sleeves sewn closed, or placing a bandage or specialty plastic guard on the thumb or finger. If these methods are not effective, an intra-oral appliance can be placed by a dentist to prevent sucking. The appliance is removed after the habit is broken.
The most common dental effect of nonnutritive sucking is anterior, upward movement of the maxillary central incisors.
Nonnutritive sucking is unlikely to result in long-term dental effects if discontinued before the age of 5.
Interventions to help a child stop his or her sucking habit include reminder therapy, a reward system, and physical intervention.

View the Chapter 8 Photo Gallery.