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Protecting All Children's Teeth (PACT): A Pediatric Oral Health Training Program
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Nonnutritive Sucking, continued
Dental Effects
The dental effects of nonnutritive sucking directly correlate with the frequency, intensity, duration, and nature of the habit.
Nonnutritive Sucking: Sucking not relating to or providing nutrition.

The most common effect is movement of the central incisors upward and anteriorly, which may result in an anterior open bite.

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.

Other possible effects include:

Maxillary Constriction: A narrowed hard palate.

Dental effects are generally reversible and unlikely to cause any long-term problems if the habit is discontinued early.

It is important to counsel families to help children break the habit before the permanent teeth erupt, preferably beginning intervention by age 3.

If the child is struggling to break the oral habit, 36 months is an appropriate age to consider referral for dental evaluation and management.

When a child persists with a sucking habit, consider the following approaches:

  • Tell the child in basic terms why you want them to stop and that you believe they can do so
  • Implement reminder therapy, the use of aids such as rubber bands or string, to help a child interrupt the habit
  • Start a reward system
  • Encourage the use of a stuffed animal or other comfort object

Physical Intervention
For physical intervention to work, the child must be ready and agreeable.

Techniques include:

  • Covering hands at night with mittens or socks
  • Dressing the child in a special shirt with the sleeves sewn closed
  • Placing a bandage or specialty plastic guard on the thumb or finger

If other 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.

Fast Facts
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.

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