• drToothChampion

Time to kick those oral habits!

Oral habits such as sucking the thumb or using the pacifier are common in infants but most children outgrow these habits when they become older. When is the best time to stop these habits? What will happen if they continue with these habits?

The growth of the face, jaws and teeth is influenced by oral habits. The longer the duration, the higher risk of an abnormal development of the jaws and teeth. For example, prolonged digit-sucking (sucking on fingers) may lead to a narrow upper jaw, crossbites, a front open bite, protruded upper front teeth and a long, narrow face. Some of the chewing or biting habits may also result in chipped teeth. These may also result in speech impairment, inability to bite with the front teeth and aesthetic issues. In short, the teeth may end up looking odd and the child may find pronouncing certain words more difficult (like “sss”). Here is a list of common oral habits that you should try to stop your child from doing:

  • Sucking a pacifier

  • Sucking thumb and/or other fingers

  • Chewing cloth, dolls, toys etc

  • Prolonged use of nursing bottle

  • Biting or chewing fingernails

  • Lip habits (eg sucking lip, licking lip etc)

Open bite and protruded upper front teeth from thumbsucking habit

For some of the cases where the teeth and bite are severely affected, braces may not be able to correct the bite perfectly when the child is older. So it is better to get the child to stop the oral habits as early as possible. You should start getting your child off the pacifier or thumb-sucking habit at around age of 18 months to 3 years old if he/she is still on the habit. The sooner you start to remind the child, the better the success in getting the child to stop the habit earlier…and hence less risk of problems with the jaw growth and bite. Needless to say, these oral habits are unhygienic and increases the chance of your child getting sick.

Most children may not be aware that they are doing these habits. Here are some methods to try helping your child to lose these harmful oral habits:

1. Reminder

You can start by using a reminder for them to stop their habit. You can use plaster, bandage, mittens or socks around the fingers or hand as a reminder. Some parents use awful-tasting nail polish to serve as a reminder for the child. You should also tell your child to stop if you catch him or her doing it. It’ll be good if the other family members in the household also help to do the reminders so that the message to the child is consistent.

Another way to remind the child is to show them images of consequences from these oral habits. Some children will think twice after seeing photos of misaligned teeth associated with their oral habits. You do not want your child’s teeth and jaws to grow abnormally, so better start reminding him/her to stop any oral habits. Remember to be supportive and not embarrass the child.

2. Positive reinforcement

This is tied to the reminder method as well. If the child follows your instructions, you should shower him/her with praises and hugs. Most children do well with positive reinforcement but it needs to be immediately after the child displays the correct behaviour (eg stops putting his/her finger in the mouth) so that the child can associate the positive reinforcement with the right action that you want him/her to do.

3. Reward chart

Rewards can come in different forms, tangible and non-tangible. Some do well with praises, attention and hugs from loved ones while others do better with small gifts. Start with a reward chart and keep track of the child’s progress daily in stopping the habit. For every good attempt in stopping the habit, stamp on the chart or put a fun sticker for the relevant day. At the end of collecting say 10 stickers or stamps, reward your child with either a trip to the toy store or a visit to the zoo etc. For this to work, you need to be consistent and strict…meaning if he/she still continues with the oral habit, resist from giving a sticker or it’ll send a wrong message to the child.

Examples of fancy reward charts

4. Set a timeline

Children above the age of 3-4 years old may understand this better. Set a deadline for the child to drop his/her oral habit. For example, tell your child that by Christmas or by his/her next birthday, the pacifier needs to be donated to Santa/daddy/mommy in return for a gift. Prepare a gift that the child anticipates so that he/she would likely be more willing to let go of the habit. If you throw your child’s pacifier without prepping him/her, be ready that he/she may throw a tantrum. An agreed timeline with your child can help him/her to be better prepared for the day.

There are also other oral habits such as lip-licking, nail-biting and grinding which can start when the child is older. It is important to check and see when the child does the habit and why. Grinding in young children (usually 4 to 8 years of age) happens to be fairly common. This is largely thought to be due to growth changes in the jaws or hyperactivity of the jaw muscles. Try getting your child to have a relaxing bedtime routine such as reading a book, listening to a story or soothing music before sleep. If you notice your child grinding while she/he is asleep, try changing his/her sleeping position to stop the grinding. Lip-licking and nail-biting tend to happen in older children. Lip-licking may cause redness (sometimes fungal infection) around the lips while nail-biting can contribute to chipped nails and teeth edges.

Aside from just reminding your child to stop these habits, parents should also look at addressing the root cause of the oral habit. Some cases may be due to anxiety and stress, possibly due to changes in lifestyle or social setting. Talk to your child. Managing the anxiety or helping your child to adjust to the changes around him/her can help to reduce the frequency of these oral habits or sometimes eliminate them completely.

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