Anticipatory Guidance (continued)

Non-Nutritive Sucking

Although most children discontinue nonnutritive sucking behaviors on their own before the permanent teeth begin to erupt, some continue beyond that stage. If the child regularly engages in non-nutritive sucking behaviors, gently intervene to help the child stop. These methods are presented in the order in which they should be attempted:

• Talking with the child. Discussing the problems caused by the habit. Sometimes this alone is enough to make the child stop sucking.
• Using reminder therapy. This approach is appropriate for children who want to stop sucking but need some help. An adhesive bandage secured with waterproof tape on the finger or thumb can remind the child not to suck. A mitten or sock placed on the hand at night can also be effective. Stress to the child that this is a reminder, not a punishment.
• Using a reward system. Under this system, the child, a parent, and the health professional agree that the child will discontinue the habit within a specified time period and will then receive a reward. The reward must be motivating to the child. Charting small successes may help (e.g., placing colored stars on a calendar for each day the child does not suck a pacifier or his or her finger or thumb).
• Physically interrupting the habit. If none of the preceding methods are successful, and the child truly wants to stop the habit, two other methods can be tried: (1) The child’s arm can be loosely wrapped in an elastic bandage during the night to prevent flexing the arm and inserting the thumb or fingers into the mouth. Stress to the parent that the bandage should not be wrapped tightly. (2) A dentist can place an appliance in the mouth that interferes with sucking.