3.4 Anticipatory Guidance
Some children require additional sucking beyond that needed for nourishment. This type of sucking, known as non-nutritive sucking (e.g., sucking a finger, thumb, or pacifier), provides emotional benefits, enabling the child to become calm and focus attention. Although non-nutritive sucking habits in children under age 3 are believed to be of little consequence to the orofacial structures, such habits, when they persist, may cause oral health problems such as maxillary anterior flaring, lingual inclination of mandibular incisors, posterior cross bite, and anterior open bite.
Following are several approaches to intervening with children who have a non-nutritive sucking habit. These are presented in the order in which they should be attempted.
- Talk with the child, if the child can understand cause-and-effect statements. Discuss the problems caused by the habit. Sometimes this alone is enough to stop the habit.
- Use 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 or engage in other harmful habits. 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.
- Use a reward system. Under this system, the child, the parents, and the oral 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.
- Physically interrupt 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. Stress to the parents that the bandage should not be wrapped tightly. (2) A dentist can place an intraoral appliance in the mouth that interferes with sucking.