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“Non-nutritive sucking behavior”? That’s a mouthful—literally! This term describes behaviors such as thumb sucking and pacifier use, which are generally healthy, self-soothing activities for infants and toddlers. But, if followed too long, this comforting habit can have uncomfortable consequences for your child’s dental health.

When children are nursed or bottle-fed, placing a nipple in the mouth helps trigger the sucking reflex, enabling the flow of milk or formula. This is called nutritive sucking, because nourishment is the goal. The sucking reflex is so essential that it develops even before birth. And while the purpose of this reflex is nourishment, it provides other benefits as well.

For small children, sucking can be a comfort mechanism to help them cope with stressful situations and calm themselves. That’s why you often see your child sucking on a pacifier, toy, thumb, or fingers when feeling overwhelmed or tired. Non-nutritive sucking behavior, or NNSB, refers to these habits: sucking without nutritional benefit.

Such habits are extremely common in young children. Most children stop sucking their thumbs or pacifiers between the ages of two and four, and often even earlier. But if your child hasn’t, it’s a good idea to talk to Dr. Robin E. Lents about easing your child away from this familiar habit before the permanent teeth start to arrive.

Why? Because when sucking behavior lasts too long, it can have orthodontic consequences. Just as the gentle pressure of braces or aligners can help shift teeth and jaws into the proper alignment, the pressure from sucking thumb and pacifier can push growing teeth and jaws out of alignment.

• Studies have shown a clear link between NNSB and malocclusions, or bite problems. These include overjets (protruding upper teeth), open bites (where the upper and lower teeth don’t make contact when biting down), and crossbites (where one or more upper fit teeth inside lower teeth).
• As young bones are still growing, prolonged, vigorous sucking can affect the shape and size of a child’s palate and jaw.
• When the teeth are pushed out of alignment, difficulties with pronunciation, such as lisps, can develop.

Sucking habits can be difficult to give up. If your child is still self-comforting with the help of thumb or pacifier past age three, and certainly if you’ve noticed any changes in teeth or speech, there are several gentle, positive steps you can take to protect your child’s dental health.

• Talk to Dr. Robin E. Lents about strategies for weaning your child from pacifier and thumb, as well as possible comforting substitutes. Your healthcare team can offer suggestions for making this transition as easy as possible for your child—and for you!
• Discuss recommendations you’ve found in books or online which might be a good match for your child’s personality. Whatever you decide on, whether it’s a gradual phasing out, small rewards, a goals chart, or any other method, use positive reinforcement and plenty of encouragement.
• Set easy goals at the beginning, such as going thumb-free while playing a game, or enjoying a favorite video, or any stress-free activity, to give your child a feeling of accomplishment to build on.
• Be proactive with orthodontic health. One good idea is to schedule an orthodontic visit when your child is around the age of seven—or earlier if you notice problems with tooth alignment, speech, or bite.

Thumb sucking and pacifier use can be important, instinctive sources of comfort for very young children. And, of course, NNSB is not the only cause of childhood malocclusions. Many bite problems are genetically based and/or affected by the size and shape of your child’s teeth and jaws.

But eliminating the preventable oral health problems caused by prolonged non-nutritive sucking behaviors—that’s an opportunity we can’t afford to pass up. After all, wanting to ensure healthy, confident smiles for our children is instinctive parental behavior!

“But they are only baby teeth; won’t they just fall out?” Our team at Shoals Pediatric Dentistry, PC has had these questions asked many times from parents over the years. Primary teeth, or “baby teeth,” will indeed come out eventually, to be replaced by permanent teeth as the child grows and develops. These teeth serve a great purpose as the child continues to develop and require specific care.

Because baby teeth are temporary, some parents are unenthusiastic about fixing cavities in them. This may be due to the cost or having to force a child undergo the process—especially having to receive an injection. But if a cavity is diagnosed early enough, an injection can often be avoided. More important, failure to fill cavities in primary teeth when they are small and manageable can have lasting consequences in cost and health concerns. Serious illnesses in children have been diagnosed which began as a cavity.

Primary teeth act as a guide for permanent teeth. When decay reaches the nerve and blood supply of a tooth, this can cause an abscess. Severe pain and swelling may result. At that point, the only treatment options are either to remove the tooth or to perform a procedure similar to a baby root canal. When a primary tooth is lost prematurely—to decay or a painful abscess—the adjacent teeth will often shift and block the eruption of a permanent tooth. Braces or spacers become necessary to avoid crowding or impaction of the permanent tooth.

There is nothing more heartbreaking for Dr. Robin E. Lents than to have to treat a child experiencing pain and fear. To all the parents of my little patients our team strongly recommend filling a small cavity and not waiting until it becomes a larger problem such as those described above.

Prevention is the key to a healthy mouth for our smallest patients. Parents should allow the child to brush his or her teeth using a pea-sized amount of fluoride toothpaste and then take a turn to ensure the plaque gets removed from all surfaces: cheek side, tongue side, and chewing edges of all the teeth.

Your infant’s first teeth will begin to appear around six to 12 months of age. You might wonder how important these primary teeth really are. After all, baby teeth are destined to fall out within a few years and be replaced by a full set of permanent teeth. However, baby teeth have important functions, and proper care can set the stage for excellent oral and overall health.

Promote Better Nutrition

The appearance of your baby’s primary teeth around six to 12 months of age coincides with changes in your infant’s nutritional needs. Beginning at six months, exclusive breastfeeding is no longer nutritionally sufficient; this is the age at which you should introduce solid foods.

At six to eight months, when your baby can start to chew, strained or pureed fruits and vegetables are appropriate. As your little one’s teeth grow in and chewing abilities progress through 12 months of age, you can gradually add cereal, bread, cooked meats, and other adult foods to his or her nutritious diet.

Increase the Life Expectancy of Baby Teeth

Although baby teeth are inevitably going to fall out and be replaced by permanent ones, making baby teeth last serves an important role that can have benefits into the future. Baby teeth serve as placeholders for permanent teeth. If they decay and fall out too soon, permanent teeth are more likely to grow in crooked.

How to Take Care of Baby Teeth

Your baby’s primary teeth are already in his or her mouth at birth; they are just invisible because they have not broken through the gums. Since they are already present, your baby can get cavities if you do not practice proper oral hygiene from the beginning.

• Do not let your baby fall asleep with a bottle in his or her mouth.
• Brush your child’s baby teeth twice a day as soon as they come in.
• Floss your child’s teeth as soon as he or she has two teeth that touch.
• Visit Shoals Pediatric Dentistry, PC for your baby’s first checkup when the first tooth arrives.

Dr. Robin E. Lents and our team know how overwhelming it can be to pick the right dental products for your children. When you visit the dental aisle at the grocery store, you see too many options to choose from. We want to help you make an informed decision based on your son or daughter’s needs.

First, you should consider your child’s age and where he or she is in terms of development. Most kids are unable to floss properly until around 12 years of age because of the necessary dexterity. If your youngster is under 12 years old, make sure to assist with flossing every night.

Another option is to use flossers for children. This will make the exercise a bit easier for your little one, because flossers have different-sized handles to fit all ages of hands.

When you’re looking for a child’s toothbrush, the head should be a little bigger than the top portion of your son or daughter’s thumb. If a toothbrush is too big, it won’t be able to reach small areas in the mouth properly. Battery-powered toothbrushes are also recommended because they improve overall brushing quality for both adults and children.

If your child is too young to spit, he or she should use toothpaste without fluoride. Small children tend to swallow toothpaste, even when they don’t intend to. Try looking for a toothpaste that has xylitol listed as the first ingredient. This is a natural sweetener that is beneficial to teeth.

You should also try to identify a flavor that appeals to your child. Same as adults, children like to brush more if they enjoy the flavor that lingers in their mouth after brushing.

It’s smart to look at the ingredients in a toothpaste for the benefits your child needs. Some toothpastes contain sodium fluoride, which fights effectively against cavities. If your child has a sweet tooth, or has already had a cavity, we recommend buying a toothpaste with this ingredient.

Stannous fluoride is another popular ingredient that discourages cavities and includes anti-bacterial properties. You should also watch for the ingredient triclosan, which also suppresses bacteria. These ingredients are both recommend for children who have a high risk for cavities.

Anti-sensitivity toothpaste should also be easy to find in the dental aisle of the store. It contains potassium nitrate to help with sore gums and teeth.

If you’re still unsure which dental products your child should be using, contact our Florence office. Once we have general information about your child and his or her dental health, we can guide you in the right direction.

When it comes to picking the right toothbrush, toothpaste, floss, and mouthwash for your child, Shoals Pediatric Dentistry, PC is always here to help.