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Non-Nutritive Sucking
The instinct to suck is a normal physiological behavior performed by almost all
infants. When an infant/toddler performs this behavior and no nutrition is obtained
it is referred to as non-nutritive sucking (NNS). Generally, non-nutritive sucking
decreases with age and a majority of toddlers discontinue between 2- 4 years of
age.
Infants and toddlers will commonly utilize a pacifier or one or more digits for
NNS. Digit sucking has been found to cause more severe dental effects than pacifiers
because of the strong pressure on the teeth and dental arches.
NNS can affect both the primary and permanent dentitions. Dental effects are minor
in children under the age of three years. Dental problems that are commonly associated
with prolonged NNS include:
Open bite: The upper front teeth do not overlap
(vertically) the lower front teeth. Increased overjet: the upper front teeth protrude
outward and sometimes beyond the upper lip
Decreased palatal width: The sagittal growth of
the upper arch is inhibited or slowed
Posterior cross-bite: The primary and permanent
molars in the upper arch occlude inside the lower molars.
Decreased maxillary inter-canine width: The space
between the maxillary right and left canine teeth is decreased often leading to
dental crowding.
Breaking the habit
Parents and children should know the dental effects of long-term sucking. Positive
reinforcement is important for children who actively try to restrain from thumb,
digit or pacifier sucking. A dentist should be consulted if the habit continues
after eruption of the permanent dentition.
Bruxism
Parents will often report that their child is grinding their teeth and making an
irritating noise while doing so. Bruxism is a self-limiting behavior that decreases
as the child becomes older and the permanent dentition erupts. Children often experience
attrition of the primary dentition and do not experience pain or discomfort. Children
with neurological disorders are likely to have a bruxing habit that continues throughout
their childhood and adulthood. If a child or young adult experiences attrition of
the permanent dentition resulting from bruxism the dentist should be consulted regarding
the possible fabrication of an occlusal guard.