Almost every day, pediatric dentists get asked how to break a pacifier or thumb sucking habit.  It’s a classic problem that has frustrated parents and kids since time out of mind, but like most challenges of parenting, almost every family eventually navigates their way through with minimal emotional and physical scarring.

Usually, we talk about the effects of “non-nutritive sucking (NNS)” from a dental perspective and the influence these habits can have on your child’s mouth. Teeth end up in their final positions when there is a balance of forces between the lips pushing teeth in and the tongue pushing teeth out.  When a foreign object enters the picture (or, more specifically, a child’s mouth), this balance of forces is changed.  The top front teeth have a tendency to lean forward, the lower front have a tendency to lean backwards, and the bones of the face remodel to make room for the object.  If the sucking is hard enough, the top jaw can remodel in the back as well, raising the roof of the mouth and drawing the back teeth toward each other, and this can have negative effects on a child’s bite.

Some of these problems may self-correct when the habit stops and the teeth are again subject to the usual pressures of lip and tongue.  The earlier the habit is broken the better, because once permanent teeth start coming in the likelihood of self correction declines.  If the teeth don’t move themselves back into place, there are plenty of friendly orthodontists who can help nudge them back into a more favorable arrangement.

There are many tricks to break NNS habits, but we don’t recommend shaming or punishment.  If there’s a corresponding blanket or stuffed animal they like to hold or while they suck their thumb or pacifier, taking that away may help disrupt their habit pattern and they may quit altogether. Often children will grow out of NNS habits around 3 years old. Find something that resonates with your philosophy and your child’s personality. If your little one is not ready to kick the habit at three, or if you are trying to stop before then, read on.

When it comes to thumbs or fingers, our first bit of advice is to start by talking to them. Make them mindful of when they are sucking their thumb. Ask them how they are feeling when they suck their thumb.  Their dentist can show them how their smile has changed or might change. We will often recommend setting an appropriate goal date to stop: “When you turn four, you’ll be a big kid and you’ll be all done with sucking your thumb/pacifier.” Sticker/reward charts work for some families.  A sock or loosely-wrapped Ace bandage around the preferred hand at bedtime can change the environment enough to discourage the habit.  Icky tasting nail polish can quickly let them know that their thumb is in their mouth.  If all else fails, dentists can place a special type of retainer that can remind kids not to suck their thumbs.

Pacifiers can help keep parents sane in those first twelve months, but afterwards, the cons can outweigh the pros.  With pacifiers, you have the benefit of being able to remove the pacifier (removing thumbs is a bit trickier, requires special equipment and is frowned upon by both clergy and law enforcement). Again, we recommend starting by talking about it. Then set a goal date to stop. Sometimes parents will tell kids that getting rid of the pacifier is part of growing up just like getting rid of a bottle, learning to use the potty, etc. Many parents swear by the cold turkey method. Another popular strategy is to trim the pacifier nipple nightly until there is not enough remaining for your child to suck on. Often once something with the pacifier feels askew kids will loose interest in it. Sometimes parents will put their child’s pacifier into a build-a-bear, and they can snuggle with it instead of the pacifier. 

Like the rest of parenting, breaking a NNS habit can be challenging and rewarding.  Make sure to keep your dentist and pediatrician informed of what’s working and what’s not, and hopefully the team can come up with a strategy to keep everyone content.