ORAL HABITS & BEHAVIOR MODIFICATION

THUMB SUCKING, TONGUE THRUSTING, and MOUTH BREATHING

Oral habits can move teeth into unhealthy positions such as a large over-jet (Buck Teeth), a cross-bite or an open-bite. Cross-bites will not self-correct. An open-bite and a large over-jet may self-correct when the habit is discontinued at the right time.

Controlling the habit at the right age will allow the permanent teeth to come into healthier positions and prevent more difficult problems.  Most kids discontinue oral habits on their own soon enough.  If your child has an oral habit, keep your approach positive. When you find your child abstaining from the oral habit, offer praise. Avoid scolding about oral habits. Remind your child that abstaining helps their teeth come in pretty, straight and means they are growing up.

A behavioral approach at the right age using a calendar, stickers, a reward, and positive encouragement is effective for helping children having trouble abstaining to learn new habits.

Thumb sucking is normal until the age of 4 or 5 years. Most children stop on their own.  I suggest that no attempt be made to stop this habit until then. At this age a behavioral approach is usually successful.  Some children may find an appliance helpful.

Tongue thrusting can be helped with a combination of a behavioral approach, tongue exercises and a tongue crib appliance. The appliance is cemented in and is helpful while the incisors reposition, usually 1 or 2 years.

Mouth breathing may be a habit or necessary because of nasal obstruction. Nasal obstruction should be evaluated by a physician.

HABIT BEHAVIOR MODIFICATION

(He=He/She) Helping your child learn to overcome his digit habit is different from most things you will teach him. Reminding your child to stop his habit will just make it worse. It is his problem, not yours, and he will need to want to stop before you can help him.  He is in the game; you need to be present but on the sideline and be the cheerleader.

After he has decided he would like to learn to stop, select a prize or goal. This does not have to be expensive, just special enough to capture his imagination more than his habit, such as a trip to a museum or camping in the backyard or a special item. Then place a calendar where it will be visible for everybody important.  Each 24 hours that your child accomplishes his goal, he receives a mark or sticker on the calendar and LOTS of praise.

If he does not succeed, his behavior is ignored. Instruct everyone who is important to your child to refrain from reminding your child to stop his habit, remember, it is his problem.  When he comes to you for his mark, and he has not been successful, share his disappointment and then encourage him to keep trying.  You will need to check on your child at bedtime and some during the night.

If there is a time that your child is having a particularly hard time succeeding, ask his permission to try some physical reminder such as bad tasting fingernail polish or wearing a sock over the hand or your moving his hand away from his mouth.  Be sure your have his permission. If he reports that he cannot go to sleep without his habit, tell him that if he wants to use his habit, that will be fine, but remind him that he won’t get his sticker, and it will be longer before he gets his prize and he won’t be helping his teeth to come in pretty and straight. Encourage him and tell him that if he will try a little longer, he can go to sleep without his habit and then he will get his sticker and his prize will come sooner with straighter teeth.

When your child succeeds for 24 hours per day for 14 days in a row, he may have his prize.  If your child has not succeeded in two months, just stop this program and we can re-evaluate his habit at the next preventive visit.

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