Oral habits are absolutely normal!!!!! Surprised???
Yes, you read it right, oral habits are considered as a part of normal development of a child. Oral habits in children are completely normal forms of self-soothing and exploration of the environment. Oral habits until 3 years of age are considered normal. Oral habits that are prevalent well beyond the normal age frequently result in facial deformity and malocclusions.
We all have habits: things we do everyday often without consciously thinking. Some of them are good but not all of them. That’s why it’s important to prevent your child from developing harmful habits. Pacifier sucking, followed by thumb/finger sucking are the most common harmful habits in childhood. Childhood is the mirror which reflects the propensities of adulthood.
Trident of factors, like duration of the habit per day, degree and intensity of habit are responsible for any habit to produce detrimental and lasting effects. There are various reasons for developing thumb sucking habit, significant relationship exists between duration and intensity of thumb sucking and the amount of time spent in feeding sessions.
Thumb and finger sucking are believed to cause a number of changes in the dental arch and the supporting structures. Some of the effects of thumb sucking are:
- Forward position of the upper and lower front teeth.
- Increased horizontal gap between the upper and lower front teeth leading to increased overjet of teeth.
- Increased vertical gap between the upper and lower front teeth leading to open bite.
- Development of tongue thrusting habit, secondary to thumb sucking due to open bite.
- Narrow dental arches
- Smaller upper lip
- Soft tissue lesion on the thumb/Deformation of the thumb
- Short finger nail
- Increased risk of trauma to upper front teeth, to psychological health, speech defect (Especially lisping), middle ear infection and enlarged tonsils.
If the child chooses this habit in the first year of his or her life, the parents should move away his or her thumb smoothly and attract the child’s attention to other things such as toys. After the second year of age, thumb sucking will decrease and will be appeared just in child’s bed or when he/she is tired. Some of the children who do not stop this habit, will give it up when their permanent teeth erupt, but there is a tendency for continuing the thumb sucking habit even until adult life.
The 5 steps are…..
- Direct interview with child if he/she is mature enough to understand
- Encouragement: This can give the child more pride and self-confidence
- Reward system: There is more involvement of the child
- Reminder therapy which includes schemical and mechanical approach
- Orthodontic appliance
Initially awareness of the habit: the extent, the consequences and the benefit of cessation of the habit has to be explained to the child. Dental changes due to thumb and finger sucking do not need any treatment if the habit stopped before the 5 years of age and as soon as giving up the habit, dental changes will be corrected spontaneously. The success of any habit interception procedure largely depends upon the child’s co-operation and willingness to be helped to discontinue his/her thumb sucking habit. Thus the parents and the dentist should seek to motivate the child, and not to frighten and scold the child. Use of chemical approach is an age old method and it has shown to be less effective. Placing bitter tasting or foul smelling preparation on the thumb that is sucked can make the habit distasteful.
The use of mechanical aids are basically reminding appliances that assist the child who is willing to quit the habit but is not able to do so as the habit has entered the subconscious level. These appliances usually consist of a frame work placed palatal to the upper front teeth. The frame is placed exactly where the child places the thumb. Its raised rigid design keeps the thumb from laying snugly against the palate. The appliance is either removable or fixed. Other aids that can be used to intercept the habit include bandaging the thumb, bandaging of the elbow, wearing long sleeve sleeping gown. Once the habit affects the permanent teeth the damage is irreversible, which requires orthodontic intervention.
In today’s highly stressed environment, school/college going kids are subjected to various kinds of pressure/stress in different forms. Oral habit can be a form of distressing. Parents should play the role of friend, emotional support and a guide to the child rather than shamming or nagging them. If the habit is causing a dental problem, it is the privilege and responsibility of the dentist to work with the child and parents toward a resolution of the problem.