Most Oral Habits are present in children of 3–6 years of age. The finding of an oral habit is very important and is normally noticed by the parents or the dentist. So the annual check-ups at the dentist are very important to keep a check on any habits. The habit, if not eliminated before 4-5 yrs, is of concern to the paedodontist as it will affect the permanent or adult teeth. So efforts to eliminate and discourage the child’s habit may be as simple as just talking to the child or having the dentist perform some treatment.
Most Common Oral Habits:
- Thumb and finger sucking
- Tongue thrusting
- Mouth breathing
- Clenching or Teeth Grinding
- Nail biting
- Lip sucking
Thumb and Finger Sucking
Thumb-sucking and finger habits are amongst the most common of all the habits. Sucking is a natural reflex and babies will use thumb, fingers or pacifiers and other objects to suck on. It makes them feel a sense of security and also relaxes them. In fact, it is shown that the embryo in the mother’s womb sucks on their thumbs. So parents should not worry if the behavior is occasional or if it is during any stressful time. This could be the child’s way of getting comfortable with the environment and feeling secure. In most cases, a child will suck his/her thumb or finger until around the age of 4 years. Around 20% of the children to continue to suck their digits beyond 5 years of age. These older kids suck their thumb or fingers while watching TV, in the car, in school or anytime during the day. This habit in older children can cause dental problems.
Thumb-sucking for a long period can cause a lot of problems, so it is important to detect it early and treat it so that there are no physical and psychological effects.
Signs of Thumb and Finger Sucking:
❖ The appearance of calluses on the digits
❖ Speech problems such as lisping when talking
❖ Flared upper front-teeth
❖ Cross-bite
❖ Altered facial growth
❖ Nose might be tipped up
❖ Crooked teeth
Some Tips to Stop Sucking Habits
❖ Try to praise the child a lot when he/she is not sucking instead of getting angry when he/she is. This is a way of positive reinforcement.
❖ Very often thumb-sucking is used as a security mechanism. The child could be insecure so parents must focus on correcting the anxiety by giving the child lots of love and hugs, a toy bear or dog, or maybe a favorite blanket to replace the habit.
❖ Present the child with some reward on the day he/she does not suck his/her thumb or finger. You can mark a star on his/her calendar or give him/her a special treat.
❖ A reminder can be used if none of the previous tips help, by either putting a bandage on the thumb or using a sock or glove on the hand at night.
A thumb-sucking appliance might be used by the dentist as a last resort.
Tongue Thrusting
Child’s tongue has a very important effect on the palate and the teeth. Abnormal tongue movement like a child thrusting his/her tongue can lead to orthodontic problems. In most cases it might not be the only cause of a problem like a crooked tooth, but it can keep it from becoming normal. Speech of the child can also be affected by abnormal tongue movement.
Tips to Help
❖ An orthodontist can try and correct abnormal tongue thrusting habits by doing some tongue exercises. Friendly reminders by parents also help.
❖ Dentists recommended breastfeeding as this problem is mainly seen in bottle-fed children.
❖ A myofunctional therapist can give an appliance to correct the habit
Mouth Breathing
Breathing through the mouth most of the time instead of through the nose is called mouth breathing.
In such a case, there is some form of nasal obstruction and hence the child ends up only using his/her mouth for breathing. Most times this habit is only discovered during a routine dental check-up, because of the gum condition.
This is normally caused by:
❖ Child’s inability to breath through the nose due to obstruction
❖ Relaxed posture or Lip incompetence.
It is very common to see kids between 3 and 6 years of age with a slightly parted mouth. It only appears that they are breathing through the mouth, but may actually be nasal breathers. So, in this case, parents have no cause to worry.
On the other hand, if this habit shows symptoms such as red gums, puffy gums, or bleeding gums, then the parents should consult with an ENT specialist. Dental Surgeons can help by fabricating an appliance.
Clenching or Teeth Grinding
Bruxism is “grinding of teeth” and is very common in children. Most kids grind only during their sleep at night. It is sometimes so loud that the family is unable to sleep. Many kids clench their teeth while concentrating or doing an activity.
Some Reasons could be:
❖ Bruxism or grinding could be due to some psychological reasons. Stress due to some family situations, or new environment, or school problems might be causing the child to grind.
❖ According to a theory, it could be because of some inner ear pressure at night. To relieve the pressure the child may grind at night.
Signs of Grinding:
❖ The teeth grind together without any food between them and wear out the outer covering enamel. The teeth, therefore, become flat and shorter.
❖ The jaw or face may be sore in the morning due to the strong grinding at night.
❖ The noise of grinding and clicking is very annoying.
Generally, bruxism in kids is common up to 6 years of age. Since the primary teeth start dropping at around 6 years, and new adult teeth start erupting in their place, the mouth has mixed dentition. This causes the teeth to be in irregular bite positions and most children stop grinding their teeth at this stage. However, some children continue to grind and need treatment.
Tips to Stop Grinding
❖ The dentist must make the child aware of the grinding. If the child is made conscious then he/she might stop grinding.
❖ Excessive grinding needs a special bite splint called night guard. This is made of special plastics that can be put between the teeth and stops the grinding.
❖ Parents can reduce any stress the child might have. Try to make bedtime very peaceful and quiet. A hot bath and story-telling are always good!
Nail Biting
This habit is generally seen in slightly older children. The incidence increases until adolescence due to increased stressful situations. Kids of this age go through a lot of physical and emotional changes and sometimes pick up this habit.
Some Signs are:
❖ Chipped or notched teeth, mostly front teeth
❖ Nails and nail beds are damaged & badly chewed upon
There is no treatment that dentists need to do this: if you generally make the child conscious of his/her habit, it reduces gradually.
Lip Sucking Habits
These habits involve manipulation of the lips.
All kinds of habits exist, like:
❖ Lip licking
❖ Lip pulling
❖ Lip biting
❖ Lip sucking.
Habits like lip licking and pulling mainly lead to red inflamed and chapped lips. Most commonly, kids have a habit of sucking the lower lips. This can lead to dental problems, like:
❖ Upper teeth jutting ahead called an over jet.
❖ The lower teeth getting pushed inside.
Your dentist will recommend you to an orthodontist if the child has a severe problem which needs treatment. Most other lip habits need no treatment and a lip balm can be used to heal the lips.
HIGHLIGHTS
• Thumb-sucking will have no bad effects on the child’s teeth if stopped by 3–4 years of age. Only worry if it continues longer.
• A pacifier must not be allowed after permanent teeth erupt.
• Habits like tongue thrusting and lip biting need to be addressed if they are causing a problem.
• Mouth breathing is cause for concern if it has symptoms.
• Grinding of teeth requires some treatment if it continues past 6–7 years of age.
• Missing or extra teeth can be fixed by the dentist.
• Cleft lip and palate are not so common and require special care.