Non-nutritive Sucking
Nonnutritive sucking satisfies a psychological need and diminishes with age; most children stop by two to four years of age. Persistent non-nutritive sucking increases the risk of anterior open bite, palatal narrowing, and delayed speech development.
Anticipatory Guidance
- Intervene to stop habit by 36 months, especially if changes to bite are noted.
- Offer positive reinforcement, such as a star chart or stickers.
- Restrict to limited situations (only in bed, naps, stressful times).
- Cover hands at night with mittens.
- Provide stuffed animal or other comfort object. In general, pacifier use is preferable to digit sucking as it is less likely to cause a problem and the habit is easier to break (the pacifier can be removed).
- Recommend never to dip pacifier in honey or other sweetened foods.
References
American Academy of Pediatric Dentistry. Policy on pacifiers. The Reference Manual of Pediatric Dentistry. Chicago, IL: American Academy of Pediatric Dentistry; 2025:86-9.
Brecher EA, Lewis CW. Infant Oral Health. Pediatr Clin North Am. 2018; 65(5): 909-921.