oral habits in children

Our body is a complex machine that keeps changing gradually as we grow old. Every child has unique characteristics and behavior. Most of the times, children who feel overwhelmed or anxious may develop certain oral habits as a coping mechanism. They feel secure and comfortable by performing such activities.

However, prolonged use of such oral habits can have debilitating effects on the health of the teeth and gums. Additionally, it can lead to the initiation of dental problems. Some of the oral habits that are commonly adapted by children include tongue thrusting, lip biting, thumb sucking, and prolonged use of the pacifier.

Most children grow out of this habit as they become older. It is essential to monitor these activities and help the child to withdraw from performing these oral habits. Additionally, the parents should take the initiative to teach good oral habits and educate the child about oral hygiene.

Such practices help in the structural development of the child and help him to maintain this habit throughout life. (1) Today’s article will highlight some of the everyday oral habits that children develop and its effects on the oral tissues. Moreover, we will also look at some tips and remedies to prevent the oral habits.

Why do children develop bad oral habits?

Children are always curious to know about their surroundings. Moreover, they like to try new things and explore the world around them. Often such events bring in a feeling of anxiety and nervousness. As a result, they develop repetitive behavior as a symptom of deep-rooted psychological practice. Oral health is one of the prime health concerns that can impact the behavioral and structural development of the child. (2)

Bad oral habits can have harmful effects on the natural development of the face and oral tissues. Most of the times, children grow out of these habits as they grow older. However, prolongation of such oral habits can be alarming. As parents, it is essential to know about the bad oral habits of children and encourage the child to stop the practice.

What are the different oral habits a child can develop?

Prolonged bottle-feeding

Prolonged bottle-feeding can have severe consequences on the oral health of the child. Most children fall asleep with milk of bottle in their mouth. This allows prolonged contact of the sugary milk with the teeth which can cause tooth decay and cavity formation. The activity of bottle feeding is similar to a thumb-sucking habit. It can cause a series of malocclusions which mainly include –

  • Anterior open bite
  • Spacing between the teeth
  • Forwardly placed upper front teeth
  • Increased overjet and overbite
  • Hyperactive lower lip
  • Development of mouth breathing

The ideal time that should be used for bottle feeding ranges between 12-18 months after birth. It is essential to start reducing bottle feeding by this time. Encourage the child to drink from sippy cup or glass. Some of the practical techniques to wean the habit of bottle feeding are listed below –

  • Use a sippy cup or even a cup with a straw-filled with water. Demonstrate your child, the technique to drink from a sippy cup and encourage him to follow you. Often children find their fun in new activities. Praise the child for every time he sips the water from the cup.
  • A booster to the technique mentioned above is to show the child how other children drink from a sippy cup. Children love to mimic people and learn from them. You can use this to your advantage and encourage your child to perform the same activity. (3)
  • If your child is too attached to bottle-feeding while sleeping, replace the bottle with a comfort blanket or a toy. Having an alternative always provides a sense of security to the child. Distract the child with toys before sleep. This way, he will forget about the bottle.

All of the efforts that you, as parents, put in to train your kids requires dedication and motivation. Training a child can be extremely tough; however, to get fruitful results, you will have to keep going and never give up on your child.

Extensive use of pacifiers

Some of the harmful effects that long term use of pacifiers can have on your child’s oral health include –

  • Change in the shape of the mouth
  • Discrepancies in jaw alignment
  • Impaired development of the teeth
  • Malocclusions
  • Speech impairment
  • Improper tongue position

Ideally, pacifiers are an excellent way to soothe and comfort a crying baby until the age of two years. Pacifiers have a positive influence on the overall health of the baby when used right from birth to six months of age. The American Academy of Family Physicians (AAFP) determined that use of pacifiers contributes in reducing the risk of sudden infant death syndrome.

However, this habit should not be continued for a long time. Prolonged use of the pacifier can interfere with the establishment of breastfeeding. Additionally, it can also increase the risk of ear infection in older babies. Dental effects become evident after two years of age. (4) Behavior modification techniques are the only way to wean the habit of pacifier use. Always take a positive approach –

  • Encourage your child to stop the use of a pacifier and praise him every time he tries it
  • Some times children become anxious and stressed on not using the pacifier. Substitute this with lots of warm cuddles and show love and affection to the child. This provides a sense of security and comfort.
  • Never shout or scold your child for using the pacifier. Instead, show love and encourage the child not to repeat this activity next time.

Tongue thrusting

Tongue thrusting is a common oral habit in children which involves a forcible protrusion of the tongue through the upper front teeth. Most of the times, children perform this activity while swallowing or speaking. Tongue thrusting can have some significant consequences on the development of teeth in children. Some of the signs include –

  • Interference in the proper growth of the jaw
  • Anterior open bite
  • Forwardly placed upper front teeth
  • Inflammation of the gums (4)
  • Difficulty in speaking
  • The child may develop a habit of lisping
  • Hyperactive lower lip
  • Speech impairment

Tongue thrusting is also regarded as a significant consequence of thumb-sucking habit. Typically, children reduce this activity and grow out of it by the age of two to four years. However, prolonged tongue thrusting should be taken care of by dental professionals.

Parents can follow positive reminder and encouragement technique which allows the child to control the habit consciously. Praise the child every time he tries not to thrust his tongue. In severe cases, professional dental appliances may be used to break the habit. These include –

  • Bluegrass appliance – a fixed dental device that consists of a Teflon roller to distract the child from tongue thrusting.
  • Palatal crib – this appliance is similar to the bluegrass device except this has a metal crib which restricts the tongue movement towards the upper front teeth.
  • Tongue exercises are a great way to modify tongue movements in the mouth.

Thumb-sucking and nail-biting

Just like tongue thrusting, thumb sucking is another widespread habit that children develop. As the name suggests, thumb sucking is performed by exerting pressure with the thumb against the upper front teeth.

Nail-biting is a repetitive behavioral activity which can open up a potential portal for the entry of germs and bacteria in the mouth. The oral impact of thumb sucking and nail biting is similar to the signs of tongue thrusting. However, children with thumb sucking and nail-biting may develop additional symptoms such as –

  • Gingival injury
  • Broken skin on the thumb or finger
  • Frequent episodes of stomach infections
  • Paronychia

Typically, thumb sucking is considered as usual until the age of three years. The prolonged habit of thumb sucking can indicate a sign of anxiousness, stress, and lack of confidence in the child. It is essential to take utmost care while treating this habit. (5)

Parents should carefully monitor the frequency of thumb sucking and encourage the child to stop the activity consciously. Some home treatment modalities for thumb sucking are listed below –

  • Use of thumb bandage which may bring an uncomfortable experience for the child and allow him to wean away from the habit.
  • Sometimes, chemical therapy using asafetida or pepper on the thumb can also give fruitful results. Habit reversal therapy for nail-biting includes use of bitter-tasting nail polish. (6)
  • It is essential to understand that children may feel insecure and uncomfortable during the treatment. Parents should communicate and reassure the child about the benefits of growing out of these habits.

Lip biting

Lip biting is the most common repetitive behavioral habit seen in children. It mainly affects the alignment of the teeth and disrupts the development of the jaw. Additionally, the child may encounter frequent episodes of lip sores and inflammation. (7)

Usually, cognitive behavioral therapy is recommended to treat lip biting. In this therapy, the child is educated about the oral habit and its harmful effects. Moreover, the medical professional helps to identify the type of psychological attachment for development of lip biting. This process may require a lot of time depending on the level of understanding between the child and the professional.

Constant love, care, and support often help to speed up the process. Sometimes, relaxation therapies and medications may be used as adjuncts to modify the behavior of the child and encourage them to stop the habit of lip biting. Other oral habits include –

  • Poor eating habits – children are the most difficult to control when it comes to eating sugary snacks. Poor eating habits have a significantly debilitating effect on the health of the teeth and gums of a child. Since children do not brush their teeth after every meal, the food residues stick to the tooth surface until they hare cleaned.

Plaque and bacteria develop in the mouth as a result of poor oral hygiene. The bacteria ferment the sugars from food debris and attack the tooth surface. Such events initiate a vicious cycle of tooth decay and gum disease.

It is essential to develop a habit of feeding healthy food like fresh vegetables and fruits right from childhood. Occasional sugar treats are an excellent method of behavior modification.

  • Improper tooth brushing – teaching brushing technique to children can be a tedious task. However, it is essential to pay attention to their brushing habits. Most of the children do not enjoy tooth brushing. As a result, they end up brushing too hard or do not clean each tooth surface.

Always explain the child the importance of every good oral habit. Educate them on the efficiency of gentle tooth brushing. Also, tell them the harmful effects of improper tooth brushing.

  • Chewing hard dirty objects – many children get treated with candy bars or hard candy sticks for good behavior. Although rewarding the child with occasional treats is good, it is equally important to choose the treat wisely.

Biting on hard candy can often lead to tooth fracture and unnecessary pain and discomfort. In mild cases, it may chip the tooth surface which may affect the smile of the child. Therefore, it is best to avoid hard food items, instead treat them with soft food substances. For example a nutritious homemade cookie.

Take away message

Every parent care for their child’s overall health and well-being. Oral health has a direct link in maintaining proper body functions, growth, and development of the child. Often children fall into the trap of adapting oral habits like thumb sucking, tongue thrusting, and lip biting. Additionally, many children get attached to the use of pacifiers so much that it becomes difficult to wean away from this habit.

Such activities may be useful for a while. However, prolonged oral actions can impact the health of the teeth and gums. Furthermore, it can cause malocclusion that can directly affect the growth and development of the permanent teeth. It is essential to monitor these oral habits and seek appropriate dental treatment. Moreover, parents should actively participate in teaching proper oral health practices to take care of their teeth.