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“Non-nutritive sucking behavior”? That’s a mouthful—literally! This term describes behaviors such as thumb sucking and pacifier use, which are generally healthy, self-soothing activities for infants and toddlers. But, if followed too long, this comforting habit can have uncomfortable consequences for your child’s dental health.

When children are nursed or bottle-fed, placing a nipple in the mouth helps trigger the sucking reflex, enabling the flow of milk or formula. This is called nutritive sucking, because nourishment is the goal. The sucking reflex is so essential that it develops even before birth. And while the purpose of this reflex is nourishment, it provides other benefits as well.

For small children, sucking can be a comfort mechanism to help them cope with stressful situations and calm themselves. That’s why you often see your child sucking on a pacifier, toy, thumb, or fingers when feeling overwhelmed or tired. Non-nutritive sucking behavior, or NNSB, refers to these habits: sucking without nutritional benefit.

Such habits are extremely common in young children. Most children stop sucking their thumbs or pacifiers between the ages of two and four, and often even earlier. But if your child hasn’t, it’s a good idea to talk to Dr. Goodall about easing your child away from this familiar habit before the permanent teeth start to arrive.

Why? Because when sucking behavior lasts too long, it can have orthodontic consequences. Just as the gentle pressure of braces or aligners can help shift teeth and jaws into the proper alignment, the pressure from sucking thumb and pacifier can push growing teeth and jaws out of alignment.

• Studies have shown a clear link between NNSB and malocclusions, or bite problems. These include overjets (protruding upper teeth), open bites (where the upper and lower teeth don’t make contact when biting down), and crossbites (where one or more upper fit teeth inside lower teeth).
• As young bones are still growing, prolonged, vigorous sucking can affect the shape and size of a child’s palate and jaw.
• When the teeth are pushed out of alignment, difficulties with pronunciation, such as lisps, can develop.

Sucking habits can be difficult to give up. If your child is still self-comforting with the help of thumb or pacifier past age three, and certainly if you’ve noticed any changes in teeth or speech, there are several gentle, positive steps you can take to protect your child’s dental health.

• Talk to Dr. Goodall about strategies for weaning your child from pacifier and thumb, as well as possible comforting substitutes. Your healthcare team can offer suggestions for making this transition as easy as possible for your child—and for you!
• Discuss recommendations you’ve found in books or online which might be a good match for your child’s personality. Whatever you decide on, whether it’s a gradual phasing out, small rewards, a goals chart, or any other method, use positive reinforcement and plenty of encouragement.
• Set easy goals at the beginning, such as going thumb-free while playing a game, or enjoying a favorite video, or any stress-free activity, to give your child a feeling of accomplishment to build on.
• Be proactive with orthodontic health. One good idea is to schedule an orthodontic visit when your child is around the age of seven—or earlier if you notice problems with tooth alignment, speech, or bite.

Thumb sucking and pacifier use can be important, instinctive sources of comfort for very young children. And, of course, NNSB is not the only cause of childhood malocclusions. Many bite problems are genetically based and/or affected by the size and shape of your child’s teeth and jaws.

But eliminating the preventable oral health problems caused by prolonged non-nutritive sucking behaviors—that’s an opportunity we can’t afford to pass up. After all, wanting to ensure healthy, confident smiles for our children is instinctive parental behavior!

As a parent, you want the best for your children, and that includes doing their best in school. You can support them by taking an interest in their activities, being enthusiastic about attendance, and helping them with homework. There may also be one more way you can help your children succeed at school. Surprisingly, research suggests that children with better oral health are likely to do better in school.

What the Research Says

One study in North Carolina looked at risk factors for poor school performance among school-aged children. As expected, the study found poor school performance linked to low socioeconomic status, low levels of parental education, and poor overall health. However, it also found a strong link between poor oral health and poor school performance, with children classified as having poor oral health 40 percent more likely struggle in school.

These findings are generalizable to the rest of the country. For example, attendance is an important factor in academic achievement, but dental conditions are responsible for a loss 51 million school hours among schoolchildren each year. Dental pain and infection are linked to poorer performance.

School-Based Programs to Promote Oral Health

In light of the apparent benefits of good oral health for school performance, some schools are taking steps to promote better oral care and health. In Maine, for instance, schools in need can apply for grants through School Oral Health Program (SOHP). The SOHP consists of four components:

1. Oral health education for all children to support healthy behaviors
2. A weekly fluoride mouth rinse to strengthen teeth
3. Dental screenings to identify children who may need dental care
4. Dental sealants, or plastic coatings, on back teeth to guard against decay

The State of Maine also supports an “Annual Sugar Out Day” to raise awareness of the effects of sugar on dental health and to help students choose low-sugar alternatives.

Oral Health Habits to Adopt

You can help your child improve oral health and do better in school by encouraging good oral hygiene. This includes brushing at least twice a day with a fluoride-containing toothpaste, and reminding your child to drink water after eating. Also, regular trips to our Frisco office can help prevent serious tooth problems.

Quick trivia question: define “mamelon.” Some kind of warm blooded animal? No, not a member of the mammal clan, but good guess. A fruit of the gourd family? Nope! There are watermelons, and honeydew melons, and even canary melons, but no ma-melons. Those little rounded bumps you notice on the edge of your child’s permanent incisors when they first emerge? We have a winning answer!

• Why Do We Have Mamelons?

We have eight incisors, or biting teeth, in the front of our mouths—four on top and four on bottom. Mamelons are actually a clue as to how these incisors were formed. Even before a baby is born, the permanent teeth begin to take shape. Three different groups of cells develop to form the incisal edge of these front teeth. As they fuse together, they create three lobes of enamel on the erupting edge of the tooth. It’s these lobes, or bumps, that give the teeth a serrated appearance.

Whether your child’s mamelons are quite prominent or barely noticeable, if you are worried about them, relax! They are almost always a temporary part of your child’s smile, and disappear over time with chewing and normal wear. But what if the mamelons overstay their welcome?

• Cosmetic Concerns

Because mamelons are composed of enamel, without the underlying dentin layer found in the body of the tooth, they can appear translucent or a bit different in color. They might wear away unevenly, leaving the tooth edges looking misaligned. Or, they might not wear away at all if your child’s tooth eruption is delayed. Talk to Dr. Goodall if mamelons are a cosmetic concern for you or your child. You might discover that they are wearing away naturally, or we can discuss ways to polish or smooth them down if needed. This is a painless procedure that doesn’t require an anesthetic. Generally, however, this is a matter where time will resolve the issue for you.

• Orthodontic Implications

Occasionally, mamelons might become a topic of discussion for orthodontic reasons. Sometimes, mamelons do not wear away over time because of a malocclusion (misaligned bite). Your orthodontist will let you know your child has a bite problem and can explain treatment options. Your orthodontist might also suggest smoothing away the mamelons to ensure that the edges of the incisors align correctly and symmetrically while the teeth are in the process of straightening. Again, this is not always considered a necessity, so weigh your options with your dental care provider.

So, if you notice that your child’s beautiful new teeth are bumpy or serrated as they erupt, don’t be concerned! If you have any questions about mamelons, talk to Dr. Goodall at your next visit to our Frisco office. This is a natural occurrence and most likely just a temporary “bump” in the road. Soon enough, mamelons will be a memory—and the answer to a pretty difficult trivia question.

September is National Childhood Injury Prevention Month, and Dr. Goodall and our team at More Than Smiles are excited to share some tips to keep your child safe. Childhood is a time when dental injuries are common. Even a simple fall on the playground at recess can lead to a lost or broken tooth. What can you do as a parent to protect your child’s teeth in addition to his or her head and bones? These tips will help you prevent mouth and dental injuries to your kids.

First, use common sense when your children play sports. An estimated 13 to 39 percent of oral-facial injuries occur when children are playing sports. Make sure your child wears a face guard, mouthguard, and helmet as appropriate. Contact sports, such as football, require this gear, so insist that it gets worn.

Next, teach your children not to walk or run with things in their mouths. This is particularly difficult for toddlers and preschoolers, who love to explore the world orally. Insist that items are removed from the mouth whenever the child is in motion, and try to redirect the child to softer items for oral stimulation.

For small children, be careful when you put a spoon or fork in the mouth. While this won’t damage teeth, it can damage the delicate skin between the lips and gums or under the tongue. Allow your child to direct his or her own feeding; never shove a spoon in your child’s mouth if he or she is not interested, to avoid this type of injury.

Finally, make sure your children are seen regularly by Dr. Goodall. Regular dental checkups will keep the teeth clean, strong, and healthy, and limit the risk of injuries.

If your child is injured in spite of your best efforts, contact our Frisco office right away. Quick action may be able to save a missing tooth, and a quick response on your part will limit the long-term effects of the injury.