Learn how prolonged thumb sucking, prolonged binky use and bottle use can impact healthy facial growth and development, when, why and how to stop.

Thumb-sucking, finger sucking and pacifier use are emotional topics for many patients and their families. Oral habits are often developed as coping or self-soothing mechanisms and are correlated with increased dopamine release in the brain. 

While a sucking habit can bring soothing to an upset child, it can also have a significant impact on the healthy growth and  development of the face, mouth, airway and teeth. 

These sucking  behaviors can be grouped under a list of habits known as non–nutritive sucking habits. Meaning they do not get nutrition from this sucking action. Within this group, we can also find the use of pacifiers, blankets, or sucking on other fingers as a comforting behavior.[1] Thumb, finger and pacifier-sucking have been considered an activity that serves as an adaptive function by providing stimulation or self-soothing.[2]

Non-nutritive sucking habits are common in young children, and as they grow older, they tend to stop them. In most cases, this habit ceases spontaneously between 2 and 4 years of age.

What is the cause of a sucking habit?

Babies and children begin sucking their thumbs as a reflex, making them feel secure and safe. It can start in the womb. The behavior may extend into adulthood for similar reasons. Adults may suck their thumbs as a response to stress or anxiety. A sucking habit could also be a response to trauma.

Oral habits can even have an  impact the way a child swallows and can predispose them for chronic tongue thrusting and mouth breathing! 

What is the best age to stop the pacifier?

The earlier a child can shake their sucking habit, the better! This is why the American Academy of Pediatric Dentistry recommends reducing pacifier use and thumb sucking by 18 months of age.

Why is it important to stop these habits?

If thumb sucking continues, negative consequences can occur, such as a deformity of the thumb, fingers, nail, teeth or facial structures. Form follows function. 

In a normal bite, the upper teeth grow to overlap the lower teeth. But it’s possible for the pressure of a thumb, finger or pacifier resting on the gums to interfere with normal tooth eruption and even jaw growth. Some thumb-suckers develop an “open bite,” meaning the teeth don’t overlap when a child bites together; instead, there is an open space between the upper and lower teeth. If Not corrected the tongue will go forward into that space and create a tongue thrust swallow. That’s why thumb sucking is definitely something we should keep an eye on.

The evaluation and management of sucking habits highlights the professionals team approach in managing patients with this condition.

The incidence of thumb sucking can be very variable depending on the geographic area. 

If the habit persists while the permanent dentition is erupting, malocclusion can occur. This condition can be managed with different approaches, from parental and patient advice, fitting a dental appliance, or behavior modification techniques such as positive reinforcement, calendar with rewards, and counseling, among others.[1]

The development of sucking by itself is a primitive reflex that develops early in infants. Sucking behavior in children is associated with self-comfort and security feelings. Parents commonly introduce pacifiers to help the infants calm down when agitated. A study done in Italy by Ferrante et al. reported that thumb sucking behavior in their study was initiated to stimulate the nasopalatal receptors and receive muscular balance to release psychological and physical tension. Therefore, it seems that finger sucking is closely related to the psycho-emotional maturity of a child. Most children discontinue this habit spontaneously by the age of 4 years when more developed self-management skills arise.[2] 

We don’t teach our kids how to self-regulate at a young age. Half of us adults still do not know how to self regulate. Simply introducing a breathing technique could help our kids with this transition.  A simple inhale  5 counts in through the nose with belly rise using the diaphragm then hold for 2 counts  and exhale  5 counts out through the nose is a great start to helping anxiety when they are little.

Sucking can be characterized by the frequency, intensity, and duration of the habit. The duration of the force in the thumb/digit is more critical than its magnitude, and the resting pressure has the greatest impact on the position of the tooth. Sucking habits can lead to dental and skeletal malformations. Again form follows function. Meaning the habit can change the shape of the face and the function of the tongue and facial muscles.

How to stop the pacifier without causing trauma 

When weaning your baby from the pacifier, try to do this at a time when there aren’t any big milestones or changes going on.

First, Slowly reduce the amount of pacifier time and stop using the pacifier during non-stressful times. 

Then, don’t allow the pacifier outside of the crib. 

To take the pacifier away for good. Be sure to avoid weaning your child off his pacifier during major life changes, like teething, illness, or moving.

Pacifier Weaning Methods 

For babies under 6 months, we recommend using one of two methods, depending on how quickly you want the pacifier gone and the level of protesting you’re comfortable with. Both methods are explained in much more detail:

Cold Turkey

This method works by taking away the pacifier completely. During this process, you might need to help your baby settle for their naps – no doubt they will be upset while they get used to not having a pacifier. 

But don’t worry, at every nap they will take less and less time to settle. It will take about 3 days to break the habit (sometimes sooner!) if you’re consistent in your approach.   

Gradual Method

With this method you replace the pacifier with another tool.. When you lose the pacifier, you continue using this tool as well. This 3-step process does take a bit longer but is great for babies who don’t respond well to sudden changes or who are very reliant on their pacifier for soothing..

Some kids suck to help soothe themselves . You as their Mom know what is best, trust your instincts always!!

As a Mom and a Myofunctional Therapist I like to transition to a Myo Munchee. This will encourage proper tongue function and is a great transition to big kid status!

For more information:


You can schedule a call with us to help guide you!


 I do not recommend putting you little one to sleep with the Munchee. 


Along with your child’s favorite blankets, doll, and teddy bear, thumb sucking can be one of the most comforting aspects of childhood or maybe a symptom of sleep apnea. 

According to a recent report, between 75% and 95% of infants suck their thumbs or fingers, so chances are there’s a thumb or finger sucker (or a former ) in your family.  No worries?

In most cases, they outgrow it. However, it’s important to pay attention to your child’s habits in case his or her behavior has the potential to affect overall oral health.


Most children begin sucking their thumbs or fingers from a very young age; many even start inside the womb. Sucking is a natural reflex for an infant and it serves an important purpose. 

Sucking generally provides a sense of security and contentment for a little one. It can also be relaxing, which is why many children suck their thumbs or fingers as they fall asleep. 

It is important to  know the reason behind thumb and finger sucking. It may also indicate that the child is trying to bring their lower jaw forward to open their airway, because they are having a hard time breathing. 

According to the American Dental Association, most children stop sucking on their own between the ages of two and four. They simply grow out of a habit that is no longer useful to them. However, some children continue sucking beyond the preschool years, many because they can’t breathe. Airway issues in the age group 2-6 are very  underdiagnosed.

Studies show that the older a child gets, the lower the chances are of stopping the habit without intervention. If your child is still sucking when their permanent teeth start to erupt, it may be time to take action to break the habit.


First, take note of how your child sucks his or her thumb or fingers. If the sucking is passive, with the thumb gently resting inside the mouth, it is less likely to cause damage. On the other hand, If the thumb sucking is aggressive, placing pressure on the mouth or teeth, the habit may cause problems with tooth alignment and proper mouth growth. 

Prolonged sucking affects both the teeth and the shape of the face and may lead to a need for orthodontic treatment in the future.

Referral to a pediatric dentist to evaluate dental complications can be considered when the non-nutritive sucking habits persist beyond the 4 years of age despite appropriate behavioral interventions.

An oral examination is crucial to evaluate for possible complications of sucking habits. The first oral evaluation for all children is recommended when the first tooth erupts, no later than 12 months. Examining the oral soft tissues, palate, alveolar ridges, and any erupted/ erupting teeth is essential. Once dental care is established, monitoring the developing primary dentition and occlusion should be done at regular visits. 


Considering helping  your child end the habit, follow these guidelines:

  1. Always be supportive and positive. Instead of punishing your child for thumb or finger sucking, give praise when he or she doesn’t.
  2. Start a progress chart and let your child put a sticker up every day that he or she doesn’t suck. If your child makes it through a week without sucking, he or she gets to choose a prize. When the whole month is full, reward your child with something great (a toy or something they will feel good about); by then the habit should be over. 
  3. Making your child an active participant in his or her treatment will increase the willingness to break the habit.
  4. Take note of the times your child tends to suck (long car rides, while watching movies) and create diversions during these occasions.
  5. Explain clearly what might happen to the teeth if he or she keeps 

thumb or fingers sucking.

  1. If you notice your child sucking when he or she is anxious, work on alleviating the anxiety rather than focusing on the thumb or finger sucking.
  2. Put a band-aid on your child’s thumb or a sock over the hand at night. My Mom used the bitter paint and tabasco sauce, none of which worked for me.
  3.  Let your little one know that this is not a punishment, but rather a way to help remember to avoid sucking so they do not have future issues.

Whatever your method, always remember that your child needs your support and understanding during the process of breaking the habit no matter what habit it is.

Treatment options if the habit persists:

Treatment options can range from counseling to the patient and parent, using different mouth appliances, implementing behavior-modification techniques such as advice and incentives for changing behavior, and applying a nasty tasting substance to the children’s thumbs myofunctional therapy or combinations of these treatments. 

There are several options available with orthodontic appliances, including palatal cribs, spurs, palatal bars, hay rakes, and cage-type appliances. As a myofunctional therapist I do not recommend these because they prevent the tongue from suctioning to the roof of the mouth. Which is opposite of our goals for airway, breathing and sleep.

In severe cases, there can be a need for orthognathic surgery. Once treatment is completed, there is still the possibility of relapse and reestablishment of malocclusion if the habit is not corrected.

Nonsurgical and non-orthodontic interventions that have been studied for treatment in cases of an anterior open bite originating from sucking  habits include orofacial myofunctional therapy and stomahesive wafers. Orofacial myofunctional therapy involves a set of exercises that reeducate muscles involved in swallowing, speech, and resting posture. 

If at any time you suspect your child’s sucking habit may be affecting his or her oral health, please give us a call and schedule a chat. We can help you assess the situation.

If these habits persist that can lead to airway, sleep and breathing issues. All of which are Orofacial Myofunctional disorders that may require Orofacial Myofunctional Therapy.

Sleep and breathing are essential to human development, health and daily life. The typical human breathes more than 25,000 breaths each day and swallows up to 2000 times per day. 

Thumb and finger sucking can lead to mouth breathing, an open bite and a tongue thrust swallow.

Recent research has shown a significant increase in the incidence of sleep-disordered breathing. A growing body of research has also shown that orofacial myofunctional disorder (OMD) and sleep-disordered breathing exist together. 

Research has also shown strong correlations between Orofacial Myofunctional Therapy (OMT) intervention and better outcomes for patients with sleep-disordered breathing (SDB) including diagnoses of obstructive sleep apnea (OSA), and pediatric obstructive sleep apnea (POSA).

For more information on eliminating oral habits: 

Schedule a call with me for a chat. 



“Nobody Ever Told Me (Or My Mother) That! : Everything from Bottles and Breastfeeding to Healthy Speech Development” by Diane Bhar

“Sleep Wrecked kids” by Sharon Moore

“Breathe, Sleep Thrive” by Dr. Shareen Lim


Borrie FR, Bearn DR, Innes NP, Iheozor-Ejiofor Z. Interventions for the cessation of non-nutritive sucking habits in children. Cochrane Database Syst Rev. 2015 Mar 31;2015(3):CD008694. [PMC free article] [PubMed]


Kumar V, Shivanna V, Kopuri RC. Knowledge and attitude of pediatricians toward digit sucking habit in children. J Indian Soc Pedod Prev Dent. 2019 Jan-Mar;37(1):18-24. [PubMed]