What are non-nutritional sucking habits and what are the best interventions?

Non-nutritional sucking habits are learned patterns of muscular contraction. The most common types are:

• Finger habit
• Lip wetting or sucking
• Abnormal swallowing or tongue thrusting
• Abnormal muscular habits

Sucking is the best-developed sensation avenue for an infant. Deprivation may cause an infant to suck on the thumb or finger for additional gratification.

If a child stops non-nutritional sucking habits within his or her first 3 years of life, the damage usually is limited to the maxillary anterior segment and presents as an open bite. If the habit continues past 3 years, the damage may be long-lasting and detrimental to the developing
dentoalveolar structures. After 4 years of age, a finger habit can become well established and is much harder to stop. Oral structures can become further deformed by palatal constriction and posterior crossbite.

Tongue and lip habits are often associated with a finger habit and produce added compensatory forces that can lead to full-blown malocclusion. Thumb and finger habits can cause an anterior open bite, proclination of the upper incisors, lingual movement of the lower incisors, and constriction of the maxillary arch. Lip sucking and lip biting can procline the maxillary incisors, retrocline the mandibular incisors, and increase the amount of overjet.

Tongue thrusting and mouth breathing may also play a part in the creation of a malocclusion. An anterior open bite is the most common dental problem associated with the anomalies.

1. Ideally, the patient should understand the problem and want to correct it. 
2. The timing of intervention is controversial. Some experts suggest beginning therapy around age 4 years to prevent irreversible changes, whereas others suggest waiting until the patient is about 6 to 7 years old to ensure that he or she can understand the intent of the therapy.
3. Patients who decide to accept appliance therapy should have support and encouragement from their parents to help them during treatment.
4. The dentist should know the patient well to provide intervention and advice at the correct time.
5. The dentist should be able to evaluate the deformity and extent of its effects so that it can be treated in the best possible manner.

Source: Dental Secrets, Elsevier, 2015