When to Be Concerned

• Thumb sucking or pacifier use that continues past age 4
• Vigorous sucking (as opposed to passive resting)
• Changes in tooth alignment or bite
• Open bite (front teeth do not meet when biting)
• Narrowing of the upper jaw
• Speech problems related to tooth position

Tips for Breaking the Habit

Praise your child when they are not sucking. Identify triggers (stress, boredom) and address them. Use positive reinforcement — reward charts work well. Avoid negative reinforcement or punishment. For older children, involve them in choosing to stop. Talk to our team about habit-breaking appliances if needed.

Pacifier vs. Thumb Sucking

Pacifier use is generally easier to stop than thumb sucking because you can control access to the pacifier. Both habits can affect tooth development if continued past age 4. We recommend weaning from the pacifier by age 12-18 months and stopping completely by age 3.