Non-nutritive sucking (NNS), which includes dummy use and thumb sucking, is a natural reflex in infants that provides comfort and security. However, prolonged NNS beyond the age of two to three years can cause changes to facial growth, jaw development, and tooth alignment that may require orthodontic treatment later in life. At Pure Smiles in Fulham, Dr Ayzaaz Akram has a specialist interest in facial development and orthodontics and regularly advises parents on managing sucking habits.
Non-nutritive sucking refers to any sucking behaviour that is not related to feeding. It is distinct from nutritive sucking, which occurs during breastfeeding or bottle feeding.
| Type | Examples | Purpose |
|---|---|---|
| Nutritive sucking | Breastfeeding, bottle feeding | Nourishment and nutrition |
| Non-nutritive sucking | Dummy, thumb, fingers, blankets, toys | Self-soothing, comfort, security |
The sucking reflex is present from birth and is one of the first coordinated muscular actions a baby performs. It is entirely normal and serves an important role in early development. The concern arises only when the habit persists beyond the developmental stage where it provides benefit.
When a child sucks on a dummy or thumb for extended periods, the repetitive pressure on the teeth, palate, and jaw can cause measurable changes to facial and dental growth. The severity depends on the duration, frequency, and intensity of the habit.
Open bite is one of the most common consequences. The front teeth fail to meet when the child bites together, creating a visible gap between the upper and lower front teeth. This occurs because the dummy or thumb physically prevents the teeth from erupting into their normal positions.
Crossbite can develop when persistent sucking pressure narrows the upper jaw (palate). A narrow upper jaw means the upper teeth sit inside the lower teeth rather than outside them when biting together.
Protruding upper teeth (increased overjet) result from the forward pressure of the thumb or dummy pushing the upper front teeth outward. This increases the risk of dental trauma from falls or sports.
Changes to palate shape occur because the developing palate is soft and malleable in young children. Sustained pressure from a dummy or thumb can cause the palate to become high and narrow, affecting breathing, speech, and the space available for adult teeth.
Speech development issues can arise from altered tongue positioning and palate shape, particularly affecting sounds like “s”, “t”, “d”, and “l”.
Most dental and paediatric guidelines recommend that non-nutritive sucking should ideally stop by the age of two, and certainly before the age of four when permanent teeth begin to develop beneath the gums.
| Age | Risk Level | Recommendation |
|---|---|---|
| 0-6 months | Minimal | NNS is normal and beneficial for self-soothing |
| 6-12 months | Low | Begin reducing dummy use, particularly during daytime |
| 1-2 years | Moderate | Actively wean off the dummy; limit to sleep time only |
| 2-3 years | Increasing | Habit should stop; dental changes may begin |
| 3-4 years | High | Persistent habit likely to cause measurable dental effects |
| 4+ years | Very high | Orthodontic assessment recommended |
The earlier the habit stops, the greater the chance that any developing dental changes will self-correct as the child grows. If the habit continues beyond age four, orthodontic intervention is more likely to be needed.
Stopping a dummy or thumb-sucking habit requires patience and consistency. Punitive approaches are not effective and can increase the child’s anxiety, making them more reliant on the habit for comfort.
Strategies that work well include:
If your child is struggling to stop despite consistent effort at home, speak to your dentist. We can provide additional guidance and, if needed, refer to a specialist.
Dr Akram has spent over a decade studying facial development and orthodontics, working with leading international experts in the field. His clinical experience at Pure Smiles has reinforced the importance of early intervention.
Through treating many young patients who required orthodontic treatment to correct bite problems caused by prolonged NNS, Dr Akram advocates for early awareness and proactive management of sucking habits. The goal is not to alarm parents but to equip them with the knowledge to make informed decisions during their child’s early years.
Bring your child for a dental assessment if:
Early assessment does not necessarily mean immediate treatment. Often, monitoring is all that is needed, with intervention only if natural correction does not occur.
At Pure Smiles in Fulham, we welcome children of all ages and provide a friendly, reassuring environment for young patients. Whether you need advice on managing a sucking habit, a routine check-up, or an orthodontic assessment, our team is here to help.
learn more to book an appointment at our New Kings Road or Fulham Road practice, or call us on 020 7736 6276.
A dummy is generally considered easier to manage because you can control when and where it is available, and ultimately take it away. Thumb sucking is harder to stop because the thumb is always accessible. However, both can cause similar dental effects if the habit persists.
Not necessarily. If the dummy is stopped by age two, most minor dental changes will self-correct as the child grows. The risk of needing braces increases significantly if the habit continues past age three or four.
Orthodontic dummies are designed with a flatter shape that accommodates the palate more naturally than standard dummies. While they may reduce some of the pressure on developing teeth, they do not eliminate the risk of dental changes from prolonged use. The duration of the habit matters more than the type of dummy.
Children should have their first dental visit by their first birthday or within six months of their first tooth appearing. Early visits allow the dentist to monitor development, provide preventive advice, and build a positive relationship with dental care from the start.
