Guidelines for Treatment and Referral for Elimination of Oral Habits
□ Is the child five years of age or older?
□ Does there appear to be a dental malocclusion (anterior openbite, overjet, Class II (retruded) mandible relationship, posterior crossbite or narrow palate) developing that may be related to the sucking habit?
□ Does the child brux or grind his/her teeth, which may be related to a posterior crossbite or anterior openbite dental malocclusion?
□ Does the child complain of clicking or locking of the jaws, headaches, pain in the ear, neck or shoulder, vertigo or tinnitus (ringing in the ear) that may be related to temporomandibular joint problems?
□ Does the child have lacerations on the inner cheeks that that may be related to a unilateral posterior crossbite dental malocclusion and subsequent lateral shifting of the lower jaw?
□ Are the front teeth protruding thereby promoting the potential for fracture and/or trauma to these teeth, or negative peer response?
□ Does the parent feel that drooling is a problem? (This may be related to excessive protrusion of the upper front teeth which inhibits efficient saliva collection and promotes the pooling of saliva in the corners of the mouth.)
□ Does the child posture habitually with lips open that may be related to an openbite, excessive vertical development, or excessively protruding incisors?
□ Is there radiographic evidence of root resorption on the primary or permanent maxillary incisors?
□ Does the child have difficulty biting into foods with the front teeth or avoid certain types of food as a result of an openbite and/or overjet dental malocclusion which compromises biting and chewing ability?
□ Does the child complain of frequent stomach aches which can be related to inadequate chewing efficiency because of the dental malocclusion resulting from the sucking habit?
□ Does the child have calluses, infected fingernails or fingers growing crooked as a result of a sucking habit?
□ Does the child experience frequent viral and/or bacterial infections which may be related to the frequent placement of thumb or fingers in the mouth?
□ Does the child exhibit the speech articulation errors:
/s/, /z/, /sh/, /ch/, /j/, /t/, /d/, /n/,
/l/, /p/, /b/, /m/, /f/, /v/, or /r/?
□ Is the child exposed to negative response from peers, relatives, parents, siblings or others in their environment as a result of articulation problems?
□ If the child has articulation problems, and has been in speech therapy for an extensive amount of time, perhaps the sucking habit, associated dental malocclusion and subsequent oral facial myofunctional disorder may be limiting the success of therapy.
□ Does the sucking activity take place during the day as well as at bedtime?
□ Does the child avoid spending the night with friends because of fear that his/her sucking activity during sleep will be discovered?
□ Does the sucking activity take place across two or more settings such as home and school or in the presence of others outside the immediate family?
□ If the sucking activity takes place at school, is it affecting scholastic achievement or socialization skills?
□ If the sucking activity does not occur in the classroom, are there any problems with difficulty sitting still, disruptive behavior, chewing clothing, pencils, hair, fingernails, etc.?
□ Is the child exposed to negative response and/or antagonism from parents, grandparents, siblings, peers or others in the environment as a result of the sucking activity?
□ Does the child appear to be excessively withdrawn, anxious, angry or aggressive?
□ Does the child have a conjoined behavior such as hair pulling (causing hair loss), nose picking or genital fondling resulting in negative response from those in the child’s environment?
□ Does the child frequently retreat to the sucking behavior to avoid confrontation rather than asserting himself/herself?
PARENTS SHOULD CONSIDER INTERVENTION BY A TRAINED, THIRD-PARTY IF:
- The child has reached the age of five and parents cannot motivate the child to discontinue the behavior.
- Gentle reminders have turned into nagging and an atmosphere of conflict, antagonism and frustration surrounding the behavior.
- Parents are divorced and/or one parent is not consistently supporting or following through with a habit elimination program.
- Two or more children in the family have a sucking habit.
For more information, call CHRISTINE 719-442-6653