Our Blog

“Non-nutritive sucking behavior”? That’s a mouthful—literally! This term describes behaviors such as thumb sucking and pacifier use, which are generally healthy, self-soothing activities for infants and toddlers. But, if followed too long, this comforting habit can have uncomfortable consequences for your child’s dental health.

When children are nursed or bottle-fed, placing a nipple in the mouth helps trigger the sucking reflex, enabling the flow of milk or formula. This is called nutritive sucking, because nourishment is the goal. The sucking reflex is so essential that it develops even before birth. And while the purpose of this reflex is nourishment, it provides other benefits as well.

For small children, sucking can be a comfort mechanism to help them cope with stressful situations and calm themselves. That’s why you often see your child sucking on a pacifier, toy, thumb, or fingers when feeling overwhelmed or tired. Non-nutritive sucking behavior, or NNSB, refers to these habits: sucking without nutritional benefit.

Such habits are extremely common in young children. Most children stop sucking their thumbs or pacifiers between the ages of two and four, and often even earlier. But if your child hasn’t, it’s a good idea to talk to Drs. Don and Mindy about easing your child away from this familiar habit before the permanent teeth start to arrive.

Why? Because when sucking behavior lasts too long, it can have orthodontic consequences. Just as the gentle pressure of braces or aligners can help shift teeth and jaws into the proper alignment, the pressure from sucking thumb and pacifier can push growing teeth and jaws out of alignment.

• Studies have shown a clear link between NNSB and malocclusions, or bite problems. These include overjets (protruding upper teeth), open bites (where the upper and lower teeth don’t make contact when biting down), and crossbites (where one or more upper fit teeth inside lower teeth).
• As young bones are still growing, prolonged, vigorous sucking can affect the shape and size of a child’s palate and jaw.
• When the teeth are pushed out of alignment, difficulties with pronunciation, such as lisps, can develop.

Sucking habits can be difficult to give up. If your child is still self-comforting with the help of thumb or pacifier past age three, and certainly if you’ve noticed any changes in teeth or speech, there are several gentle, positive steps you can take to protect your child’s dental health.

• Talk to Drs. Don and Mindy about strategies for weaning your child from pacifier and thumb, as well as possible comforting substitutes. Your healthcare team can offer suggestions for making this transition as easy as possible for your child—and for you!
• Discuss recommendations you’ve found in books or online which might be a good match for your child’s personality. Whatever you decide on, whether it’s a gradual phasing out, small rewards, a goals chart, or any other method, use positive reinforcement and plenty of encouragement.
• Set easy goals at the beginning, such as going thumb-free while playing a game, or enjoying a favorite video, or any stress-free activity, to give your child a feeling of accomplishment to build on.
• Be proactive with orthodontic health. One good idea is to schedule an orthodontic visit when your child is around the age of seven—or earlier if you notice problems with tooth alignment, speech, or bite.

Thumb sucking and pacifier use can be important, instinctive sources of comfort for very young children. And, of course, NNSB is not the only cause of childhood malocclusions. Many bite problems are genetically based and/or affected by the size and shape of your child’s teeth and jaws.

But eliminating the preventable oral health problems caused by prolonged non-nutritive sucking behaviors—that’s an opportunity we can’t afford to pass up. After all, wanting to ensure healthy, confident smiles for our children is instinctive parental behavior!

In a perfectly predictable world, your child’s teeth would come in—and fall out—right on schedule, right in place. But life isn’t perfectly predictable, and teeth can erupt—or fail to erupt—in their own time and in unexpected places. Let’s look at a few of the ways your child’s teething development can differ from “typical” schedules.

• Leaving So Soon?

Sometimes a baby tooth is lost early because of injury or decay. And baby teeth are important for more than creating an adorable smile. These little teeth help your child with eating, speech, and jaw development. And they serve another purpose as well—they are essential place holders for your child’s adult teeth.

When a baby tooth is lost too early, the neighboring teeth can drift into the open space. Adult teeth waiting to arrive will tend to erupt in any space left available, whether it’s the right space or not. This can lead to bite problems and misaligned and/or crooked teeth. Depending on your child’s age, and which and how many teeth are affected, your dentist might recommend a space maintainer.

Fixed space maintainers are attached to the lost tooth’s neighboring teeth to keep them in place. Removeable space maintainers resemble retainers, and are usually recommended for older children. Both fixed and removable appliances serve to keep the baby teeth spaced apart just as they should be, preventing neighboring teeth from shifting to fill the empty spot, and making sure there’s enough room for the adult tooth to arrive right on schedule and right where it belongs.

• Hangers-On

Losing baby teeth too early isn’t the only punctuality problem that can arise with little teeth—sometimes baby teeth don’t seem to realize when they’ve worn out their welcome.

The roots of baby teeth are much smaller than those of adult teeth. When a permanent tooth starts to erupt, it pushes against the root of the baby tooth above it. This pressure breaks down the root of the primary tooth, leaving the tooth loose and just waiting to fall out.

Sometimes primary roots don’t dissolve, though, which means the permanent teeth will erupt beside those lingering baby teeth. The result is a double row of teeth. Because all these teeth in one small jaw can cause crowding and misalignment, it’s a good idea to schedule a visit with Drs. Don and Mindy when you see two sets of teeth where only one is welcome! This is especially true for older children, when the molars start erupting.

• No-Shows

When a tooth fails to erupt at all, it’s called an embedded tooth. When a tooth is blocked from erupting, it’s called an impacted tooth. Factors like the jaw size, tooth size, genetics, trauma, and medical conditions can affect eruption.

There’s no perfect eruption schedule for every child. Even typical eruption charts provide a range of several months to several years during which baby teeth arrive, baby teeth are lost, and adult teeth appear.  But any time you have any concerns about your child’s tooth development, talk to Drs. Don and Mindy to see whether the situation will correct itself in time or whether treatment is recommended.

If the unpredictable occurs in your child’s teething schedule, working proactively with our Charleston  dental team is the best way to create a lifetime of predictably happy, healthy smiles.

You may have heard this term the first time you or a friend got your wisdom teeth. That makes sense, as wisdom teeth are the teeth most often impacted in teenagers and young adults. But other permanent teeth can be impacted as well. What exactly do we mean by “impacted teeth,” and what can we do to treat them?

The term “impacted” means that somehow a tooth has been blocked from erupting properly. A tooth may be completely blocked by another tooth, erupt in the wrong space, or even come in from the wrong direction. Depending on the teeth involved, there are several different options for treatment.

From Baby Teeth to Permanent Teeth

Normally, when children lose a baby tooth, a permanent tooth is right there, ready to take its place. But teeth don’t always behave according to plan. Occasionally, that baby tooth just won’t budge, and the permanent tooth starts to erupt behind it. When this happens, a simple baby tooth extraction will often let the permanent tooth move into its proper position on schedule.

A more complicated situation develops when upper teeth are impacted because there isn’t enough space in the mouth for them. In this case, a device called a palatal expander might be used to gradually widen the upper jaw to allow the permanent teeth to erupt without crowding.

In other rare cases, a tooth (often the canine) fails to erupt and may require oral surgery to uncover it, followed by orthodontic treatment to guide it into position.

Impacted teeth can result from other causes as well, and every impacted tooth should be treated as quickly as possible. Left untreated, the teeth can fail to erupt at all or erupt in the wrong place, crowd other permanent teeth, damage the roots of the teeth near them, and lead to difficulties eating and dental pain.

Wisdom teeth

Wisdom teeth are often a problem because there is simply not enough room in the jaw for them.

Wisdom teeth that are completely impacted (still in the jawbone) can sometimes be left alone if they aren’t causing other problems. But if impacted wisdom teeth develop cysts, affect the teeth around them, or lead to other dental complications, they should be extracted.

Partially erupted teeth, those that have begun to emerge through the gums but don’t erupt fully, can be the source of different gum and tooth problems. Because the gum tissue overlaps the tooth, food particles and bacteria can become trapped, leading to rapid tooth decay and even infection. In this case, extraction is probably the best option.

Be Proactive

The term “impacted” actually comes from the Latin root meaning “pushed against.” But teeth that don’t erupt at the right time, in the right place, can have a different kind of impact on dental health and appearance. And the earlier we can catch these problems, the easier it is to treat them.

Regular exams and X-rays with Drs. Don and Mindy at our Charleston office will show the progress of the teeth even before they erupt, and if there will be the space for them to fit in the mouth properly. We may recommend a visit to the orthodontist by the age of seven to see if there are any signs of potential orthodontic problems.

Intervention at an early stage can prevent potential problems from becoming major ones. That is why it’s so important to be proactive when teeth are erupting in children and young adults. After all, a healthy, confident smile makes a real impact!

Part of the charm of your child’s smile is those delicate, diminutive baby teeth. We enjoy those smiles while we can, because soon enough, primary teeth make way for the adult teeth that will last your child a lifetime. So you might be surprised if Drs. Don and Mindy and our team recommend a crown for your child’s baby tooth. Is this procedure necessary when the tooth is going to fall out eventually anyway?

Yes, it really is. If a primary tooth is lost before its normal lifespan, several problems can arise.

• Biting and chewing—a full set of baby teeth is best for proper chewing and digestion. And chewing also helps develop face and jaw muscles.
• Speech development—primary teeth help guide speech production and pronunciation.
• Spacing—a baby tooth serves as a place holder for the adult tooth waiting to replace it. If a primary tooth is lost too early, teeth may drift from their correct location and cause overcrowding or misalignment.

When is a Crown Necessary?

The enamel in a baby tooth is thinner than the enamel found in adult teeth, and a cavity can spread quickly throughout a tooth. Within a short period, the tooth’s structure might be too weak for a regular filling. Sometimes the pulp inside the tooth becomes injured or infected and an endodontic treatment is necessary to remove pulp tissue from inside the tooth. The interior will be filled, but the delicate enamel surrounding it will be fragile. Or an accident can leave a tooth fractured or broken, but still vital.

In each of these cases, a crown will protect the tooth from further decay or damage, and will allow the tooth to function normally until an adult tooth is ready to replace it.

What Types of Crowns are Available?

By far the most common choice for a primary tooth is a stainless steel crown. These crowns are prefabricated and can be fitted snugly to your child’s individual tooth. They are easy to place, less expensive than other crown alternatives, and will last until the tooth is ready to fall out in its proper time. If your child suffers from a metal allergy, or a more natural looking crown is necessary, talk to us about other possible options during your appointment at our Charleston office.

Sure, preserving a baby tooth that was never designed to be permanent seems contradictory. But saving a tooth that helps your child develop proper eating habits, speech production, and correct adult tooth alignment? Those are benefits that will last a lifetime.