Binkies, Bottles, and Thumbs, OH NO!

Barbara Tritz
· November 16, 2016 ·

10 minutes

“So Cute!”

Babies with a thumb in their mouth always elicits coos and smiles from adults.

Until recently, even I thought that pacifiers were “okay”, and that at least it wasn’t the thumb in the mouth.  Now, though?  When I see babies and young children sucking on a thumb, pacifier, bottle, or sippy cup, I think oh nooo!  This baby, this child is permanently altering bones of their face, a change that can lead to severe consequences for their entire life.  Nobody is talking about this very real health issue that we are allowing to be created.    

When you know more, you see more. Now I know, and am here to share this vitally important information about what happens when things other than food or breast nipple are introduced to a baby’s mouth.

Thumbs, fingers, sippy cups, arms, cheeks, blankets, you name it. Babies, and children (and even teens and adults) suck on it, some for years and years.

You, as the caregiver, are charged with the well-being of this child and it is up to you to give them the best upbringing you can. I realize it’s hard to take away that pacifier or sippy cup (more on this in a moment), but look at the lifelong consequences of not intervening early. Here’s a list of very real, very detrimental repercussions from what we, in the profession, call “Non-Nutritive Sucking”:  

  • Crooked teeth
  • Deviated nasal septum
  • Underdeveloped jaw
  • Jaw joint pain/dysfunction
  • Wisdom teeth impaction
  • Snoring
  • Obstructive sleep apnea
  • Sinus infection
  • ADHD
  • Head and neck pain
  • Ear infections
  • Poor eyesight
  • Allergies
  • Early wrinkles
  • Elevated stroke risk
  • Relapsed orthodontics
  • Long face syndrome 

How does this happen? Your baby’s wellness begins on day one! It starts with oxygen and developing a great airway.

Brace yourself- here’s the technical “why”: When blankets, thumbs, or pacifiers are in the mouth, baby’s bones mold around it because of the strong vacuum the sucking creates. This results in incorrect swallowing habits that are likely lifelong. This non-nutritive sucking pattern also trains the tongue to rest on the floor of the mouth. When the tongue rests down, behind the lower front teeth, facial growth and development goes awry. The face bones grow down and back resulting in an underdeveloped jaw, chinlessness, and crooked teeth. This then creates a narrow airway. No air equals obstructive sleep apnea (OSA) even in children and sets them up for a lifetime of problems such as attention deficit disorder, stroke, heart attack, and early death. Yes, it is that serious.

When the tongue is down, the mouth is open. When the mouth is open the child “mouth breathes“. Mouth breathing, open mouth chewing, and lisping are all signs there’s a problem with proper tongue placement and breathing.

The nose is made for breathing; that is its job. The mouth is made for eating and talking, and only in an emergency – breathing. The tongue, the mighty tongue! is the keystone of the head. It sets the groundwork for all facial development. Its place, its home is on the roof of the mouth about a half-inch behind the front teeth (NOT down on the floor of the mouth). This placement encourages proper facial growth and development.

People are always wondering why jaws are shrinking and teeth don’t “fit”. Folks, we are in fact doing it to our children. We are allowing the creation of crowded, crooked teeth and underdeveloped jaws. This process is called: klinorynchy. We are speeding evolution along, and not in a good way.

Sippy cups- even I am guilty of giving them to my children. The convenience and no mess? Heaven for a busy parent. I just did not know how BAD they were for facial development. Unfortunately even these cups teach the tongue to rest down low on the floor of the mouth. Click here for a better, healthy spill proof cup and here for a fabulous cup for little hands. The sippy cups interfere with developing a mature swallow. Drinking from bottles and sippy cups instead of drinking from an open cup and eating hard food also leads to insufficient jaw joint size, and bone density, as well as smaller, weaker face and neck muscles. Pacifiers, blankies, and fingers do the same.

Here’s the even sadder part- but probably the MOST important part: most pediatricians and dentists say, “no worries, the child will outgrow this habit by the time they are five, and that there is no real damage to them.” These doctors heard this in school and have never bothered to update themselves. They could not be more wrong! Sixty percent of a child’s facial growth and development happens by age four, and by age nine it is 90% done. Click here for my references.

Sadly, most orthodontists wait until age 12 or 13 to start orthodontics. Way too late, they missed the growth window. The jaw is too developed by this point and the tongue’s too big for the underdeveloped jaw. Breathing problems continue, teeth are crooked, and bad habits are hard to break. I attended the AAPMD Airway Summit in Tuscan, AZ, and heard Dr. Kevin Boyd, orthodontist, discuss how important it is to develop a good healthy airway in children BEFORE the jaw develops. A six-year child in his practice is an old child, almost too late to fix!

Crowded teeth are an indicator the face is NOT developing and forming properly and is actually collapsing. Braces may fix the crowding, but it ignores the real root of the problem- the tongue position and airway development. Did you ever wonder why your ortho treatment failed and you needed a redo? Yep, it a tongue and airway issue that never was corrected.

Infants- breastfeeding is best, for as long as possible.  Breastfeeding provides unmatched nutrition.  The immunoglobulins and human protein in the breast milk help infants resist allergies.  Formula, on the other hand, provides a significant source of protein allergies and stuffy noses. Stuffy noses cause mouth breathing. Breastfeeding teaches baby to swallow correctly and breathe – nasal breathe – while eating.  If you need to use formula or bottle-feed breast milk, and many parents do at some point, please, sit baby nearly upright and use a nipple with the smallest hole/lowest flow possible so baby works her jaws to get the milk out. Look up “paced bottle feeding.”  Laying baby down with a bottle can result in ear infections

Okay, moving along from that intense section- take a deep breath (in and out through your nose!)

Mouth breathing- what to look for in your child

Tongue should not be obvious when they talk, except for the TH sound.
                Dark circles under the eyes from allergies
                Slumped shoulder

Flaccid lips, lips parted, upturned nose
Flaccid lips, lips parted, upturned nose

Poor sleep
                Large tonsils and adenoids
                Open mouth chewing
                Parted lips
                Upturned nose
                Flaccid lips

We’ll talk about what do in a minute.

Next: The Thumb

I totally understand that babies need to suck to learn to soothe themselves.  I nursed my babies far longer than most folks thought “normal” for that very reason.  They need to suck.  One hundred percent of babies suck.  And I have no intention of ever shaming a child because they suck things.  I also understand they won’t quit until they are ready.  
However- parents, pay attention to what’s happening.  The thumb pushes the lower jaw backward.  A lower jaw that is pushed backward creates an airway issue- no ifs, ands, or buts.
Often thumb-sucking is accompanied by a bedwetting issue.  I wonder if this isn’t linked back to lack of oxygen and a narrow airway?  When a child or adult is in deep sleep, they do not produce urine. When there’s a lack of oxygen, the body puts out a hormone that makes more urine.  I wonder if the child, by sucking on something never reaches that deeper stage of sleep, but doesn’t wake up enough to use the bathroom?  This is only my hypothesis, for now.  I’m still looking for data that discusses how deep babies and children sleep while sucking. 

the Thumb

Another ponder-able thought: the connection between tethered tissue under the tongue (tongue tie) to thumb sucking.  

When the tongue is tethered to the floor of the mouth, it cannot reach “the spot“.  (I did an entire post on The Mighty Tongue and discussed how important the spot is to correct facial development.)  “The spot” is the proper rest posture for the tongue, which I alluded to earlier.  It’s just against the ridge you feel about a half-inch behind your front teeth.  This special spot is where the nerve endings from the trigeminal nerve open to the mouth.  When this place is rubbed, it releases endorphins.  (I know that sounds funny, but here’s the source.) Also, rubbing this area stimulates the pituitary gland to release growth hormones.  Another ponderable: do children who are small for their age have more tongue ties and mouth breathing?

Chewing, sucking and rubbing this area makes your child feel good.     

Again, I have a hypothesis- could the child that is sucking fingers, binkies, or thumbs have a tongue tie?  There’s a little piece of skin under the tongue, and sometimes this short tissue holds the tongue down so it cannot reach the roof of the mouth.

Read my blog post on tongue ties.  This frenum can be gently cut to release the tongue.  Again sadly, most professionals don’t know about or even recognize a tongue tie and the value of releasing it.  There is an association of professionals knowledgeable about tongue and lip ties called the International Affiliation of Tongue Tie Professionals if you have any concerns your child may have a tethered tongue.  

How Do I Help My Child?

Pacifiers should start to disappear by six months of age. Switch to other chewies!

Pacifiers are easiest to make disappear if they are “disappeared” one by one. (Again, I confess that I am guilty of encouraging my children to use a pacifier because it soothed them to sleep, and I admit, I wanted a decent night’s sleep.) 
I’ve heard of parents snipping a tiny hole at the tip of the pacifier, which renders it un-suckable.  I suggest you keep pacifiers only in the crib to be used at bedtime.  Often, pacifier use will accompany a blanket.  Blanket and pacifier stay in bed.  Sometimes, when the blanket disappears, the accompanying habit may stop as well. (I have to update myself: it is not recommended for infants to have blankets, pillows, or really anything in the crib with them!)

Fridababy makes a “pacifier weaning system” you can find on my favorite products list.

Sippy cups.  Use a real cup. Throw away those sippy cups. Four-year-olds should not be using them. Period. You can teach little ones to use an open cup as soon as you introduce solid food! I have cup suggestions on my favorite products list too!

When there’s a finger or thumb involved, get help.  A myofunctional therapist can help your child in a positive way with behavior modification.  It is an extremely complex behavior.  Ignoring it and hoping it’ll go away is not constructive.  And ignores the airway issue.

Read Helping the Thumb Sucking Child by Rosemarie Van Norman.  Learn about the cause(s) of your child’s habits so you can understand and address the whole behavior.  There are indeed gentle, constructive, and effective techniques to help your child.  Begin your efforts by reading Rosemarie’s fabulous book to help guide you. Click on my link on Barbara’s Book shelf to read all my favorite books.

This website has more good suggestions for helping baby or toddler transition to being binky-free.

My favorite tools to help baby and toddler chew, suck, and mouth are…

ARK chewy toys which are on my favorite products list. Love these for toddlers!! They also make necklaces and other products for older kids that need to chew or suck.

There is a product called a Myomunchee and they make a Bebe munchee. If you are interested in the Bebe munchee please let me know – I can order one for you. You can order mini munchees directly from the company. The munchees teaches baby, toddlers, and children to chew properly, nasal breathe, stimulate saliva, plus it cleans the teeth. It makes the child put the tongue up on the roof of the mouth and seals the lips. How much better a tool can we ask for to help grow our children?

My Grandson and his Bebe Munchee

My least favorite approach:

Many dentists will recommend an appliance called a “crib”.  It’s basically a rake that pokes out so the thumb or fingers won’t want to go in the mouth.  

The problem with that, in my opinion, is the tongue needs to be on the roof of the mouth to expand the palate organically. With those spikes there, no tongue will rest up on the roof of the mouth.  Read my post on The Mighty Tongue to see why that’s so important.  Once the crib is removed, the thumb goes right back in.  The root of the problem was never resolved. 

Palate expander and crib - do you want that in your mouth? 
Palate expander and crib – do you want that in your mouth? 


I have not touched on speech issues or speech-related issues. I am not a speech-language pathologist, so I cannot address speech issues with any authority. There are so many awesome ones out there! Check out Melanie Potock as a starting point.

Grow a Healthy Child

The benefits of proper facial development:  

Strong jawline
               Optimal growth and physical performance
               Straight teeth
Airway health
               Balanced facial features
               Higher IQ 

So: Moms, Dads, Grandparents, and relatives, the precious bundle you’d give your life to protect is in your care. Will you allow this to happen now that you know the very real consequences?
Put away those sippy cups, throw away the pacifiers, work with a myofunctional therapist to teach your child how to keep those fingers out of their mouths.  Your child needs you to be the parent. Being nice and ignoring these problems is detrimental to their total health, development, and life-long well being. 

A healthy face looks good and has good tone.   

Jon Heder in Napoleon Dynamite
Sam Heughan as Jamie in Outlander
Sam Heughan as Jamie in Outlander, and Jon Heder in Napoleon Dynamite


Do you want your child to look like Jamie (I’m a big Outlander fan) or Napoleon Dynamite when they reach adulthood? I vote for Jamie. It’s in your control.
Health starts with you.  Now, you know more and see more.



’til next time, keep smiling,


Barbara 
Biological Dental Hygienist Extraordinaire 😉 
Specialist in Orofacial Myofunctional Therapy


       

   

Hello, I'm Barbara Tritz

Unveiling the Stories Behind Dental Hygiene

Loving science, especially biology, from an early age, Barbara is a registered dental hygienist, certified biological hygienist, and orofacial myofunctional therapist. In 2019, she received the Hu-Friedy/ADHA Master Clinician Award from the American Dental Hygienist Association.

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2 Comments

  1. Dr, Aseem Gulati

    Good post and so good things you shared about our teeth, these are most important part of out body and thanks for sharing it.

    Reply
  2. Barbara Tritz

    Dr. Gulati,
    Thank you for your wonderful comments! Do you have myofunctional therapists in India?
    Barbara

    Reply

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