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Thumb sucking can be an all too common habit for many children. It is also an instinctual, natural reflex for many children as a way to soothe themselves. However, over time thumb sucking can be detrimental to a child’s dental and physical development. While it is perfectly natural and healthy when a child is in its infant stages that same habit can become very problematic as they begin to develop teeth and socialize with others.

Is Thumb Sucking Normal?

Yes! It is quite normal. The thumb sucking can occur even in the womb. As infants, children learn about the world thru putting things in their mouths but eventually it becomes a soothing mechanism to make them feel secure and happy and even help them to fall asleep.

Dental Issues From Thumb Sucking

According to the American Academy of Pediatrics treatment for dental problems caused by thumb sucking is generally needed only in children who continue to suck their thumbs past their fifth birthday.

Thumb Sucking Habit marielaina Perrone DDSOnce the permanent teeth begin to erupt and develop in the mouth, the constant thumb sucking may cause dental issues. The common sign is the top teeth push out and upward, and bottom teeth to push inward. This tooth movement due to thumb sucking can cause the following issues:

-Development of a “buck tooth” appearance

-Inability to close the front teeth (open bite)

-Damage to the roof of the mouth

Speech issues

Pacifiers are known to cause similar issues as thumb sucking but the habit of using the pacifier is a far easier habit to break, it can be thrown out, whereas a finger can not. The determining factor if thumb sucking causes dental problems or not, includes the intensity and length of time of the thumb sucking. Checking a child’s thumb for damaged skin and calluses can help determine the severity of the thumb sucking habit. Many children simply rest their thumbs in their mouth and do not actively suck on them. These children are far less likely to develop any long term dental issues from this type of thumb sucking. Aggressive thumb sucking however will have a higher likelihood of developing issues with their primary and permanent teeth if the thumb sucking habit continues.

Speech problems caused by thumb sucking are related to the misaligned teeth, distorted palate, and tongue thrusting. The tongue does not have the ability to find the correct placement for proper enunciation, and the tongue muscle actually needs to be retrained for proper placement of sounds. Tongue thrusting is the pushing forward motion of the tongue when swallowing, causing a continued pressure on the teeth even when not thumb sucking. Speech problems can include not being able to properly say S’s, T’s and D’s, lisping, and tongue thrusting when talking.

Children who are thumb sucking may need treatment include:

-Those who have not stopped thumb sucking on their own by age 4-5.

Speech problems are becoming noticeable due to thumb sucking.

-Peer Pressure – If they are teased or feel embarrassed socially by their thumb sucking.

Tips For Breaking The Thumb Sucking Habit

Breaking a thumb sucking habit will not be easy. The longer your child does it the harder it is to break them of the thumb sucking habit. The following are some tips to help move the process along and break them of their thumb sucking habit.

Communication. Talk to your child about their thumb sucking habit. Explain how it can affect their teeth and kids might make fun of them. Ask how they feel and what you can do to help? Talk about alternative options when the thumb sucking urge comes on.

-Positive reinforcement. This works wonders with children especially of this age. Simple rewards like extra play time or a trip to the park can go a long way to helping break the thumb sucking habit.

Ignore The Issue. Some kids have a thumb sucking problem as an avenue for attention. I would not recommend this as a long term way of breaking thumb sucking habit but it is worth exploring.

-Offer Up An Alternative. Parents should give their child encouragement and offer to do a different activity when they feel the thumb sucking urge coming on. Could be something like squeezing a pillow or hugging their favorite toy.

Speak To Your Dentist. As an authority figure in your child;s life they may have more impact in this area. Your child may listen to them more intently. Your dentist will also offer dental treatment options. These can include:

-Behavioral Therapy.

-Special Nail Polish. This nail polish will be placed over thumb nail and have a foul taste for your child when they go into thumb sucking habit.

-Thumb sucking device that covers thumb. This will physically make it hard to get comfort when thumb sucking.

-Dental Habit Appliance. This is a custom made dental appliance that will make it impossible for your child to continue thumb sucking comfortably.

Thumb Sucking Conclusion

Breaking your child’s thumb sucking habit will take patience and persistence on both your parts. It is a very difficult habit to break especially the longer it is allowed to continue. If you need help call your dentist. Sometimes a group effort is what is needed. Also, be aware that putting too much pressure on yourself or your child can make matters worse. Best to take a calm, methodical approach.



Speech Pathology – Speech and language pathology is concerned with issues surrounding human speech and language communication disorders.

Child development has many milestones including taking that first step, first eating of solid foods, and speech. The maturation of the speech process is one of the most important milestones in any child’s development. Speech development is a form of learned behavior that is influenced by many things like environment, parental involvement, and the child’s own mind and musculature. For most children speech development is an easy process but for some children they have difficulties and need extra attention and help. Studies have shown about 10% of children have some form of speech pathology that if not corrected will cause issues for them later in their development.

Speech is defined as the expression of or the ability to express thoughts and feelings by articulated sounds in a language. The actual mechanism of speech can be complex. The actual speech is coordinated by various parts of a child including their musculature, breathing, teeth, and mental/neurological capacities.

Actual speech begins with a baby crying and how the baby learns to communicate its needs and desires. This is why shortly after birth that a baby has different cries and a mother can distinguish a cry of pain from a cry of hunger.

At about the 6 month mark most babies begin to make sounds very similar to speech, attempting words but not quite there yet. In most children this will ramp up quickly over the next 6 months. When actual talking begins words are formed in isolation and not in complete sentences. Some kids aquire words and language very quickly and amass a larger vocabulary at an early age while others are slower to develop. There is a large spectrum of what is considered normal.

Speech Pathology Disorders

A speech disorder refers to a problem with the actual production of sounds. A language disorder refers to a difficulty understanding or putting words together to communicate properly.

Speech disorders include:

-Articulation disorders: difficulties producing sounds in syllables or saying words incorrectly to the point that listeners can’t understand what’s being said.

-Fluency disorders: Another name is stuttering. Stuttering is characterized as abnormal stoppages of speech, repetitions, or prolonging sounds and syllables.

-Resonance or voice disorders: problems with the pitch, volume, or quality of the voice that distract listeners from what’s being said. These types of disorders may also cause pain or discomfort for a child when speaking.

-Dysphagia/oral feeding disorders: these include difficulties with drooling, eating, and swallowing.

Language disorders can be either receptive or expressive:

-Receptive disorders: difficulties understanding or processing language.

-Expressive disorders: difficulty putting words together, limited vocabulary, or inability to use language in a socially appropriate way.

How Do Teeth, Tongue, and Oral Cavity Affect Speech?

Teeth and tongue and oral structures play an important role in the pronunciation of the consonants f, v, s, z, etc..,  In general children can compensate for minor oral issues and have no problems with speech.  Some dental issues are more extreme and may prevent or hinder pronunciation. Here are a few:

1. Open Bite . This is an oral malocclusion in which the front teeth do not close together. Many speech sounds require closed front teeth to enunciate.

2. Short Frenum. This is the attachment under the tongue, which can be so short that the tongue is actually attached at the tip to the tissue at the bottom of the mouth. The tongue needs to move and touch different areas to produce t,d,n,l,r sounds. This can usually be relieved with a small surgery with an ENT doctor.

3. Lack of Teeth. Whether due to early loss or lack of normal tooth development, loss of front teeth can make it extremely difficult to produce sounds well.

4. Cleft lip or Palate. Lack of full closure of lip or palate allows air to disrupt proper formation of speech sounds. Surgical closure helps to fix the problem, but speech therapy is generally still necessary.

5. Thumb Sucking After Effects. Prolonged thumb sucking can push front teeth forward, cause an open bite, and deform the palate. This combination can make proper speech development a challenge.

6. Tongue Thrust. This is when the tongue, during swallowing or speaking, pushes through the teeth. If not addressed with orthodontics, myofunctional therapy, or orthodontic appliances, the problem will cause movement of teeth and increased difficulty with speech. Tongue thrust needs to be diagnosed by your dentist.

Conclusion

Since speech is an important part of development, disorders may hinder personal, social and educational experience. Your dentist may be able to help you with diagnosing oral issues related to your child’s speech issues. Proper referrals to specialists can help get your child on the right path to proper speech development.



In the past, orthodontics was routinely an early teen event that began once all of the baby teeth were gone and permanent teeth were in. Recent advances in the understanding of a child development as well as modern materials have re-evaluated the time for orthodontic treatment to an earlier age. It is now recommended by the American Association of Orthodontists that every child should receive an orthodontic evaluation by age 7. But Why?

Common Orthodontic Problems Found At Age 7

1. Buck Teeth. Do the upper front teeth stick way out of line?

2. Deep Bite. Do the upper teeth cover the lower teeth?

3. Underbite. Do the upper teeth fit inside the arch of the lower teeth?

4. Open Bite. Do only the back teeth touch when biting down?

5. Crowded or overlapped teeth. Do the teeth have too much or too little space in certain areas?

6. Misaligned front teeth. Do the spaces between the upper two front teeth and lower two front teeth not line up?

7. Crossbite. Do the lower teeth fit properly inside the upper teeth?

8 .Missing teeth. If there are baby teeth that never developed, there will not be a permanent tooth to follow. Jaw x-rays may also find that certain permanent teeth are not  presently formed or are unable to come down on their own.

9. Extra teeth. When there are double teeth, extra teeth or malformed teeth.

Generally, orthodontic treatment does not begin at age 7 but it is good to get a head start to avoid any complications down the road. However, early orthodontic treatment may be necessary before age 7 if the following appear:

-Problems Speaking

-Proper Chewing Is Difficult

-Abnormal bite development

-Clicking or popping in the jaw

-Permanent teeth that are erutping into the mouth crowded or overlapped

-A thumb sucking problem

-A teeth grinding problem

-Issues biting cheeks or biting into the roof of the mouth

Benefits Of Early Orthodontic Treatment

Early orthodontic evaluation provides both timely diagnosis of problems and increased opportunity for more effective treatment. Early intervention gives the ability to guide growth and development, preventing more serious issues later. When orthodontic intervention is not necessary, an orthodontist can carefully monitor growth and development and begin treatment when it is ideal.

Early orthodontic treatment is also referred to as interceptive treatment or Phase I treatment. Some of the most direct results of interceptive treatment include the following:

-Creating room for crowded, erupting teeth

-Creating facial symmetry through influencing jaw growth

-Reducing the risk of trauma to protruding front teeth

-Preserving space for teeth that are coming in

-Reducing the need for tooth removal

-Reducing Phase II treatment time with braces

Phase II orthodontic treatment begins when all of the permanent teeth erupt and usually involves a full set of braces and not just a localized treatment plan.

Orthodontic Conclusion

While not every child will need early orthodontic treatment, it is best to know in advance what the options will be going forward. It is important to remember, orthodontics is not strictly a cosmetic endeavor, bite alignment is the ultimate goal. The issues presented above can all be corrected fairly easily if done in a phased approach. However, allowing this early intervention time to pass can complicate treatment requiring more extreme measures (i.e. teeth removal or surgery) to fulfill the same goal.


Pacifiers are used as a soothing tool in infants and very young children. The habit of sucking is a normal, natural behavior for babies. This is how they receive all of their nutrition in the first months of life. Some babies will even begin sucking on their fingers or thumb inside the womb. Babies will also suck for other reasons. It is a soothing

Pacifier Use Marielaina Perrone DDS

Be Smart About Pacifier Use!

behavior that can help them relax and sometimes even put them to sleep. It can relieve anxiety and make them feel secure and happy. They are especially useful during the first six months of life.

Studies have also shown a benefit from pacifier use in development of jaw muscles as well as decreasing risk of sudden infant death syndrome. Pacifier use is generally safe and effective in its job for the first two years of life but problems can arise with continued pacifier use after age 2.

Dangers Of Continued Pacifier Use

Research has shown that pacifier use before the age of 2 is natural and healthy for a baby. After the age of 2 problems can arise that can endanger the child’s oral health going forward. Some of the dangers associated with continued pacifier use include:

-Increased risk of middle ear infections. Researchers theorized it may have something to do with the change in pressure equilibrium inside the ear caused by the constant sucking.

-Improper growth or development of the mouth.

Misalignment of Teeth. These issues might include displaced teeth, overbites, cross bites, and open bites.

-Increased Risk of Tooth Decay. Kids who use a pacifier longer, also tend to drink from a bottle longer. All this sucking combined with liquids applied directly to the teeth can cause tooth decay and badly formed teeth.

Pacifier Use Marielaina Perrone DDS-Development of a Thumb Sucking Habit. This will accelerate and make any issues even more pronounced.

-Germ ingestion is increased throughout life with long term use of pacifiers. Research has shown that children who use pacifiers after infant stages are more likely to pick up and put items in their mouths.

-Sleep disruption. They have a problem because they grow used to having the pacifier in their mouth while sleeping, and can’t sleep without it. This issue isn’t limited to pacifier users. It’s also true of kids who suck their thumb past infancy. Older thumb suckers often mimic the health issues of pacifier users.

Correct Pacifier Use

Here are a few tips for correct pacifier use:

-Use specially designed orthodontic pacifiers. A good example is the advanced airshield orthodontic pacifier by NUK.

-Keep Pacifiers clean and free of unwanted germs. Always wash a new pacifier prior to use.

-Regularly check your child’s pacifier for cracks or tears. These can become a choking hazard and should be thrown away immediately.

-Do not tie the pacifier around your infants neck.

Following these rules will help ensure your babies pacifier use is safe and healthy.

What Can Be Done To Stop Pacifier Use

While the use of pacifiers before 2 years old is very beneficial it is not always easy to get your child to stop at their 2nd birthday. Some tips to help wean your child off the pacifier include:

1. Take It Away Sooner Than  Later.

To break the pacifier habit taking the pacifier away sooner than later is the most effective strategy. Babies have their own powerful ways of protesting the end of a belovedPediatric Dentistry Marielaina Perrone DDS habit like the pacifier. But taking it away when your child is too young to express his displeasure and negotiate with words can make the transition simpler and easier. Once the pacifier is taken away, do not give it back!!! Tell them it is gone, show it to them in the trash, and then bring it outside to the garbage. Children understand the concept “all gone”.

2. Change The Pacifier’s Taste.

You are probably familiar with the idea of stopping nail-biters by painting their nails with something that tastes unpleasant. A similar method sometimes works to separate kids and their pacifiers.

3. Leave it for the Pacifier Fairy

The pacifier fairy is a first cousin to the tooth fairy. This magical creature may help your child make the transition from being hooked on the pacifier to living pacifier-free. A nice replacement gift from the fairy is also a great idea.

4. Lose it

This may come as a revelation: Next time you’re frantically looking for your child’s precious pacifier, stop. If it’s lost, let it be lost. Alternatively, you can lose it on purpose. Both strategies have worked for desperate moms and dads.

Pacifier Conclusion

For many infants weaning off the pacifier can be very difficult. Some kids are not only physically attached to the pacifier but emotionally attached as well. In those children it is doubly hard to break the habit. As hard as it may be for parent and child, for the child’s health it is a very important reason to break the habit at the right time before any damage can occur.