Non-Nutritive Suckling (NNS) Habits

Non-nutritive sucking habits (NNS), including digit sucking and pacifier use, are well established risk factors for malocclusion. The most common outcomes include anterior open bite, posterior crossbite, and increased overjet. This can be explained by altered muscle forces and growth patterns, an imbalance in tongue-lip-cheek forces, which can cause narrowing of the maxilla, lack of anterior contact, and protrusion of the incisors.¹⁰

Duration, frequency, and intensity are the strongest predictors of occlusal changes. Habits persisting beyond ages two to three significantly increases these risk factors.¹⁰