We expect our babies and toddlers to constantly put things in their mouths. But what if that behavior continues into the preschool years and beyond? You may wonder if this could be a sign of a neurodevelopmental disorder or if it’s just a stage that’s taking your child a bit longer to outgrow. Ultimately, taking steps to help your child with their oral fixation will limit the negative oral behavior and reduce the effects it can cause.

Here we’ll give you a better understanding of what an oral fixation is, what it may be related to, as well as methods to help your child better manage the behavior.

What is oral fixation?

Oral fixation falls under a category of behavior called “stimming.” According to Medical News Today, “Repetitive body movements or repetitive movement of objects is referred to as self-stimulatory behavior, abbreviated to stimming.”

Oral fixation is just one type of stimming. Different types of stims can be visual, auditory, tactile, etc. 

Stimming behavior is often associated with neurological disorders such as Attention-Deficit Hyperactivity Disorder (ADHD) or Autism Spectrum Disorders (ASD), but can also be a normal part of child development or seen in children experiencing anxiety. In fact, most people exhibit stimming behavior in some way (twirling hair or tapping your foot are common), but there are more “atypical” stims, and oral fixation usually falls into this category.

Oral fixation may include:

• Thumb sucking
• Difficulty weaning a child off their pacifier or a bottle
• Nail biting
• Chewing on fingers or inside of cheeks
• Excessive chewing of clothing, pencils, or other non-food items
• Licking objects
• Teeth grinding

You might be wondering why your child can’t just stop these behaviors.

It’s likely that he or she is receiving sensory input from doing so. This can help manage a stressful situation, and it's often done subconsciously. It’s important to remember that some children just take longer to move away from orally fixated behaviors as they mature, but it’s also something that you’ll want to monitor.

Is it a cause for concern?

Chewing or mouthing objects during infancy and toddlerhood is a normal part of child development. That’s the way they explore the world around them. It’s when your little one heads off to preschool and you notice that the orally fixated behavior continues that you may become concerned. You may wonder if a sensory disorder is present or if your child’s behavior falls outside of what is considered typical for their age.

If your child continues to demonstrate stimming behavior past the toddler years, it’s possible that it may be related to one of the following:

• ADHD - Oral fixation and other stimming behaviors such as fidgeting, pacing, humming, etc. are common among people with ADHD. These behaviors may aim to “quiet down some of the sensory systems that are prohibiting focus or creating unpleasant sensations in the body,” according to betterhelp.com. 
• Autism and ASD - Stimming behaviors are commonly associated with Autism Spectrum Disorders. This may not always present itself in the form of an oral fixation, but many children will use chewing or biting items as a way to reduce anxiety and cope with sensory overload.
• Anxiety - Chewing is often used as an outlet to reduce stress among children with anxiety.
• SPD - According to Anxious Toddler’s website, “Not every child with Anxiety has SPD and not every child with SPD has anxiety, but a large proportion do.” When a child has too much sensory input from the environment around them, chewing and sucking aim to self-soothe as a response.

It’s important, however, to understand that there may be another cause for your child’s orally fixated behavior. Some children and adults will demonstrate stimming behavior even without any related delays or disabilities. Any and all concerns should be directed to your child’s pediatrician.

Though you may choose to let the behavior go, doing so can lead to further negative effects such as:

• Separation anxiety
• Tantrums past the typical age range
• Excessive drooling
• Picky eating 
• Oral motor issues that can affect your child’s speech as well as jaw and teeth formation

Additionally, you want to be able to help your child avoid putting dirty items in their mouth, soaking and ruining shirt cuffs or collars, and even putting items in their mouths that they could be a choking hazard.

How to Help a Child Manage Their Fixation

Whether your child’s oral fixation is related to a neurological disorder or they just are yet to outgrow the habit, there are different methods you can take to reduce the behavior. Though treatment can be difficult since oral fixations are often an unconscious behavior, with professional help and a dedicated effort by you, your child’s compulsive stimming can improve.

We recommend the following steps to help your child with their stimming behaviors which will hopefully improve their emotional well-being, as well.

1.) Consult With an Occupational Therapist or Speech Pathologist

It is always advised to consult your pediatrician as the first step if you have any concerns. If you don’t believe that your child’s oral fixation is related to any delay or disorder, you can always try the suggestions below. However, the best way to get advice is to reach out to your child’s doctor. 

From there, they can do an evaluation or suggest next steps. They may also refer you to an occupational therapist or speech pathologist. They are experts in identifying root causes of your child’s oral sensory seeking behaviors and can offer guidance and support to help your child in the best way possible.

2.) Identify Triggers for the Orally Fixated Behavior

Pay close attention to your child and when they exhibit their oral fixations the most. Take note of what happens before you see the stimming behavior as well as what the surroundings look like around them in that moment. Jotting down notes can be helpful in order to pinpoint trigger patterns that lead to the behavior.

Once trigger(s) have been identified, you want to help reduce the triggering behavior. Sticking to routines can help reduce unnecessary stress that may lead to your child’s stimming behavior.

It is unlikely that all triggers will be completely eliminated, so it’s important for your child to have an appropriate substitution that they can use for chewing or other coping strategies in place.

3.) Find an Appropriate Chew Replacement 

Because stimming is an important way for children with a disorder or anxiety to better cope with their environment and reduce stress, there’s no need to try to stop the chewing completely. Instead, you want to give them proper replacements that won’t affect their speech or teeth formation. Helping your child find a proper replacement will reduce the likelihood of them chewing holes in their clothing or putting potentially dirty items in their mouths.

Having your child chew gum once or twice per day or give them access to chewy snacks such as dried fruit, celery, popcorn, licorice, or granola. But we also recommend providing your child with a chew toy that’s wearable so it stays clean and they always have it available.

Tasty Tie is great for the younger set with oral fixations - we also recommend you check out our list here. Older children will do well with a chew-type necklace, such as this one. Can be purchased HERE.

4.) Redirect the Behavior

Another way to help your child once you notice their negative oral fixation, is to try to distract them in a way that allows them to redirect their behavior in a positive way. This is especially necessary when the behavior may be unsafe (such as chewing on an object they could choke on.)

Redirection can include offering something appropriate to chew on as listed above, taking your child out of an overwhelming situation, or moving them on to something else they like to do.

Does this mean that you need to respond every single time your child is chewing on something? Not at all. In fact, it’s a good idea to 

5.) Get Rid of the Sippy Cup and Pacifier

If you haven’t already gotten rid of your child’s sippy cup, it’s time. According to Speech in the City, use of a sippy cup can prolong an immature sucking pattern. Having your child utilize a straw or drink from an open cup will help them strengthen muscles around the lips and cheeks and help with tongue retraction. Ditching the cup can help your orally fixated child to improve their speech.

Additionally, you don’t want to prolong your child’s use of the pacifier past the age of 3 if you can help it. For help on pacifier weaning, read: “How to Drop the Paci When You Think It’s Time.”

Moving Forward in Helping Your Child Manage Their Oral Fixation

Be sure to honor your child’s need for oral stimulation and the release and calming that it allows. Although it’s referred to as a “negative” oral behavior, you never want to treat your child like they are being "bad." Instead, you want to set your child up for success by encouraging them to utilize better substitutions or redirecting their behavior in a positive way. Making a commitment to seeking out the resources you need to help your child while being empathetic to their needs is the best thing you can do for them.