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Oral fixation: Habits, risks, and resolutions

Oct. 26, 2022
Lara James, RDH, talks about oral fixation and its negative effects on oral and systemic health. Here’s what to watch for and ways you can make a difference in your patients’ lives.

Oral fixation is defined as an oral condition involving a person who has an unconscious obsession with their mouth.1 This obsession promotes the need to constantly suck or chew on something. The incessant desire to keep the mouth busy is an outlet to release nervous energy and to self-soothe. A fixation is a persistent focus of the id’s pleasure-seeking energies at an earlier stage of the psychosexual development. Such fixations occur when an issue or conflict in a psychosexual stage remains unresolved, leaving the individual focused on this stage and unable to fully move on to the next.

The stages of psychosexual development

According to psychoanalyst Dr. Sigmund Freud, there are five stages of psychosexual development. Each stage is focused around an erogenous zone. One of the five stages is the oral stage, and if this stage is not fully completed and resolved during the time of development, an adult oral fixation may occur. A fixation is an unhealthy attachment to one of these erogenous zones where the adult remains stuck in that particular stage of development.2 If this stage has any kind of conflict or if a considerable amount of energy is expended at this developmental stage, it could leave a dominant impression on one’s personality.3 If the oral stage isn’t resolved at the time of development, there’s a residual need throughout life to try to fix it.

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The oral stage happens from birth to 21 months when the infant’s pleasure center is focused on the mouth and lips, which are used for sucking and feeding. This is the age when the infant puts everything in the mouth—from hands, fingers, wrists, toys, pacifiers, clothing, blankets … just about anything within hands reach. One of the first prominent objects the baby’s mouth becomes accustomed to is a mother’s breast, for milk. The act of nursing is a dependent act used for food and survival. According to Dr. Freud, the time that may cause the future danger of having an oral fixation is during weaning.2

Weaning is a gradual withdrawal of the infant from the mother’s supply of milk, a bottle, or a pacifier. This new loss to the infant makes the experience a prominent moment in the development of self-awareness, independence, and trust. Weaning teaches infants that they don’t have control over their environment, and this experience limits the self and pleasure. According to Dr. Freud, the oral character is formed when nursing is neglected or overprovided, or weaned too early or too late, causing an adult maladaptive oral fixation.

Being overindulged during nursing occurs when feeding urges are always met, causing the infant to grow into a dependent, helpless, and entitled adult. Infants who are neglected—e.g., when nursing is cut short, or they are not nursed when needed—leaves the infant orally frustrated. This causes infants to grow into envious, suspicious, and pessimistic adults.1

Oral fixation habits

In psychology, a fixation is a persistent focus on an earlier psychosexual stage. A person who is fixated on the oral stage is so because the conflict hasn’t resolved itself. Oral fixations manifest themselves through eating, talking, smoking, alcoholism, thumb-sucking, and nail-biting. The constant chewing of gum, candy, ice, and toothpicks become habits. The traits of being overly talkative, gullible, manipulative, or sarcastic can arise from an oral fixation.

Dr. Carla Fry, a registered psychologist in Canada, suggests that if after two years of age a child is still sucking or chewing on objects, they may have an oral fixation. The biggest clues are clothes soaked with saliva and holes in shirts. She believes this may be caused by the child’s failure to make the full transition from the oral exploration stage into other forms of sensory learning. Kids with oral fixations are usually shy or anxious, and they release that anxiety or nervous energy by sucking or chewing on objects to self-soothe. Dr. Fry says an oral fixation can come from a sensory processing disorder, which affects a child’s adaptation to sensory information.4

Oral fixation personality

Oral personality is defined as this: “According to the original theories of psychoanalysis, a personality fixed emotionally in the oral stage of development, whose sexual and aggressive drives are satisfied by putting things in his or her mouth. Depending on when the fixation occurs, oral personalities tend to be either optimistic, generous, and gregarious or aggressive, ambitious, and selfish.”5

Oral dependent qualities are considered to contribute to overeating, being overly talkative, smoking addictions, and alcoholism.6

Oral sadistic qualities include sarcasm and a biting personality.6

Oral-aggressive personality stems from obsessive focus, is hostile, verbally abusive, exploitative, ambitious, jealous, and violent.7

Oral-receptive personality results in an obsession with eating and drinking and curtails tension through oral activities associated with eating, drinking, smoking, and nail-biting. These individuals tend to be passive, needy, and sensitive, especially to rejection. They will absorb other people’s ideals.7

The mouth and risks

Constant objects in the mouth can wear down tooth and periodontal structure. The possible rubbing on gums can promote injury and cause recession. When gums recede, the bone follows, causing bone loss depending on the level of aggressiveness.

Any chewing, sucking, or drinking of sugary products increases the risk of decay. Chewing and playing with harder objects such as ice or pencils may cause chips or fracturing of the teeth. This can result in thinner enamel and dentin exposure, which increases the risks of sensitivity and decay.

Constant movement of the mouth can promote temporomandibular joint (TMJ) issues. Wearing down the joint through consistent repetitive motion leads to a plethora of problems—jaw pain, headaches, limited opening of the mouth, jaw popping, lockjaw, and arthritis, to name a few. All are debilitating.

If smoking is the chosen fixation, it commonly causes a multitude of systemic and oral health issues, such as periodontal disease, increased decay, xerostomia, and a higher risk of lip, tongue, throat, and mouth cancers. Alcoholism as the drink of choice for oral fixation contributes its own damage as well, causing poor oral habits, dry mouth, a higher risk of decay, an increased risk of periodontal disease especially when combined with smoking, increased clenching and grinding, and a greater chance of oral cancer.

Oral fixation resolutions

Since oral fixation means constantly having objects in the mouth, it’s usually not harmful unless it gets out of control. Ways to resolve these fixations are behavioral, cognitive, and cognitive-behavioral therapies to help develop new behavior patterns. The process of transference—essentially an old fixation transferred to a new habit—allows the individual to consciously deal with the problem. One example is chewing sugar-free gum instead of chewing on ice.

In a child’s situation, recognizing the habit of choice for self-soothing is important to determine the cause of anxiety behind it. Scolding, disciplining, or forcing the child to quit usually isn’t helpful and can encourage further anxiety and power struggles. Dr. Fry says to “watch the behavior, think about what could be causing it, and then work on it together.” One way to help overcome oral fixation is to practice breathing exercises, such as five breaths in and five breaths out, whenever anxiety is felt. If a child uses chewing to self-soothe, give the child gum, crunchy snacks, or “chewelry”—a child-friendly necklace or bracelet designed for orally fixated children. A pediatrician, child psychologist, or occupational therapist may be needed to resolve this behavior, especially if it starts to affect language development. According to Dr. Fry, most children will wean themselves from being orally fixated by the age of 8.4

Editor’s note: This article first appeared in Through the Loupes newsletter, a publication of the Endeavor Business Media Dental Group. Read more articles and subscribe to Through the Loupes.


  1. Oral fixation psychology. Flow Psychology. https://flowpsychology.com/oral-fixation-psychology
  2. Carnevale J, Chapel L, Frye T. Oral fixation signs and causes. Study.com. https://study.com/academy/lesson/oral-fixation-definition-lesson-quiz.html
  3. Cherry K. What is a fixation? Verywell Mind. September 23, 2019. Updated January 27, 2022. https://www.verywellmind.com/what-is-a-fixation-2795188
  4. Loney S. Just the facts, baby. Is your child orally fixated? Justthefactsbaby.com. June 23, 2014.
  5. Definition of oral personality. https://www.dictionary.com/browse/oral-personality
  6. Oral fixation. Psychology Wiki. https://psychology.fandom.com/wiki/Oral_fixation
  7. Freud’s psychosexual stage theory. Changing Minds. http://changingminds.org/explanations/learning/freud_stage.htm