Thumb Sucking! What should I do?

One of the more common reasons parents of very young children enter an orthodontic office is to discuss thumb sucking. Thumb sucking is a very soothing, subconscious habit that can make permanent changes in the tooth and jaw positions if persistent. Many parents and their children have significant difficulty deciding why, when and how to address this issue.

When should I start to worry?

Most dentists and orthodontist agree that if the habit is broken by age 4 or 5 there should be few long term issues associated with the habit. Most importantly, thumb sucking should be ceased by the time the first permanent teeth are erupting. Usually children will stop sucking their thumb during the day due to peer pressure. How intensely a child sucks on fingers and thumbs will determine whether or not dental problems may result. Children who rest their thumb passively in the mouths are less likely to have difficulty than those who vigorously suck their thumb.

What will happen to my child's teeth?

The thumb can make a very powerful impact on the development of proper alignment and occlusion (biting) of the front teeth and form of the upper jaw. You may see the upper front teeth pushed forward with or without spaces between the teeth. The lower front teeth may be pushed back. The upper and lower front teeth may have some space between them in an up and down direction. This is called an open bite and sometimes causes difficulty chewing and/or with pronunciation of certain sounds. If the habit persists long term, it can cause the front teeth of the upper jaw (the premaxilla) to deform permanently to accommodate the presence of the thumb.

Secondary to the thumb habit, other long term effects may be present. Even after a thumb habit has ceased, an open bite in the front teeth may persist due to the presence of a tongue thrust. This is a forward positioning of the tongue during speech and swallowing that seals off the spaces between the teeth as a compensation during normal functioning. This habit can be even more difficult to break than the thumb habit sometimes requiring retraining exercises over an extended period of time. The presence of the thumb in the mouth also causes the tongue to rest lower in the mouth, taking away its ability to aid the development of the proper width of the upper jaw. This lower posture can lead to the development of a narrow upper jaw and a cross bite of the back teeth.

How can I help my child break the habit?

Most children stop sucking their thumbs without much intervention at all. However, some individuals need more help. First of all...in order to stop, they need to want to stop. Make sure you use positive reinforcement when trying to break this habit. And...don't be shy about involving your child's dentist, physician or orthodontist. A discussion with someone other than a parent can be helpful encouragement and take some of the pressure away from other family members when dealing with this sensitive issue.

Many devices have been developed to stop children from sucking their thumbs. Plastic thumb guards, thumb splints, spicy or bitter tasting paste to paint on the thumb, socks on hands, and other methods have been developed to aid parents with this difficult task. These methods can all be effective, but will not work for all children. Most importantly, don't make your child feel bad if they are having difficulty. Stopping this habit is the same as taking away a comfort item like a blanket or pacifier. They should be rewarded and encouraged when they have made positive changes. Also...sometimes the first attempt at habit modification is not successful. If this happens, take a short break and try again. Eventually, with persistence, you will be successful.

Consult your local orthodontist if you are having difficulty and need advice. And, remember...ask questions! The more you understand the information being presented to you, the better you will feel about the decisions you will make.