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Thumb Sucking Solutions Offered by Dr. Debra Fink, a St. Louis Orthodontist

What Should You Do About Your Child's Thumb Sucking?

I have found that many parents that visit my St. Louis orthodontic office ask me questions about their children’s thumb or finger sucking behavior, so I wanted to write a post to address many of these valid concerns. Although this type of behavior may not be immediately evident when your child is born, ultrasound scans have found that this activity often begins before birth because babies are born with a natural sucking reflex that allows them to obtain nourishment. Even though this reflex disappears during a baby’s first year, many children continue to suck fingers or thumbs as a coping mechanism when they are tired, hungry or upset as it is pleasant, calming and it provides them with a sense of security. This is why many babies engage in this behavior as they are in the process of falling asleep. Thus, it is important to note that this activity is a very normal response to anxiety and stress and generally is no indication that a child suffers from insecurity or emotional problems. As a result, parents should not be alarmed if their babies regularly suck their fingers or thumbs, so long as they are kept clean.

What happens if children do not stop the sucking habit

Between the ages of two and four, most children stop sucking their fingers and thumbs on their own according to the Journal of the American Dental Association. That is, this type of activity tapers off naturally as children become more active and seek to use their hands to explore their surroundings and as children enter school or play groups they may also feel peer pressure to stop placing their fingers in their mouths. However, if your child continues this behavior after the age of four, you should take corrective action as will be described below. At this age, your child’s permanent teeth begin to emerge and regular finger or thumb sucking beyond this point may cause damage that will require extensive orthodontic treatment to correct.

Even so I have learned from my years of treating children as a practicing orthodontist in St. Louis that there are a number of factors that will determine the extent of the difficulties that will result from this type of habit. The first factor is the intensity of the thumb or finger sucking. If your child sucks passively with the thumb or finger gently resting inside the mouth, it is less likely to cause difficulties. If, on the other hand, your child sucks his finger or thumb intensely and creates a significant amount of pressure in his/her mouth, it can lead to problems with tooth alignment and jaw growth. The second factor is the amount of time your child spends engaging in this activity. If it is regular and habitual, especially during the day, it is more problematic than the occasional thumb or finger sucking, especially if it only occurs while your child is falling asleep.

Depending on these factors, there are a number of common problems that result from regular thumb or finger sucking once the permanent teeth have emerged. If you see any of the following signs you should schedule a free consultation at my St. Louis orthodontic office.

  • An overbite which means that the upper front teeth protrude and the lower front teeth may also point backwards to some degree.
  • An anterior open bite which means that there is an opening between the upper and lower front teeth, when the back teeth are biting together, which results as an accommodation to the thumb or finger sucking.
  • A crossbite which means that there is an underdevelopment of the upper jaw, which often causes the lower jaw to shift to one side and thus the teeth and jaw become improperly aligned.
  • A recessive or weak chin, which means that the lower jaw does not develop properly.
  • Speech and chewing difficulties may also occur in the more pronounced cases.

What can be done at home to stop the thumb sucking habit

There is widespread agreement that you should take a positive approach with your child to help him/her overcome this habit because this will allow your child to build confidence and take pride in his/her accomplishment. A negative approach that involves criticism is unlikely to work and may even worsen the situation if your child seeks negative attention from re-engaging in this behavior. Even so, you should attempt to gently explain the consequences of this habit to your child. At the same time, here are some suggestions that you can implement on your own to help your child stop this activity:

  • At my St. Louis orthodontic office, we have found that your best option is painting or smearing a bad tasting substance such as Mavala on the thumb or finger, because it will stop this behavior in most children very quickly.
  • If you notice that your child is engaging in this activity because he/she is anxious, tired or hungry, then try to calm down and/or resolve the particular situation rather than focusing on the thumb or finger sucking behavior at that time.
  • You should take note of the particular times that your child tends to engage in this activity such as during car rides or while watching television and then attempt to create distractions during this time.
  • If the finger or thumb sucking habit occurs primarily when the child is engaged in a secondary habit, such as holding a security blanket or a favorite stuffed animal or twirling his/her hair, it is a very good idea to attempt to correct both habits at the same time. That is if you get control of the secondary habit, often the finger or thumb sucking habit disappears or is greatly reduced on its own.
  • You can start a progress chart and have your child place a sticker on the chart for each day he/she is successful at avoiding this activity. Explain that if he/she goes for an extended period of time, such as a week, without engaging in this behavior that he/she will be able to choose a prize from a list that the two of you can create together.
  • You can put a bandage around your child's thumb or finger or a sock around his/her hand at night. Alternatively, you can use an oversized long sleeve shirt or sweater that completely covers the hands. You should let him/her know that this is not a punishment, but rather it is a method for helping to remember to avoid this activity.

How can an orthodontist help to stop this habit

If none of the solutions proposed above end the habit by the time your child’s permanent teeth emerge, it may be time to seek professional orthodontic solutions. One such common solution is a device called a “fixed palatal crib,” usually referred to simply as a “crib”. I offer this type of device at my St. Louis orthodontic office and it is essentially a small orthodontic appliance that is placed on the upper teeth and the roof of the mouth and is almost invisible to outside observers. The crib is a very effective solution that usually stops the thumb or finger sucking habit very quickly because it removes the enjoyment from the behavior. This is because the crib prevents the thumb or finger from touching the gums behind the front teeth and the roof of the mouth. Even so, you should be aware that your child likely derives a substantial amount of comfort and security from this behavior so he/she is likely to be restless, unhappy and uncomfortable after the crib is inserted. You can alleviate this by providing the child with extra affection and attention for a short time while your child adjusts to the new orthodontic appliance in his/her mouth.

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