Pediatric Thumb Sucking – An Overview

Pediatric Thumb Sucking Overview


Why do  children suck on their thumbs in the first place?

Thumb sucking is a natural reflex for all children and babies.  In fact, it is quite normal for a developing fetus to suck his/her thumb in the womb.  Thumb sucking provides a sense of security to the child.  This is why we see most thumb sucking occur at night or during periods of separation from parents.  It also soothes the child and often helps them fall asleep.  Children will often suck their thumbs after being put to bed for the night as well as any other time of day when they are tired. 

What problems are caused by sucking?

The most significant problems will result due to prolonged sucking when the adult teeth begin to erupt.  This can often occur as early as age 5.  Continued sucking can cause problems with proper growth of the mouth and alignment of teeth.  It can also cause changes in shape to the roof of the mouth.  The intensity and duration of the sucking is very important.  These are the main two factors that determine the severity of problems.

Are pacifiers a better alternative?

Not really.  Pacifiers will cause the same problems as thumb sucking.  The only real difference is that breaking a pacifier habit is typically much easier since it can be taken away from the child.  If you give your child a pacifier, never dip it in food or drink.  This will only heighten the child's attachment to the device.  Additionally, never dip it in sugary foods like honey as prior generations did.  This will cause a significant increase in cavities.  When you go to the pacifier isle at the store you will likely see two primary types of pacifiers:  Orthodontic and traditional.  Orthodontic pacifier nipples have a rounded top and a flat bottom, and were designed to prevent tooth troubles later in baby's life. However, if your baby prefers a rounded traditional pacifier nipple, go with what works. Both types of pacifier nipples have been found to cause dental problems.  In my opinion, limiting the amount of time baby spends with the pacifier and taking the pacifier away after baby's first year are far more predictable methods of minimizing dental damage.

When & how should I help my child stop thumb sucking?

Most children stop sucking their thumbs on their own between the ages of 2-4 years.   For school age children, peer pressure comes into play and often convinces them to stop.  After age four, parents should take a more active role in breaking the thumb sucking habit.  Here are some suggestions:

  1. Don't scold the child for thumbsucking.  Instead, use praise and positive reinforcement for not sucking.  In my office we will give children "homework" to stop sucking their thumb before they have their teeth cleaned again.  They're told they'll receive an extra special reward if they return in six months and mom/dad tells us they've broke the habit.  This basic psychology works very well and can be reaffirmed at home.
  2. Address and try to correct any sources of anxiety in the child's life.  Sometimes this is a very difficult topic for parents to address, but do everything possible to minimize these sources.
  3. Involve your dentist!  Often having someone other than a parent speak about the topic works wonders.
  4. Place a sock or thumb sucking glove over the child's hand at night
  5. Apply non-toxic bitter nail polish to the thumb or fingers.
  6. Consult an orthodontist regarding oral appliances that can assist in breaking the habit.
  7. If none of the preceding suggestions work, and years pass without success, consider a consultation with a childhood psychologist to address the mental aspects of why the habit cannot be broken.

If you would like to speak about pediatric thumb sucking, or any other dental topic, please feel free to call the office and schedule a complimentary appointment with me.  Email and Twitter are also available options.  I am extremely passionate about modern dentistry and love discussing it with patients, so don’t hesitate to contact me. 



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