Thumb Sucking: Should I Be Concerned?

Sucking is a normal baby reflex, which can often persist into childhood. It helps babies and toddlers feel secure and happy, and helps them learn about their world and developing teeth. Thumb sucking is fairly common, and a habit which often starts before birth. (There  are plenty of parents who report seeing their baby sucking his or her thumb in ultrasound  pictures.) It is also soothing, and helps to induce sleep or calms the child when placed in  stressful situations. 

For most kids, it just feels good, so many continue this habit into their toddler, preschool years, and sometimes into their elementary (and middle school years.) 

“Thumb habits” (and pacifier habits, for that matter) can significantly alter the developing  dental arch: they can alter the shape of the arches and the position of the teeth, especially if  the habit continues over a long period of time. Passive sucking may not be harmful to development, but more vigorous sucking can lead to changes in the growth (or expansion)  of the palate, and/or teeth alignment. A proper bite is important for the adult teeth which  are set to replace the baby teeth. This progressive development, which starts in the early  years of development(and thus can be stunted by thumb habits,), can lead to permanent bite  problems, TMJ, and other issues (e.g. sleep apnea, recurrent ear infections.)  

The ADA (American Dental Association) recommends that children be encouraged to stop  their thumb sucking habit by age four, if possible, during waking hours. Daytime habits can  be modified (or halted) with verbal correction, although a few tricks can also be employed.  For the majority of preschool-aged thumb suckers, the habit declines or ceases when the  child notes that few (if any) of their friends enjoy the same habit. Many will stop, or  significantly curtail the habit between the ages of 3-5, just based on observation of their  peers. 

Nighttime thumb sucking habits may fall under a different category, of course, because most  kids are not controlling it… These can be a little more difficult to modify, as they become a  natural part of a child’s sleep routine. 

There are some tips that can help the situation. 

Ways to Help Your Child Quit Their Thumb Sucking 

• Give praise when your child doesn’t suck their thumb. Being supportive and positive  is very important. Employ those around the child to help, as well. Grandparents who  may watch a child when one or both parents are at work, for example. 

• Notice when your child does it, and look for ways to distract them or to provide other  options. Get them active, and their hands occupied, when you feel it is a common time  of day for them to increase their thumb sucking. Sometimes, they’re just tired, and  that is a very common time to revert to the habit. 

• If your child sucks their thumb when they feel anxiety, you should look for ways to  alleviate that anxiety. Providing simple explanations to sometimes overwhelming (or  impending) situations can help, of course

• Work with your pediatric dentist (and the people they see in the office: a dental  hygienist, for example,) to reinforce the importance of decreasing (or stopping) those  habits. 

• For nighttime thumb sucking habits, it can be a little more difficult, and so oftentimes,  some physical aids are recommended. Foul-tasting, painted-on deterrents have been  moderately unsuccessful for most, but have worked for some. 

• Band-aids on several fingers, or a sock over your child’s hand (maybe duct taped to  the forearm…lol) can act as a physical deterrent to nighttime thumb habits. Similarly,  wrapping the arm with a larger Ace bandage (snug, but not tight) from forearm to  wrist, can make it difficult for the child to flex their arm, and may help slowly decrease the habit each night. 

• In some cases, a dental appliance can be designed and placed to physically block the  thumb from occupying the palate space. (And is thought important enough by  insurance companies, that most cover some portion of it.) 

• For most sucking habits, it is deemed appropriate to continue any intervention for at  least 2-3 weeks (especially for nighttime habits,) as it takes time to modify those deep-seated habits. For dental appliances, most are left in place for at least 6-8 weeks,  with follow-up (and a cheerleading/encouragement session with the dental office)  every few weeks, as needed. 

• For daytime habits, a progress chart (maybe a kitty kat calendar with days marked,  for example) is a great way to build momentum in changing day-time sucking habits,  and reaching goals. Rewards for a full week, 2 weeks can be laid out at the beginning,  when goals are discussed. 

• In a similar context, pacifiers (more easily discarded than thumbs, of course) should  be dscontinued over a period of time, with rewards at each stage of quitting. For  some, going “cold turkey” works well, too! 

Being conscious of the thumb sucking problem and working with your child will help. Their  forever smile depends on you and the good habits that you encourage.

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