It is easy to understand how comforting a sucking habit can be to a child. With gentle supervision, it is normally very easy to help a child quit the habit before any damage is done. However, persistent thumb or finger sucking beyond a certain age can cause significant tooth misalignment or jaw deformation. The degree of disruption depends on several factors, such as how forceful the habit is, how often, and up to what age the habit is continuing.
Common problems caused by thumb sucking include:
- Protrusive upper front teeth. This can be a simple tooth position problem, where the upper incisor teeth are tipped forward. Occasionally, the formation of the jaw can be affected, and the upper jaw and teeth will develop in a protrusive relationship to the rest of the face.
- Tipped back lower front teeth. The pressure of the thumb forces the lower incisor teeth to tip toward the tongue.
- Open bite. The upper and lower front teeth do not overlap when the back teeth are together. The shape of the opening between the upper and lower front teeth may match the child’s finger or thumb exactly.
- Crossbite. The formation of the upper jaw is too narrow for the lower jaw, so the upper and lower teeth do not fit together properly. This seems to occur as a result of the flexing of the cheek muscles during sucking.
Thumb sucking variables include:
- Duration. Before the age of five, there are usually no jaw formation problems, although you may notice the front teeth getting out of line. Orthodontists do not usually make an effort to stop the habit before this age. After the age of five or six, the shape of the jaw may be affected by the sucking activity, so some action should be taken.
- Intensity. Some children suck a lot harder than others and may cause a lot more damage. Others suck into their teens without any affect on tooth position or jaw structure.
- Frequency. If it is less than one hour each day and the thumb or finger falls out at night, the habit is not a problem even after the age of five. However, if the child sucks all night beyond this age, some action may be needed.
Strategies For Resolving Thumb Sucking
For infants, try a pacifier. Pacifiers do not cause less damage, but it is easier to control a pacifier than a thumb when it comes to phasing it out. (Research indicates that no one particular kind of pacifier is superior to another.) For the child over five, explain the risks, offer rewards, and provide reminders such as nail polish or a band-aid. Avoid scolding or punishment, which just does not work, and it can evolve into a form of negative attention.
The child may need some emotional support, so be prepared to spend a little extra time with him or her. There is no need to talk about the sucking activity or to commiserate with the difficulty of stopping the habit. Instead, spend some extra time on favorite activities, such as stories, a movie, or playing a game or sport.
We Can Help
If you cannot help the child stop, our orthodontists will have some suggestions. Using a retainer (a removable plastic appliance that fits the roof of the mouth) will usually stop the habit. It changes the feeling of having the finger or thumb in the mouth, and the appliance itself seems to satisfy some of the urge to put a finger or thumb into the mouth. If the habit is more tenacious, addition of a habit breaking guard or a crib to the retainer may be helpful. The appliance will need to be used six to ten months to make sure the child has stopped the habit. The orthodontist can make some corrective tooth movements with the appliance as well, if indicated.
Some children will not be able to keep from removing the appliance to suck their finger or thumb. In that case, we may suggest an appliance that is cemented to the teeth.