Thumb sucking

Does sucking on a thumb cause orthodontic problems later on in life? Question answered by Dr Dana Elliott Srither.

Infants and toddlers start sucking their fingers and thumbs as a means to explore the environment around them. It is an essential step in their development.

However, a handful of young children continue to suck their thumbs past the age of 5 or 6. These children need to be identified and treated before their thumb sucking leads to severe malocclusions (misalignment of teeth).

Most experts agree that a thumb sucker younger than 5 shouldn't be pressured to stop. Most children will give up the habit on their own before they enter kindergarten.

In fact, more than three-quarters of infants suck their thumbs or fingers through the first year of life. A child usually turns to the thumb when bored, tired, or upset. It is not uncommon to see a thumb sucker simultaneously engage in other behaviors, such as twirling a strand of hair, holding onto an ear, or rubbing a ‘blankie’.

Chronic thumb sucking can cause large open bites and posterior cross bites (the constriction of the upper back teeth). The effect of thumb-sucking depends on the child’s age, the duration, consistency and force of the act. If identified before the maxilla (upper arch) is completely formed, usually around age eight to nine, many of the occlusal problems due to thumb sucking can self-correct. If, however, the habit is ignored or allowed to continue, then the dental malocclusion caused by thumb-sucking could require complex orthodontic treatment in the future.

Breaking a habit is a much easier feat when the child is a willing participant. Many parents have success with a simple behavioral approach that engages the child in the process.

Here's how it works:

First, do not mention about the thumb sucking for one month. If finger-sucking is part of a power struggle, not mentioning it may help extinguish the behavior. Next, buy a poster board and stickers to make a "progress chart". Offer a prize at the end of each week for no sucking -- and a larger reward at the end of the month. Make sure that your child has an active role in the plan; for example, decide together how many slip-ups he's allowed each week and have him choose the stickers and place them on the chart.

It may also be helpful to place a bitter-tasting liquid on the nail (not directly on the finger), especially at night, as a reminder not to suck. Products for this purpose are sold over the counter, but home remedies can be just as effective. Perfume is a good source. Each night for two weeks, get the child to choose a bottle of perfume from your collection. Place a dab at the tip of his finger. They may find the taste disgusting. Mittens, gloves, or a finger-splint may also be worn at night. It may take six weeks or more to successfully break the habit.

While your child is trying to change his or her behavior, it's essential to give lots of praise and support: an extra cuddle, a special outing, playing a new game together. Be aware of situations that might promote thumb sucking, like TV or riding in the car.

If this program doesn't work, don't despair. Breaking a longstanding habit is difficult and some children may need additional help. Talk to your child's dentist, who may recommend oral appliances that go by names like "palatal bar" and "crib" and come in either fixed or removable versions.

Answered by:

Dr Dana Elliott Srither MBBS (S'pore), Grad Dip Family Medicine, is a certified Family Physician who believes in the principles of "Get Well" and "Stay Well".

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