Thumb Sucking: Breaking the Habit

Before breathing, before birth, children will suck their thumbs. Sucking is a natural reflex that is practiced and coordinated prenatally (before birth). We have all seen the pictures of fetuses in their mother's wombs with their thumbs in their mouths. After birth, sucking provides baby's first nutrition.

Thumb or finger sucking is a convenience for parents. Children who suck their thumbs are able to comfort themselves in a variety of situations. They may be more independent. Children find their own thumbs easier than pacifiers. Thumbs are always the right size. While a damaged pacifier is dangerous, thumbs never wear out. It's easy to understand why thumb sucking is so prevalent and so hard to quit.

The major dental problem caused by thumb sucking is malocclusion. Teeth, lips and jaws have a natural relationship. Consistent pressure of the thumb or fingers against the teeth alters the normal growth of the teeth and jaws. This force can cause the upper teeth to protrude and the lower teeth to retrude. In addition, the bone that supports the teeth, even the entire lower jaw may be held back in a slower growth pattern. The habit usually stops by the time the child is five years old, and the damage usually reverses itself.

Finger habits are much harder to break than pacifier use. Pacifiers may be taken away or left behind. Fingers are always available. Sometimes, children continue their finger habits until they are older. They may need the security of sucking. The onset of puberty brings a shower of emotions that may increase the difficulty of breaking any soothing habit. Children who continue finger habits past five years old may need some type of intervention.

There are several techniques recommended for the cessation of finger sucking. Most often, children just loose interest, or peer pressure ends it. Parents, who notice a habit lasting past the fourth birthday, may help their children with a system of encouragement or rewards. A day without thumb sucking can be rewarded with praise or a special treat. The final cessation of the habit might deserve a larger reward.

Children with a more intransigent habit might require a more aggressive solution. Common recommendations include techniques that remind the child not to put their finger in their mouth or that break suction which makes the activity less satisfying. Bandaging is often recommended by physicians, dentists and parents. This may be as simple as a character bandage on the finger or thumb or as complicated as wrapping the hand in a mitten, an ace bandage or even bandaging the hand to the child's body. Most children have no trouble defeating bandaging. This technique is only effective for children who already want to stop.

Another technique that serves to remind children of the problem is to paint bitter or spicy materials their thumb or finger. The bad taste can be a deterrent to keeping the finger in the mouth. Some children can develop a taste for anything on their thumb.

Some dentists recommend taping a finger puppet, tongue depressor blade or a Popsicle stick to the finger at night. The feeling of the puppet or stick is a reminder of the attempt to stop the habit. Additionally, something attached to the thumb prevents suction.

Dentists treat older children by attaching devices to the teeth. A classic appliance that is commonly used is the "crib". The crib looks like a short row of fork tines hanging from the roof of the mouth. Another device, the "blue grass appliance" supports a large plastic bead just behind the upper front teeth. These devices accomplish both of the objectives of the treatment of finger habits - reminding and reducing suction to lessen enjoyment.

There are resources for parents who would like to help their children break the finger habit. The Totline of the Massachusetts Dental Society accepts questions on children's dentistry, and is available through their website www.massdental.org/public. The best plan is always to speak with the professionals who know you and your child. Talk with your dentist, hygienist or your child's physician.

Won't all children eventually stop their finger habit without help or stress? Most will, but timely cessation is an advantage when preventing orthodontic problems (problems with tooth alignment). Another factor to consider is that some people don't ever give up their habit. Some adults suck their thumbs or fingers. They do so for comfort and relaxation. They usually do so in private, afraid to be caught by their friends or family. Their stories are poignant and thought provoking. Read them on their award-winning web site: www.thumbsuckingadults.com.