THUMBS, FINGERS & PACIFIERS:
WHAT PARENTS SHOULD KNOW
My child sucks their thumb. At what age does it become a problem and how can I help them stop?
DR. JOHN SAYS:
"When is thumb sucking a problem?" (I will write about thumb sucking but the same
general statements also apply to fingers and pacifiers.) A thumb habit can be measured in three
ways. First, how often is the thumb
sucked? Second, how long is the thumb
sucked? Last, how intense is the
sucking? Any of the three variables can
influence whether the habit is a problem or not.
If the thumb is sucked often enough, for an
extended period of time, and with enough force there will be changes in tooth
and jaw position. The habit forces the
tongue down. The cheek muscles contract
and cause the upper teeth to collapse towards the middle of the mouth. The thumb will move the front teeth forward
and not allow them to erupt. There are
variations in what the habit will do but these are the basics. The patient will exhibit a crossbite in the
back teeth and an open bite in the front teeth.
"When should my child stop sucking their thumb?"
There are many answers and some will work for some kids but not for
all. Most dentists agree that the upper
limit of a habit is the fourth birthday.
Most agree that parents can begin work on habits as young as two years
of age. I have found the easiest habit to discontinue is the pacifier, because eventually it can be thrown away. In any case, the most important thing is that the child has to be willing and ready to stop sucking. If the child does not want to stop sucking then almost all attempts will be in vain.
"How do I help my child stop it?" There are several approaches that can be
tried. Simply reasoning with the child will
work for some. Offering some type
of reward system is often successful. With the reward system, the parent needs to define the period of time the child has to
refrain from sucking. If they are successful, they will then receive a reward in the form of a
gift or opportunity.
For some children, the habit is so ingrained that a physical reminder is
necessary to help stop the habit.
Band-Aids or unpleasant tasting solutions can be placed on the
thumb. A glove or sleeve can be placed
on the thumb and hand. Finally, an
orthodontic appliance can be placed in the mouth. The other thing I discuss with parents is to bring the pacifier back if the child begins sucking a thumb or finger as a substitute for the pacifier. Then, try stopping again in four to six months.
What to expect: I prepare parents for two things. First, parents need to be prepared for a cranky and frustrated child for several days. Keeping the child active and distracted as much as possible during the day can help these days pass more quickly. Second, the child may have difficulty falling asleep for two to three nights, so parents need to be prepared for a couple of nights of restless sleep. Finding the "right time" for both the parents and the child is very important in helping your child be successful in stopping their sucking habit! There is no magic bullet in dealing with thumb, finger or pacifier habits. The most important thing is to sit down with your dentist and discuss a plan that will result in success for your child.
