Dr. Peter, a pediatric dentist at VK Pediatric Dentistry in Arlington, VA often gets asked the question: "when should I be concerned with my child's thumb sucking?" or "how can I get my child to stop sucking their thumb?" It's a common question to a common problem in pediatric dentistry so lets dive in with a blog post.
First, we will address the problems that can be caused by a habit such as finger or thumb sucking. Second, we will address appropriate ages to stop. Third, we will offer some suggestions and advice to help even the most stubborn habits in children.
Negative Consequences of Thumb Sucking.
1) Pressure from a thumb/finger can cause constriction of the muscles of the mouth (including cheeks) which can limit the growth of the jaws, preventing them from growing to their proper size. This may lead to poor tooth relationships (crossbites) or jaw size discrepancies. It effects growth and some of these effects can be permanent if not addressed at a proper age.
2) A finger or thumb in the mouth will generally sit in the roof of the mouth, which is where the tongue should be. This can change the shape of the entire palate from a U to a V shape (which can look very poor aesthetically but also have other negative effects for growth and development).
3) When the tongue cannot sit where it normally should (in the upper palate or roof of the mouth) it will naturally want to go somewhere else, often times lower in the mouth closer to the bottom teeth. This can lead to improper tongue posture and may effect a child's sleep quality and breathing quality.
4) Thumb sucking can permanently alter the eruption location of permanent teeth, leading to something called an open bite. This causes the teeth to stick out (giving a buck tooth appearance) with excess overbite and overjet, as well as increase the risk of trauma to the front teeth.
Common presentation (moderate to severe changes) due to extended thumb sucking in a child.
When Is Thumb Sucking Normal?
As infants learn the basic function of their mouth, from sucking on a bottle to learning to speak, it's a very natural habit to start sucking on their thumbs or other fingers (and often times can include lip/cheek sucking, or sucking on a piece of clothing).. As long as the fingers are kept clean and the habit is kept it check, it's a normal habit that often ends after a few short years. The main problems start when infants start growing and continue the habit.
Age Recommendations:
Age 2-3: Thumb sucking is generally considered normal at this age but the most important thing to consider is how much time is spent with the habit (i.e. is it only at night to fall asleep or is it all day, what is the frequency, how long has the habit been taking place). Dr. Peter generally recommends trying to stop the habit by age 3 at the latest.
Age 3-6: This is a very important age for trying to eliminate a habit before the permanent teeth have erupted. In general, most children will start getting their permanent incisors (front teeth) around age 6 and if the thumb or finger habit has resolved by then, there is a greater chance of being able to correct an open bite and other negative consequences. This doesn't mean you should wait until a child has turned 6, though, as there can be changes to the palate and teeth before age 6. The longer a child continues a habit, the harder it can be to break that habit.
Age 6+: The longer you wait after age six, the greater the chance that there will be negative consequences. Although an orthodontist may be able to correct some of the consequences of the habit, it is much more difficult as a child gets older and may result in more costly treatment or extended treatment times.
In summary, thumb sucking can be considered normal until age 2-3. After that age, there may be negative consequences in the bite, tooth alignment, jaw, and orofacial function. Visit a pediatric dentist to address any concerns as well as diagnose any issues that may be occurring!
How Can I Get My Child to Stop Thumb Sucking?
This can be a source of frustration for many parents trying to stop their child from sucking their thumbs. "Do you want to stop sucking your thumb? "NO!" is a pretty common answer for the persistent. There is no one solution that will be effective in getting a child to stop sucking their thumb if they don't want to stop. Some children take longer to age psycho-socially and to understand the negative consequences that may be associated with thumb sucking. The most important things a parent can do is get a child to understand that they can't continue to suck their thumb, often by constantly reminding/letting the child know that this isn't a healthy habit. Some tips:
1) Constant reminders. The first goal is to establish that a child shouldn't be doing it. Some kids start to realize this pretty quickly but some kids need constant reminders (sometimes for weeks). You'll have a frustrating time and sound like a broken record, but every time you see your child's finger in their mouth, just remind them not to do it. You need to establish a mental connection that this is a 'bad' action. Some kids understand that hands are dirty or finger sucking is just for babies. Some kids may need a more creative approach but don't give up.
2) Mavala Stop: This is a bitter flavored nail polish that you can pain on the fingernails. This is one of the easiest options to try, though, I've found limited success with very stubborn habits. This method generally only works if a child is motivated to stop (and knows it's a habit they shouldn't be doing) but is doing it subconsciously and 'forgets' soemtimes. This is a gentle reminder to not place their fingers in their mouth. Smart children will lick the polish off but if kids are motivated to stop, this can serve as a very good reminder with the bitter flavor.
3) T-Guard or Aeroguard: I've found the greatest success with these appliances. They are placed directly onto the finger and can help break a habit. I definitely recommend wearing these for at least 3-4 weeks for a stubborn habit but they are designed to be ventilated, comfortable, and difficult to remove for children. The guards do not prevent the thumb or finger from going in the mouth, but they do prevent suction so there's no longer any pleasure left in the habit. Without the pleasure, children have no incentive to continue. We recommend getting one for each hand and sticking with it (especially at night) consistently for 3-4 weeks.
4) Elbow Straightener: This is a device that is placed on a child's elbow to prevent them from fully straightening their arm (and thus preventing their fingers from going in their mouth). This can be an effective solution for children at night who are sucking a thumb or finger subconsciously. I don't love these and don't recommend them very often but I have had some families use them with success.
If all else fails, visit a pediatric dentist. Dr. Peter Markov is expertly trained to help diagnose and address any habits that may be negatively impacting your child's growth and development. There are a variety of treatment options including expanders, bluegrass appliances, or habit crib/rakes that can help the habit stop.
VK Pediatric Dentistry
5001 Lee Hwy, Arlington VA 22207
Schedule An Appointment Today in Arlington, Virginia at VK Pediatric Dentistry
If you haven't taken your child to a pediatric dentist yet or would like to schedule an appointment, Dr. Peter and the highly skilled team at VK Pediatric Dentistry are just a phone call away. Schedule an appointment online or call us today at 703-962-7814. We look forward to providing your children a lifetime of healthy and happy smiles!