Thumb-Sucking and Tips on Breaking This Habit, Eventually

Dr. Sameera Yusufmia

It’s always wonderful to watch adoring parents gaze with pride at their newly-born sucking his/her thumb. This self soothing habit gives intense joy to the little ones and us as dentists have recognised and accepted this, hands down!

Sadly though, this cute picture can get quite complicated and ugly when the child continues this habit over the age of four and for some until the age of twenty! In this case we and the majority of society frown upon this.

Thumb sucking is definitely an inborn natural habit that a child uses to comfort him/herself when he/she is:
Some children may develop the habit later when they try and imitate a younger sibling.

As a parent, you need to know:

*When you need to be concerned
*If and when your child needs intervention (either by you or a health professional).

Background facts that you need to consider include:

*About 70% of all children thumb-suck from infancy and naturally grow out of it by the age of four.
*Only about 10% of these continue with the habit after the age of four
*The harmful effects of thumb-sucking are dependent on its duration, frequency and intensity.

Harmful effects that you need to be aware of include:

-oddly shaped fingers or thumbs
*Infections-due to the constant moistened areas the skin gets irritated and infected
*Social –The child may be made fun of at school and socially.
*Dental and Facial- the intense negative pressure that is created in the mouth affects the facial muscles, the teeth and the jaws. The upper jaw becomes more ‘V’ shaped. The upper front teeth flare outward. The lower front teeth tip inward. This results in a child having an ‘open bite’. This is when their anterior upper and lower teeth don’t meet when they bite. This in turn affects their speechchewing, swallowing and facial appearance.

Coping with your child’s habit 
* Let your dentist assess your child at an early age. You will be advised of any noticeable problems if any and subsequently on when you need to try and assist in discontinuing the habit.
* In the case where the child shows very little effect in the mouth, the parent still needs to consider the negative social aspect and try and intervene at least by the age of five.

Studies have shown that most children want to stop by the age of six. They just need to be guided. Your role is to guide them without any pressure. To be firm but calm and to support and praise them every step of the way.
Many suggestions to break the habit have been made and we hope these tips can help you! These are advised for children over four years, as the child must be able to comprehend and show some readiness.

Tip 1. Make your child aware of the habit and understand the ill effects.
The habit may be an unconscious one and you need to identify it with your child. Calmly point out to the child what you don’t like about the behaviour and why. Show them what their fingers /thumb looks like. Point out any calices Simple explanations may help. Talk about ‘bad’ germs that live on their fingers and that go into their mouths and make them sick. You could exaggerate a little, if it helps!

Tip 2.Keep tract of when your child is sucking his/her thumb.
Observe and identify when and how often your child sucks his/her thumb. It allows you to ascertain how deeply entrenched the problem is. If it happens at bedtime, or while the child is watching television, instead of socially then it is considered as a less serious problem. If it is clear that the child is doing it as a direct result of a stressful situation, then you first may have to deal with the child’s emotional well being before trying to stop the habit.

Tip 3.Distraction, keeping hands busy.
By identifying the exact times that the child may thumb-suck, allows the mum to quickly intervene by offering the child something to occupy their hands with. Finger puppets have shown to assist in occupying little hands. Promote activities that use both hands such as doing a puzzle or playing with a ball. (Instead of watching TV with idle hands).If it is a bedtime habit offer the child a soft ball to squeeze instead. Tell the child if they squeeze and hold on to the ball all night it will magically turn into another toy in the morning. You need to then obviously replace the ball with a little treat each day!

Tip 4.Creating a reward system
Breaking the habit is much easier when the child is a willing participant. Make a progress chart with the child; let him or her choose the stickers. Set an attainable target specifying the number of days. The child can then be given a star for each day that he or she doesn’t thumb-suck. When the target has been reached a desired reward is earned. To permanently end the habit a chart for few months is recommended. Daily praise for each star earned is paramount. In addition discuss with the child, how many slip-ups he is allowed and stick to that.

Tip 5 Controlling temptation
Many deterrents have been used and are available and have worked with some success especially in older children. Topical bitter substances, bandages, glove-like devices are normally used and worn on the offending finger.

Tip 6.Scheduled thumb sucking-partner in crime
This is a controversial suggestion, but has shown some positive results. A pact is made with the child. The child is asked to engage in the habit only at a specific time for a certain time daily. This is aimed at making the habit obligatory instead of involuntary resulting in it becoming less appealing to the child!

Tip 7.Dental appliance
If you have been unsuccessful with the above stated tips, don’t despair, there is a last resort. The greatest benefit of this is that it stops the habit in its tracks. It involves placing a fixed appliance in the child’s mouth (over the age of 6).It has a ‘gate’ or ‘crib’ like wire that lies behind the upper front teeth and prevents the thumb from getting to touch the palate .
Before choosing this intervention the child and parent must be educated and prepared.
Due to the immediate halting of the habit, the following problems may be expected:
*unhappy, irritable child
*few restless nights
*irritation and infection on palate caused by the appliance in the mouth.
In most cases the benefits have outweighed the risks. The child has normally continued treatment with more appliances to correct any other problems caused by the habit.

Finally one must understand that a habit takes time to develop and thus, it will also take time to be replaced by an alternative. As a parent be patient, consistent and focused on helping your child. Seek constant guidance and support if necessary.

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