What is a thumb sucking habit?
It is a habit where a child places his thumb inside the mouth and sucks it. The sucking action exerts pressure on the teeth and the soft developing bones of the face. Constant pressure from thumb sucking causes the facial bones and teeth to shift, resulting in long face with crooked teeth. Therefore, you need make effort to stop thumb sucking in your child.
Thumb sucking is a normal childhood behavior and is not a concern in the early 3-4 years of child’s life.
Moreover, a few children exhibit a finger-sucking habit. However, it is relatively less common than thumb-sucking.
When does thumb sucking start?
It is common for infants and toddlers to suck their thumb because it brings happiness, a sense of security, warmth, and being wanted.
Newborn Thumb sucking is quite common and is seen as early as 29 weeks in the mother’s womb.
4-6 months old thumb sucking often coincides with the appearance of the first pair of baby teeth. The irritating gums compel the child to put his fingers in his mouth to ease the irritation and divert the focus.
Breastfeeding satisfies a child’s instinctive suckling habit and gives them a feeling of being wanted and protected in their mother’s arms. Children who don’t get enough breastfeeding satisfy their instinctive suckling habit with a pacifier or thumb-sucking. Moreover, kids using pacifiers for prolonged duration are less likely to develop thumb sucking.
Thumb sucking in the first two years doesn’t cause any permanent damage to the teeth and face. However, thumb sucking continued after age 3 or 4 has detrimental effects on the growing facial bones and erupting permanent teeth.
The damage to the teeth is temporary for the first 3-4 years and is confined to the front teeth, provided it is stopped before age six.
Thumb sucking for more than of 4-6 hours, continuing for over a year, produces positional changes in teeth and jawbones.
What are the effects of thumb sucking?
Effects of thumb sucking on the face and teeth
A habitual thumb-sucker child has typical thumb-sucking teeth and facial appearance that results from placing a thumb for prolonged periods daily for over a year:
Narrow v-shaped arch: Narrowing of the upper jaws occurs due to prolonged cheek and lip muscle contraction during thumb sucking, forcing the jaws to move inwards from the side. 4-6 hours of daily pressure for over a year can shift teeth and bones. Although the lower jaw growth often remains unaffected.
Buck teeth and anterior open bite: During thumb sucking, the thumb placed between the upper and lower front teeth moves the upper front teeth forward and the lower front teeth inward. The thumb pad resting against the edges of the upper front teeth also pushes them into the bone, opening the bite.
Deep V-shaped roof of the mouth: The two (right and left) palatal bones form the roof of the mouth and are joined in the midline by a joint. During the early years of life, the intervening soft fibrous tissue keeps (the saw tooth-like) edges of the palatal bones in place. The palatal joint fuses (calcifies) between 11-16 years (11-13 in girls and 14-16 in boys). Constant pressure from the thumb opens the joint and causes the roof of the mouth to deepen at the area where the thumb pad is placed.
Thumb sucking blister on the thumb
The thumb of the thumb-sucking child appears red with a blister due to constant exposure to saliva in the mouth. Because of the prolonged exposure of skin to moisture, the only treatment required is keeping the finger/thumb dry and clean to prevent any infection.
Speech difficulties in thumb suckers
Lisp is commonly seen in children who have a habit of thumb-sucking. These children have difficulty making s and z words.
Anterior open bite and forward positioning of the upper teeth in a thumb sucking child causes them to place their tongue forward in the space between the upper and lower teeth. This forward positioning of the tongue is known as tongue thrust and is an abnormal tongue position. Typically, the tongue rests behind the lower teeth.
When we speak, our tongue articulates with upper teeth, front palate, and lips to make different sounds. The lisp is produced when the tongue moves too forward to create the ‘s’ sound but makes a ‘th’ sound instead.
S sound is an unvoiced sound produced when the tip of the tongue is brought near the roof of the mouth, and the air is pushed past the tongue to make a hissing sound. On the other hand, the z sound is produced by the same tongue articulation, but is a voiced sound, heard by the vibration of vocal cords.
Therefore, anterior open bite and the forward positioning of the upper teeth impact your child’s speech. Intercepting the problem at an early age with an orthodontic treatment, habit breakers, and speech therapy can help with your child’s speech and appearance.
what are the Reason for thumb sucking in babies
Following are the reasons for the babies sucking their thumb or fingers:
- The sucking action gives them a sense of safety and joy.
- Kids also start thumb-sucking when their teeth are erupting as it eases the irritation caused during teething.
- In infancy, stimulating the mouth lining through sucking brings pleasure and satisfaction to the baby and is accomplished through breastfeeding. At such a young age, the mouth is considered an oro-erotic zone. Therefore, the babies who don’t get enough breastfeeding and are bottle-fed start thumb-sucking to eliminate their desire for breastfeeding.
Prevalence of thumb-sucking – how common is thumb sucking?
The percentage of thumb-sucking habit decreases with the age of the child and is more common among girls than boys. According to a study on the Swedish population, 82% of children had thumb-sucking habits during the first five months of their life.
Another study revealed that 72% of US children between the ages of 2 and 5 have a thumb-sucking habit.
A 2014 research shows that about 48% of children at four years of age and 12.1% of children older than seven years have a finger or pacifier-sucking habit. The practice continues in 1.9% of 12-year-old children.
According to a recent study, 45% of 3-4.5-year-olds showed digit sucking, 13.6% in 6 yr old, and 5.9% of children of 7-11 years.
What are the Easy ways to stop thumb sucking
There are several ways to end or discourage thumb sucking at an early age:
Phycological therapy
It involves diverting the child’s attention towards play or toys and motivating them to discontinue the habit. For that, you need to be more affectionate to your child.
Reward therapy
Reward therapy is a way to motivate your child to quit thumb sucking. You can incentivize your child with a present they like upon discontinuing the habit. Ask the child to stop thumb-sucking for 3 or 5 days initially and then work your way up. For a young child, it may be challenging to comply if asked to discontinue the habit for more than five consecutive days.
Start slowly. It takes 21 to 40 days to make or quit a habit. Start with 3 to 5 days and increase it if the child complies. The reward shouldn’t be costly. It should be a toy or anything that motivates your child.
Reminder therapy
The reminder therapy aims to remind the child when he takes his thumb to the mouth. This therapy is helpful in children who are motivated to quit the habit, but involuntarily do it. Thumb-sucking habit, like other habits, becomes autonomous and requires conscious reprogramming to stop the practice. Reminder methods forbid them and train their mind not to take the thumb to their mouth.
The “reminder” must be neutral and not perceived as the only form of punishment.
The following measures can be used to remind the child to stop thumb sucking:
Femite
Femite, a bitter tasting solution, can help quit thumb-sucking. Femite is used to treat skin infections and contains bitter-tasting Denatonium benzoate. A few parts per million of denatonium benzoate is extremely bitter and its application discourages the child to take his thumb to the mouth.
How to use it? Apply the solution liberally to the skin and nails and allow it to dry for 10minutes.
Thumb-sucking nail polish
Bitter-tasting nail polishes containing Denatonium benzoate effectively stop the child’s habit and are available over the counter.
It can be used to stop thumb sucking in both children and adults.
The stubborn nocturnal thumb sucking in children often doesn’t comply well with to this method because the child involuntarily sucks his thumb while asleep.
NIPIT and stopper
NIPIT hand stopper is a flexible elbow guard wrapped around the elbow to restrict movement. This elbow guard remind the child not to take his thumb to the mouth. It is comfortable to wear and allows unrestricted child’s hand movement while playing. However, it limits the range of elbow movement past 100 degrees.
The child can still bring his hand to the mouth with the guard around the arm but with great effort. Most children willing to give up the habit respond well to this therapy and stop thumb sucking.
Elbow guard with a musical device
Some elbow guards have a musical device installed facing the elbow that turns on the music whenever the child bends his hand to take it to the mouth. The guard doesn’t allow the elbow flexion enough to take the finger to the mouth.
Thumb sucking guard
A thumb guard is a highly effective and inexpensive way to treat your child’s thumb sucking.
Tguard Aero thumb is an FDA-approved thumb guard for thumb suckers. Dentists, orthodontists, and pediatricians have recommended it for 20 years. The device covers the sucking digit and is strapped on the wrist to secure it in place. They are flexible, lightweight, airy, and don’t allow moisture buildup on the covered areas.
The child can take it to the mouth, but the device prevents the formation of suction. The child eventually loses motivation and stops thumb-sucking. The results can be seen within 30 days. Most people report their child quitting the habit within seven days.
Thumb sucking glove
Thumb sucking glove is also a cheap alternative to prevent the formation of suction upon digit sucking.
Appliance therapy
Thumb-sucking appliances are given when the child doesn’t respond to other methods. It requires a customized appliance fabricated in the lab on your dentist’s recommendation. The devices are either fixed or removable.
Habit breaker appliances: Fixed palatal crib and hay rake are bonded to the upper teeth, while the removable devices are delivered with clasps on the molars. They have fence-like features that cover the mouth’s roof and make the thumb placement uncomfortable.
Bluegrass appliance is another device that has a Teflon roller to hinder thumb placement.
Jaw expanders: Quad helix or hyrax expanders widens the upper jaw in children with narrow upper arches and posterior cross bites. They also work as a habit breaker and prevents child from putting his thumb/finger in the mouth.