Thumb sucking: a worrying sign your child might need an early orthodontic assessment

Thumb sucking is a common behaviour among babies and little kids.While we understand babies instinctively put just about anything in their mouth until around four months, thumb sucking isn’t instinctive. Actually, thumb sucking is thought to be reflexive, and more a technique used by a child to self-soothe. Many children simply grow out of the habit of thumb (or finger) sucking, however there are some who don’t. If it continues – and you notice it’s affecting your child’s teeth – then it could be a sign your child needs an early orthodontic assessment.Certain behaviours and characteristics are indicators or pointers to the potential need for orthodontic treatment.  At a certain age and stage, thumb sucking is one of these.Thumb or finger sucking: is it really that bad?Who doesn’t love a bit of self-soothing? Any parent will know their child’s ‘go-to’ thing to calm down, sleep or relax. For some kids, their self-soothing just happens to be their finger or thumb.Up until the age of four or five years before adult teeth erupt, this isn’t a concern, however beyond this, thumb or finger sucking can be detrimental.Continued long term, thumb or finger sucking can affect the eruption and position of teeth and jaw growth. Down the track, this means orthodontic treatment. Among the common problems caused by thumb sucking are protruding upper front teeth, tipped back lower teeth, an open bite and a cross bite.Protruding upper teeth – Front teeth protrude for many reasons, such as thumb sucking, tongue posture, and a difference in size between the upper and lower jaws. Open bite – An open bite occurs when your teeth do not close together, i.e. your back teeth bite together, but your front teeth don’t, causing a gap between your top and bottom teeth. This can result in a person having trouble with eating, biting, chewing, and wear on back teeth. Sometimes patients also struggle to make certain speech sounds.Cross bite –  A single tooth or multiple teeth don’t bite together properly as one or more teeth sit too far in on the roof of the mouth or too far towards the cheek. Occurs when the upper and lower jaw size does not match in width or the teeth are not aligned well.Although thumb sucking is not the only contributing factor to these conditions developing, it’s important to address it appropriately if it is. Not surprisingly, your local orthodontist can help.What can you do to stop your child thumb sucking?Many parents come to me concerned because they don’t know how to stop their child thumb sucking. Occasionally, their concern for remedial treatment is driven by a child being bullied. In any case, early intervention by an orthodontist can be very beneficial (and maybe even necessary) for the child’s mental and emotional wellbeing. When I see patients and parents in this situation, I usually recommend several strategies to help break the thumb sucking habit.Depending on the child’s age, I usually start by checking the parents have exhausted simple home remedies. If they have, and the child is of an age where an impression of the teeth can be taken I might prescribe an appliance designed to prevent the child from putting their finger in their mouth. This may may be a thumb crib or an expander with a thumb crib. Sometimes I’ll even engage in some counselling, for both the child and parents.One thing I’ve found that definitely doesn’t work (but tried by every parent!) is: nagging. Because it’s so universally unsuccessful, it’s not a treatment pathway I ever recommend! Are you ever too old to stop thumb sucking?It can be easy for parents to dismiss thumb sucking as ‘just a phase’ and for the majority of kids, this is true. However, if you do this too long – and delay your initial consultation with an orthodontist – the consequences can be dire. I once had a patient who was 15 years old at the time of treatment and still sucked her thumb. Apart from the orthodontic issues, which included a crossbite, protruding upper teeth and a lisp, the girl’s habit of thumb sucking had wrought havoc with her confidence and emotional wellbeing. By the time she was receiving treatment as a young woman, she was too embarrassed to sleep over at a friend’s place. Why? Because she was concerned her habit would be discovered. Addressing long standing self-soothing habits like this can be a challenge, but is certainly worth the effort. This young woman could have avoided the social embarrassment and associated orthodontic issues if she had been seen by an orthodontist for an early childhood assessment. If you’re concerned thumb sucking is an issue for your child, it’s worthwhile seeing an orthodontist to gain a clear understanding of what might be needed to prevent or reduce treatment in the future.Dr Sarah Dan is an orthodontist and an advocate of early interceptive assessment to help improve treatment outcomes for children, including those children with the habit of thumb sucking. Through her experience as a clinician, and having orthodontic treatment as an adult herself, Sarah truly understands the orthodontics from the patient’s perspective. She ‘gets’ it and has developed her unique 5-Step Process to help patients navigate the treatment journey to a confident, beautiful smile at any age and stage of life.

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