THUMB-SUCKING

General Information

DEFINITION--Placing the finger or thumb on the roof of the mouth behind the teeth and sucking with lips and teeth closed. Thumb sucking is common and is a behavior, not a disorder.

BODY PARTS INVOLVED--Mouth; teeth; tongue; pharynx; finger or thumb.

SEX OR AGE MOST AFFECTED--Children of both sexes up to age 12, but most common in young children.

SIGNS & SYMPTOMS--Sucking of the thumb (most likely to occur before going to sleep, watching TV, or when hungry, ill or tired).

CAUSES--Thumb sucking is one of the first coordinated acts that an infant can do that brings comfort, pleasure and satisfies a need for extra sucking. Thumb sucking that persists beyond infancy (particularly into preschool years) might suggest a situational disorder.

RISK INCREASES WITH

• Addition of a new baby brother or sister in the family.
• Infant senses a withdrawal of parents' interest or attention.

HOW TO PREVENT

• Thumb sucking is normal and does not cause serious damage until the permanent teeth begin cutting through gums at age 6 or 7. Most children have outgrown the habit by this age. If not, parents should work with the child to change the habit for the sake of appearance and dental health.
• Provide other comfort mechanisms early in infancy, such as pacifiers if you desire.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor or dentist (sometimes).

APPROPRIATE HEALTH CARE

• Home care.
• Doctor's or dentist's treatment (sometimes).
• Psychotherapy or counseling (prolonged or excessive thumb-sucking only).

POSSIBLE COMPLICATIONS--Protruding front teeth. Thumb sucking may put enough pressure on front teeth to move them forward eventually.

PROBABLE OUTCOME--In most cases, the habit is given up spontaneously, especially if has not become an issue between parents and child.

How To Treat

GENERAL MEASURES--

• No treatment or action is usually necessary. Methods such as punishment, shaming and reminders are usually of no avail. Other methods also are not particularly successful (mittens, bad-tasting substances on the thumb, elbow splints, etc.) and may cause additional trauma.
• For a child over 6 or 7 who sucks the fingers or thumb: Give the child extra attention. Observe if conflicts or anxiety-producing situations provoke sucking. Help the child explore other solutions to stress. If the child decides to try to stop sucking, help the child set goals. Give rewards for any progress toward the goal. Reward is not a bribe, but something earned through effort.

MEDICATION--Medicine usually is not necessary for this disorder.

ACTIVITY--No restrictions.

DIET--No special diet.

Call Your Doctor If

OR DENTIST IF

• Your child wishes to stop and behavior-modification efforts (rewards for progress) have not solved the problem. The dentist may fit a training device in the child's mouth to prevent the thumb from touching the roof of the mouth.
• The child becomes intolerant of the training device or it loosens.
• The sucking behavior does not diminish in 6 months, despite treatment.