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Thumbsucking & Pacifiers

Thumbsucking can lead to protruding front teeth, the inability of the upper and lower front teeth to bite together, and problems with eruption of teeth and development of the jaws.  Prolonged use of a pacifier can cause the same problems that thumbsucking can.  However, in the early stages of development, thumbsucking and/or use of a pacifier are very normal and comforting habits developed by children.  There are multiple ways to address this concern and keep it from becoming a problem. 

In regards to a pacifier, the parent has total control over this.  Make the choice to take away the pacifier-preferably by some point around age 2. If the child is heavily dependent, step them away from it; go from using it throughout the day to only at bedtime, and then not at all.

Because infants associate thumbsucking with pleasure, they may continue the habit throughout toddlerhood, and revert to it especially during times of stress. This need to suck usually diminishes sometime during the first year. Some toddlers, however, retain thumb or finger sucking as a normal method of relaxation.

Typically, children will outgrow the habit before it may cause any harm to the teeth or supporting structures (before age 5-6). The good news is that by the time a child is old enough that thumb sucking might harm the teeth, the child should also be old enough to understand how it is harmful. Be sure your child has regular dental check-ups every six months to a year, and try these five tricks to keep the habit from becoming a problem:

Keep little thumbs busy. Bored little thumbs and fingers often find their way into the mouth. The time-honored way of breaking any annoying or harmful habit is "distract and substitute." As soon as you see the thumb going toward the mouth, quickly distract your child into a hands-on activity or insert a toy into both hands.

Offer a sub. Tell your child: "When you feel like sucking your thumb, squeeze your thumb instead of sucking it." Or play the game of hide the thumb: "As soon as you feel like sucking your thumb, wrap your fingers around your thumb and hide it." Giving your child something else to do with his/her hands can change a harmful habit into a harmless one.

Track the trigger. Try to identify which situations set off thumb sucking. Is the child tired, bored, or stressed? Eliminate as many triggers as possible and quickly intervene with a play activity to ward off the thumb sucking.

Play show and tell. Show differences in smiles yourself to illustrate to the child what effects can occur.

Let the thumb rest at night.  The most involved cases of overbite seem to occur in those who strongly suck their thumbs throughout the night. Discourage her from going to sleep when sucking her thumb, as she will tend to revert back to this comfortable sucking habit when she wakes up. Some other tips:

  • Give the child a teddy bear that's so big he or she will have to wrap hands around it.
  • Put the child to bed with his/her hands occupied with a book or toy.
  • Set up alternative sleep-inducing props, such as lullabies and music. Make a medley of you singing your child's favorite sleep-inducing lullabies, and let it continuously play throughout the night. If your child is comfortable going to bed with this music, he/she is more likely to resettle with the music rather than his/her thumb upon waking up. 

 

Other Alternatives

Some children will not outgrow the habit as soon as we desire.  These children are old enough to understand the harm to be caused but may need extra encouragement to help to break the habit.  There are over the counter gels/coating agents (non-toxic nail polish) and remedies (like Tabasco, etc.) that can be painted on the finger to discourage the habit.  Appliances can be made that fit into the mouth to discourage the habit.  Usually this is a last resort.  If nothing is accomplished, the child will likely need braces to correct problems that may have otherwise not been present. 

The biggest key to successful intervention is to be positive and constantly reinforcing desired behavior while tactically addressing unwanted behavior, using some of the ideas shown here.