Thumb Sucking

by Dr. Moshe Ipp

How do you handle a 5 year old who still sucks his thumb? This occurs when he is lying in bed waiting to fall asleep, while he is asleep, when he has been scolded by his mother, and when he is feeling anxious or worried?

Since this little fellow is now 5 years old one should begin to become concerned because it is known that if the thumb sucking habit persists into late primary dentition (beyond 5 years of age), malocclusion will likely result, the severity of which will depend on the style, frequency and intensity of the child's sucking. It must be pointed out however that thumb sucking is a normal habit in infants and young children and parents should not attempt to restrict or deny any child this pleasure and comfort, in the early months and years of the child's maturation. It is actually a very common habit and it seems that most children develop their tendency to thumb suck in the first year of life, usually within the first few months after birth. The occurrence of thumb sucking is equally common in boys and girls and in the great majority, the habit subsides spontaneously by the child's fourth birthday. Most children depend on the sucking for security and relaxation, just like the child described in the scenario above. Malocclusion that results following prolonged sucking may be transient and self correcting or it may become permanent requiring orthodontic intervention. The treatment of thumb sucking after 5 years of age may be very difficult without the child's co-operation, readiness or willingness to stop the habit himself. It goes without saying that the parents, and perhaps the child's physician or the child's dentist should explain the consequences of prolonged sucking to the child to encourage quitting the habit before using other devices such as bandages, mitts, thumb sucking medication painted on the thumb or nail polish. It cannot be emphasized strongly enough that these additional measures should act only as reminders and not as any form of punishment. Positive reinforcement with rewards may be useful in helping the child to deal with this issue. If all of these measures fail, if malocclusion has developed and if the habit is socially embarrassing, the child should be referred to an orthodontist for further management.

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