John Murtagh, Patient Education, Third edition, McGraw-Hill Book Company

Thumb sucking
What does thumb sucking invoIve?
It involves placing the thumb or finger on the roof of the
mouth behind the teeth (hard palate) and sucking with the
mouth closed. It is basically a habit and should not be regarded
as an abnormal disorder. It is one of the first pleasurable acts
that the infant can manage.
How common is thumb sucking?
It is very common and occurs in children of both sexes up
to the age of 12 years, but is commonest in children under the
age of 4 years.
What can bring on thumb sucking?
It usually starts for no apparent reason. The child tends to
suck the thumb when relaxing, such as when watching
television or when put to bed before going to sleep. It also
tends to occur when the child is ill, hungry or tired.
Insecurity, such as the arrival of a sibling in the family, can
increase thumb sucking; it can be related to an apparent
withdrawal of parents' attention.
What are the risks?
Thumb sucking should be regarded as normal and usually
settles by the age of 6 or 7. However, if it persists beyond this
age it can cause problems with the permanent teeth, which
begin to appear at about the age of 7. One effect is that the
pressure on the front teeth may cause protrusion of these teeth
(i.e. buck teeth).
How can it be prevented?
It is best to provide other comfort measures in infants if this
habit is developing. Giving the infant a dummy (pacifier) is
preferable. If the habit persists, avoid making it an issue and
thus drawing attention to it.
What is the treatment?
No special medicine or diet is necessary.
What to avoid
nagging
punishment
scolding
gloves, mittens or arm splints
bad-tasting chemicals on the thumb or finger
What to do (for a chiId over 6 years)
Carefully observe things that provoke thumb sucking.
Find ways of avoiding these trigger factors.
Provide extra attention.
Organise pleasant distractions.
Give praise and rewards for efforts to stop.
When to seek heIp
if the problem persists after 6 years, especially if it is
excessive and persistent
if the child wishes to stop but cannot despite good efforts
(even when offered rewards for good attempts to stop)
In such situations special counselling may be required.
Sometimes the help of the dentist to fit a special training device
in the mouth may be required.
Remember
Thumb sucking is usually a passing habit that most
children grow out of by school age. Special treatment
is rarely necessary. Avoid giving attention to the
problem, but give plenty of attention to the child.
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