Thumb sucking: When Orthodontic Intervention is Needed

Disclosure :: This post is sponsored authored by local mom and friend of Lafayette Mom, Dr. Melanie Fowler. 

Thumb sucking: When Orthodontic Intervention is Needed

Babies have natural instincts to suckle, even before they are born. Thumb sucking, or finger sucking, is a way that babies can learn to self-soothe. However, digit sucking can become a big problem if the habit lingers. Our mouths develop through a combination of genetic programming and environmental factors. Sustained sucking of a thumb, finger, or pacifier can cause issues with the development of the shape of the palate, the teeth, and the bite. Narrowness of the palate, crossbites, protrusion of the upper front teeth, and open bites are common problems associated with thumb sucking.

So, when do parents need to start worrying about their precious thumb sucker?Thumb sucking and how it will affect braces down the road

I tell parents not to worry until the permanent teeth begin to erupt, which usually takes place around ages 5-6. At this age, it is important to see an orthodontist who can diagnose any teeth or palate issues, give advice regarding ways to break the habit, and to present a plan to treat any problems that have developed.

The first part of any orthodontic plan is to break the habit.

As with any bad habit, time matters. The habit did not develop in one day, and it won’t go away quickly either. Expect, at the minimum, a full month for your child to quit for good. The best at-home method to stop a thumb sucker is to have your child wear a thumb guard, or even just a long sock, over their hand. Positive reinforcement is key and there should be a calendar that the child can see and understand. Each day that the guard stays on all night long is a win! Use prizes for each day and each week, for 4 weeks. If your child misses even one night, the calendar starts over. At-home methods will work best with children who can already control the habit during school hours.

If your child has trouble controlling the habit at school, orthodontic intervention is needed. Appliances like a tongue crib serve as reminders to kids who may not even realize they are putting their thumbs in their mouths.

Once the habit is gone, some oral problems may resolve on their own. However, an orthodontist should monitor the child during this time. If the issues do not resolve, two-phased orthodontic treatment is likely. By separating the treatment into two phases, an early one around age 7 and a second one around age 12, we can manage the problems caused by thumb sucking early and then complete the overall goal of esthetics and a functional bite later. Most thumb suckers will need a palate expander and this must be done prior to puberty to avoid asymmetrical growth which may require a surgical correction.

Pacifiers are a good alternative to thumb sucking because they are easier to take away!

Pacifiers are a good alternative to thumb sucking orthodontist perspectiveI recommend trying to wean your child off a pacifier before 4 years old. By this point, they are old enough to understand that Santa or the Tooth Fairy or their baby sister needs their noonie. However, do not let them develop a thumb sucking habit to replace the pacifier. Give the pacifier back and try again a few weeks later.

The American Association of Orthodontists recommends that all children receive an orthodontic evaluation by the age of seven, even if they are being followed regularly by a general dentist, and especially if they have a thumb habit.

So, if you’ve been wondering about your thumb sucker’s teeth, don’t wait! Early orthodontic evaluations are quick and easy, and usually provided free of charge by the  orthodontist!

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Dr. Melanie FowlerDr. Melanie Fowler pediatric orthodontist

Dr. Melanie Fowler is a board-certified orthodontist with offices in Lafayette and New Iberia. She is married to Dr. Shane Fowler and they have two very busy children, Georgia and Glen. When’s she’s not working or driving to ballet and soccer, Dr. Fowler spends time teaching at LSU School of Dentistry, volunteering with Junior League of Lafayette and traveling to Perdido Key, Florida, her happy place.