Thumbsucking in Kids-Causes, Impact and Treatment

thumbsucking habitBabies love to put everything in their mouth. They have inborn drive for sucking on objects,  both animate and inanimate. Babies can indulge in type of sucking habits: Nutritive sucking and Non nutritive sucking. Breast feeding and bottle feeding is nutritive sucking. Sucking on anything that derives no nutrition to the baby is non nutritive sucking, done with sole purpose of comfort and pleasure. Several related habits— Digit sucking, and pacifier use—are forms of non-nutritive sucking.

Digit sucking is defined as the placement of the thumb or one or more fingers, toes into the mouth, most frequently found non nutritive habit in babies. In majority of infants and toddlers, thumb sucking is self limiting. Most of the kids kick their habit by the age of 5, while in few, habit of  digit sucking persists latter in life, having pernicious effects on normal growth pattern and development of orthofacial structure.

Few interesting facts about thumbsucking in kids

  • Babies suck their thumbs even when they are inside mother’s womb as early as 29th week of gestation
  • Sucking behaviors in infants and young children are mainly derived from the physiologic need for nutrients and are normal in the first 2–3 years of life
  • Seen commonly in infants and peaks at 18 to 21 months of age
  • Almost 100% of normal babies are involved in thumb sucking
  • According to the American Dental Association and the American Association of Orthodontists, parents should discourage digit sucking after age of 4 years
  • When permanent teeth start to come in, thumbsucking could prevent proper spacing and tooth alignment

Why do babies suck thumbs or fingers?

Various reasons have been mentioned in the literature for thumb sucking.

– Inherent biologic drive for sucking. Fixation of the habit occurs if the infant sucking needs are not met.

– Prolongation of nursing strengthen the oral drive in the child.

Rooting reflex, reflex of movement of  head and tongue of  infants moves towards an object touching the cheeks, responsible for thumb sucking.

– If the child is not satisfied with the sucking during the feeding period, it will remain as a symptom of emotional conflict/disturbance in the form of digit sucking to obtain gratification.

– Learning theory
This theory is most favoured and states that sucking is an innate cravings in infants and non-nutritive habit is an excess sucking urge with breast feeding or bottle feeding.

– Thumb sucking is associated with the need to seek food. In some infants it can signal fatigue, sleep, hunger, teething and shyness. New born babies use thumb sucking as a calming technique and for relaxation to fight anxiety in the first months of life.

Why does Thumbsucking habit persist?

The continuation of oral habits is usually due to physical and emotional stimuli such as boredom, stress, hunger, hyperactivity, sadness, pleasure, and various kinds of disabilities. As time passes, they often indulge in the activity unconsciously.

How does thumbsucking affect your child?

Prolonged digit-sucking habits can have a negative impact on dental, speech, physical and emotional development. Basically how the thumb sucking can affect depends upon three main factors: FrequencyIntensityDuration.

Skeletal and Dental changes

As the bone of young children are soft and pliable. Direct pressure from the digit and reduced intraoral pressure produced by sucking  can bring about the changes in the skeletal and the dental structures by disruption of balancing forces acting in oral region.

Milk Teeth Myths

Narrowing of upper jaw

Tongue counterbalances the force exerted on the dentition by surrounding muscles. However,  in kids who are active thumb suckers , tongue position lowers, the muscles in the cheeks contract inward against the upper dental arch, narrowing it. Depth of  upper jaw increases as it constricts due to unbalanced intra-oral pressures during digit sucking.

Narrow maxilla make tonsils collapse to cause snoring.

Proclination of the maxillary incisors or crowding

During digit sucking, the thumb or finger is positioned in the mouth such that there is inward force on the lower teeth and outward force against the upper teeth, pulling forward the upper jaw and teeth. Upper teeth either gets protruded or crowded.The lower teeth could also be pushed in from the knuckle of the thumb while sucking.

Lower teeth also develop crowding

Kids with protruding front teeth are at two times more risk of dental trauma and fractured teeth than those with normal occlusion.

Anterior open bite

As the thumb is placed into the mouth, there is downward and backwards movement of the  lower jaw, separating upper and lower teeth, resulting in over-eruption of posterior teeth. Also, the normal path of eruption of the incisors is affected, producing open bite which can start to be discomforting to children while eating. Due to these uncomfortable eating habits, children will normally develop a habit of thrusting tongue forward on teeth (Tongue thrust).Open bite can cause lisp in speech of thumb suckers.

Cross-bites

Upper teeth surround teeth in lower jaw. In case of thumb suckers, constriction of upper jaw makes upper teeth and lower teeth inter-digitate in opposite relation, creating cross-bite, creating dual bite.

Digit changes

Kids who are involved in digit sucking have extremely clean thumb, due to constant sucking, callous forms. Germs from thumb and surrounding areas can affect  body. Sometimes, prolonged finger sucking may cause permanent damage to digits/finger, necessitating corrective surgery.

Social Impact on Kids due to Thumbsucking

Continuation of thumb sucking habit can shake sense of pride and self esteem of a child  because of fear of being ridiculed and taunted by peers, relatives, teachers  or even total strangers.

Treatment of Thumbsucking

The treatment options that are usually considered are

(a) Reminder therapy

Covering finger with  adhesive tape or applying unpalatable bitter solution and or wearing a sock, mitten, gloves, thumb guard, long-sleeve gown will act as a reminder for kid, “Not to suck”.

These preparations are effective only if the habit is new and are less effective in countering a long-standing habit.

Digital reminders

Digital reminder is a simple device. It is comprised of attachment and alarm part. Attachment is worn on the finger which is involved in sucking. The alarm part is encased in a wristwatch. Every time whenever child takes his finger into the mouth, alarm beeps until child takes finger out of the mouth.

Elbow guards 

Main idea behind elbow guard is to restrict  the child to put thumb into the mouth. These guards are wore on the elbow, does not allow the bending of hand.

(b) Habit breaking Appliance therapy.

Habit breaking appliance keeps the thumb or finger from exerting pressure on the soft tissue of the palate. The seal is broken, there is no suction, and the pleasure of thumb-sucking is destroyed. Fixed/removable intra-oral habit breaking appliances

These appliances are very effective in eliminating a digit sucking habit if they are worn consistently for six to ten months.

What is the role of Parents?

  1. Make an appointment to your dentist, follow the treatment course religiously. Apart from habit breaking, kid may require Orthodontics treatment latter on.
  2. Don’t nag or punish your child for sucking their thumbs, it may create stress and a reason to suck their thumbs more.
  3. Teach your child the reasons why they can’t continue to suck their thumbs. Explain to them the long term effects of such a habit and what that might entail.
  4. Try to identify and avoid  the situations which makes your kids to put thumb into the mouth
  5. When your child sucks their thumb, distract them with a toy or a song.
  6. These kids used to fall asleep by sucking on their thumb, cover the thumb and make a healthy bed time routine to distract your kid.

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