Thumb and Finger AppliancesEveryone is familiar with the image of a baby, asleep sucking his or her thumb. Did you know that they even do this in the womb? Thumb or finger sucking is perfectly natural as it helps relax and comfort babies and even toddlers. But as a child grows, it’s a habit from which they must graduate. It isn’t just a rite of passage that must be checked off, socially awkward if you can imagine an older child doing it. A much more compelling reason to help your child move on in the process of growing up is the possible harm to oral health that later thumb sucking can cause.
In most children, thumb sucking stops on its own between the ages of two and four years. But if the practice persists after the primary (baby) teeth have erupted, it can drastically change the growth patterns of the jaw and cause significant misalignment of the teeth. Parents are often surprised that the habit can create problems, but truly it’s an important issue for some kids.

Children’s jaws, rich in blood supply and growing rapidly, are relatively soft and flexible — especially in kids under the age of eight. So it really isn’t hard for the constant pressure of a thumb or finger to deform the soft bone around the upper and lower front teeth. Children who are particularly vigorous thumb suckers are even more likely to change the growth patterns of the teeth and jaws.

If the thumb sucking habit persists, it can result in the upper front teeth flaring out and the lower ones moving back and inward. It can also hold back the growth of the lower jaw, while causing the upper jaw to be thrust forward. This can result in misalignment of the teeth, an anterior open bite (where the front teeth fail to close together), collapse of the upper jaw causing crossbite, or other problems. That’s why it is important to stop the behavior at an appropriate time, before damage occurs.

Controlling Thumb or Finger Sucking

Like many potentially harmful behavior patterns, thumb sucking can be a difficult habit to break. A lot of home remedies have been tried by frustrated parents. Efforts such as having the child wear gloves, coating the thumb or finger with a bitter-tasting substance — and even reasoning with their toddlers have been tried. Sometimes it works — but in other cases, the allure of thumb sucking proves very difficult to control.

If your child has a thumb or finger sucking habit that has persisted past the age of three, and you’ve been unable to tame it, then it may be time for you to visit our office. We will consider treating your child with a “habit appliance” such as a fixed palatal crib or a removable device. This crib isn’t for sleeping — it’s a small metal appliance worn inside the mouth, attached to the upper teeth.

How does it work? The palatal crib has semicircular wires that keep the thumb or finger from touching the gums behind the front teeth. Simply preventing this contact seems to take all the enjoyment away from the thumb sucking habit — and without that pleasurable feedback, a child soon loses interest in keeping up the habit. In fact, the device is often successful the first day it’s worn.

Getting and Using a Habit Appliance

If your child could benefit from a habit appliance, the first step is to get a thorough examination, which may include taking X-rays, photographs and dental impressions. The palatal crib will then be custom-fabricated to fit your child’s mouth and put into place at a subsequent appointment. Afterwards, your child will be periodically monitored until the appliance is removed — typically after a period of months.

Although wearing the crib isn’t painful, your child may experience some soreness in the upper back teeth for only a few hours after it has been put into place. He or she may also have a little trouble falling asleep for a day or two afterward. Plenty of extra attention and TLC are usually all that’s needed to overcome a little fussiness and make everything all right. While the appliance is being worn, it’s best to avoid chewing gum and eating hard, sticky food that might cause it to come loose.

A Word About Tongue Thrusting

Like thumb sucking, tongue thrusting is a normal behavioral pattern in young children. It’s actually part of the natural infantile swallowing pattern, which will normally change on its own — by the age of six, in most children. If the pattern doesn’t change, however, it can lead to problems similar to those caused by thumb sucking. Problems with tooth alignment and skeletal development can occur. Fortunately, this problem can be successfully treated with a habit appliance that’s very similar to a fixed palatal crib. Your orthodontist can help you make a determination and recommend what’s best for your child.