Dr. Tejaswini Malasane, Smile Care,Nasik

Thumbsucking in children is a pleasure giving activity or comfort giving activity. It can be attributed to the psychological needs of an individual child.

Many children tend to stop the habit by 1 year of age but few of them may carry this habit upto the age of 4 years of age. Carrying thumbsucking habit beyond this age could be detrimental. But it must be noted that pushing children to quit the habit by nagging from parents or shouting on them would make the child more adamant towards the habit.

Generally as the child gets to the age of 4-5 years he gets busy with the daily routine of the school, playing with other children and some other activities that he hardly thinks about thumsucking. But some children do not quit this habit and here parents need to adapt a careful approach in order to get their child to quit thumbsucking.

Thumbsucking has a major impact on oral health after the age of 5 years so it advisable to get the child rid of the habit by the age of 4-5 years .This is because the permanent teeth starts erupting from the age of 6-7 years.

Effects of thumbsucking :

• Narrow dental arches.
• Misaligned teeth.
• The roof of the mouth is pushed upward (deep palate) which would cause speech problems.
• Ugly callus on the thumb.
• Infection of thumbnail.
• Increased infections of oral cavity.
• Increased risk of pinworms.

Possible remedies :

• Admit the problem to the child in casual.
• Try to find out the cause of thumbsucking. Is it causal or due to stress ?
• Offer a reward for not sucking.
• A very effective method is asking the child to sit in front of the mirror and suck the thumb so that the child is embarrassed of the habit.
• Consult your dentist for an effective way to stop the habit.
• Coating thumb with a bitter medicine prescribed by your dentist may be an option.
• An orthodontist can place an orthodontic appliance which will deter the habit.
• Thumbguards are also known to deter the thumbsucking habit effectively.

Behavioral therapy :

Behavioral therapy helps a child avoid thumb-sucking through various techniques, such as substituting tapping fingers together quietly. Behavioral therapy works best if all people involved in the child's care follow the treatment plan.

Thumb devices :

Thumb devices, such as a thumb post, can be used for children with severe thumb-sucking problems. A thumb device is usually made of nontoxic plastic and is worn over the child's thumb. It is held in place with straps that go around the wrist. A thumb device prevents a child from being able to suck his or her thumb and is worn all day. It is removed after the child has gone 24 hours without trying to suck a thumb. The device is put back if the child starts to suck his or her thumb again. Thumb devices need to be fitted by a doctor.

Oral devices :

Oral devices (such as a palatal arch or crib that fits into the roof of the mouth) interfere with the pleasure a child gets from thumb-sucking. It may take several months for the child to stop sucking the thumb (or fingers) when these devices are used. When the child stops sucking, parents may choose to continue using the device for several months. This may prevent the child from starting the habit again. Oral devices need to be fitted by a dentist.