Sucking is both a natural action and need for infants. The sucking process achieves considerable self-satisfaction and this action should not be discouraged in the young child (under 2 years of age).

A controversy currently exists over whether a thumb, or a pacifier, is best for the sucking child with respect to what adverse effects this may have on the developing teeth. Essentially, there is no real difference; all non-nutritive sucking actions will result in the development of mal-positioned teeth regardless of what the child is sucking. If the habit persists beyond the age of 2 years, the primary teeth may be affected, resulting in an open bite in the front or cross bite on the side.

Do not try to break the habit until the child is 4-5 years of age, for by this time, social peer pressure would have already resolved the habit in the majority of children. If the habit is resolved by this time, the permanent teeth in many cases will come out in normal relationship. If the habit is not stopped, the child may need orthodontic management.

By the age of 4-5, 90% of children will have ceased their sucking habit. However, they may have caused their lower front baby teeth to tip inward, and their upper front baby teeth to tip outward. These abnormalities should not be treated at this stage until permanent teeth begin to come out.

The 6 year old or older child, who still has a sucking habit, has likely caused damage to their permanent teeth. Counseling, positive re-enforcement to stop, warning about the bad effects of the habit, and the use of palatal reminder appliance, are all effective means of helping the child to extinguish the habit.

Have your child make a calendar and record incidents of finger sucking. You, as a parent, should reward the child weekly for having avoided the habit. If this technique is not successful, the palatal crib mentioned earlier, can be used in children over the age of 5.

Palatal cribs & bluegrass appliances

The use of these appliances is very successful if the proper psychological preparations have taken place. A child, who has not shown improvement using the calendar and positive reinforcement methods, must not feel he is a failure or is being punished with the appliance. It is merely a REMINDER to him that he should keep his thumb out of his mouth. He must be sold on the idea that the appliance will help.

These appliances can either be fixed in the mouth, or removable. Although designs differ, they function essentially the same: they limit or obstruct the thumb from entering the mouth through the use of stainless steel.