Dear Doctor Column, June 20, 2005

Thumb Sucking Natural, Usually Ceases Before Age 5

Question:

My 4-year-old son still sucks his thumb. Will he eventually stop on his on? Is he permanently harming his teeth?

Answer:

Children suck on things because sucking is one of a baby's natural reflexes, and as infants get older it serves many purposes, such as making them feel secure and happy and to soothe themselves. Since thumb sucking is relaxing, it may help induce sleep.

Children should cease sucking by the time the permanent front teeth are ready to erupt. Usually children stop between ages 2 and 4 years. After the permanent teeth come in, sucking may cause problems with the proper growth of the mouth and alignment of the teeth. It also can cause changes in the roof of the mouth.

The intensity of the sucking is a factor that determines whether or not dental problems may result. If children rest their thumbs passively in their mouths, they are less likely to have difficulty than those who vigorously suck their thumbs. Some aggressive thumb suckers may cause problems with their baby (primary) teeth. If you notice changes in your child's primary teeth, consult your dentist.

Pacifiers can affect the teeth in the same ways as sucking fingers and thumbs. However, it is often an easier habit to break since you can control when the child has access to the pacifier.

The American Dental Association (www.ada.org) offers parents these tips:

• Praise children for not sucking, instead of scolding them when they are.
• Children often suck their thumbs when feeling insecure or needing comfort. Focus on correcting the cause of the anxiety, and provide comfort to your child.
• For an older child, involve him or her in choosing the method of stopping.
• Your dentist can offer encouragement to a child and explain what could happen to their teeth if they do not stop sucking.
• If the above tips do not work, remind the child of their habit by bandaging the thumb or putting a sock on the hand at night. Your dentist or pediatrician may prescribe a bitter medication to coat the thumb or the use of a mouth appliance.