When people find out that I’m an orthodontist, they often ask me questions about their children’s habits – and specifically about thumb sucking.

Thumb sucking is common among children.  In fact, fetuses are often seen sucking their thumbs when ultrasounds are performed during pregnancy.  At a young age, thumb sucking does not pose a threat to the teeth. However, if thumb sucking continues into later childhood it can lead to orthodontic problems – namely, it can cause the teeth to become crooked, it can affect the growth of the jaws, and can cause severe problems with the bite.  The longer the habit continues, the worse the problems become and the more difficult they are to correct.  So, depending on your child’s age, thumb sucking may be more or less of a concern.

What can thumb sucking do to the teeth?  THIS:

The bite of a 14 year-old thumb sucker – note the extreme mal-alignment and lack of proper bite

So, should you be worried about your child’s thumb sucking habit?

Here is an algorithm to help you decide:

Don’t worry about it. Thumb sucking is perfectly normal at this age, and will not likely result in damage to the teeth or bite

Don’t worry about it.  Thumb sucking is perfectly normal at this age, and will not likely result in damage to the teeth or bite

thumbsucking-ages-_ages 3 - 5

Don’t be overly alarmed, but gently encourage your child to stop the habit, without shaming or pressuring.  If the habit is stopped before age 5, there will likely be no permanent effects on the teeth and bite.  Consider a sour-tasting nailpolish to help the child stop the habit.

thumbsucking-ages-_ages 6 - 9

Thumb sucking at this age will likely affect the teeth and bite, and the habit should be stopped as soon as possible.  Visit the orthodontist to consider a habit-breaking device (see below).

thumbsucking-ages-_ages 9 +

Thumb sucking will lead to severe problems that will require braces, tooth extractions, or even jaw surgery to repair.  Prompt action is required.

What will the orthodontist do?

If your child is over 6 years old and is having trouble stopping the habit (or sucks while sleeping), the best course of action is for the orthodontist to make a thumb-crib appliance.  This appliance consists of a metal mesh which spans the roof of the mouth and is cemented in place.  It is invisible (hidden on the inside of the mouth), and is not sharp or painful.  With it in place, if the child attempts to suck his thumb, it no longer fits comfortably in place.  And because it no longer feels soothing, the thumb sucking habit will stop. The appliance is cemented in place for at least 6-8 months to prevent the habit from recurring.  If the habit is stopped early enough, the damage that it caused to the teeth and bite should largely reverse itself, or be correctable with braces.

Thumb sucking thumb crib appliance
Example shows a Thumb Crib Appliance which is used to help children who habitually suck their thumbs to break the habit.

So whether or not you should worry about your child’s thumb habit largely depends on the age of the child.  Please use the algorithm I’ve provided, and share it with your friends.  The more parents are aware of how and when to treat thumb habits, the better the outcomes will be for their children.