Many children engage in some form of sucking of the fingers
and/or thumbs. The effect of this sucking habit on the teeth
and jaws depends on the frequency and duration of the habit.
Although it is possible to deform the jaw shape and tooth
arrangement with an intense habit, intervention is usually
not indicated until approximately 5 years of age. As long
as the sucking habit stops before the permanent incisors come
in, many of the changes to the jaw and teeth will resolve
spontaneously. By that time, most children with sucking habits
have already stopped on their own. For those children who
persist in their sucking habit, some will want to stop, while
others will have no desire to stop.
The following is a step by step discussion regarding sucking
habits and methods for helping the child to succeed in stopping
the habit. The following methods require the child to have
a willingness and desire to stop the habit.
The best approach will be a straightforward discussion between
the child and Dr. Hsiao expressing concern about the effects
of the habit on the developing bite and jaws. An adult approach
to the discussion is helpful and is often enough to terminate
the habit. If this approach fails, a positive reward system
can be implemented that provides a small reward for not engaging
in the habit. In some cases, a large reward must be negotiated
for complete cessation of the habit.
Another approach involves using a method that reminds the
child that the finger or thumb is in the mouth and removing
the pleasure of sucking. This can be achieved by placing a
cotton glove on the hand or a Band-Aid on the thumb or finger
to discourage the habit. The glove or Band-Aid will remind
the child that they have placed the thumb or finger in the
mouth, and it will no longer be as satisfying to them. This
approach will interrupt the habit in the child who engages
in the habit during sleep, reading, or while watching television.
If the previous methods have not succeeded in stopping the
habit, the child who wants to stop sucking can be fitted with
an orthodontic habit appliance to actively impede sucking.
The purpose of this therapy should be explained to the child
so that they realize that the appliance serves as a reminder
and not as a punishment. When the sucking habit has completely
ceased, the appliance should remain in place for approximately
6 months to ensure the habit has truly stopped.
In about half of the children for whom such an appliance
is made, the sucking habit stops immediately. In the remaining
children, the sucking habit may persist for a few weeks, but
the appliance is eventually effective in 85-90% of the patients.
Description of Fixed Habit Appliance
The Habit appliance
is a fixed or cemented orthodontic appliance which is used
to actively impede sucking. A cemented orthodontic appliance
is not removable by the patient and remains on until the treatment
is completed. Once the appliance has been placed, Dr. Hsiao
will see the patient approximately every 4-8 weeks, with each
appointment lasting about 10 minutes.
A Final Word
It is desirable that a method be found for each child that
best suits them. If the habit continues unabated as the child
grows and develops, permanent undesirable effects can occur.
It is our goal to help the child successfully end the habit
prior to the occurrence of any permanent changes to their
bite, tooth arrangement, and jaw development. A small percentage
of children who persist in the sucking habit because they
are unable to stop or do not desire to stop, may eventually
require professional counseling to determine the underlying
need for the habit.