Finger and Thumb Habits

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.

First step

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.

Second step

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.

Third step

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.