Thumb-Sucking: When Should Parents Intervene?

If you are concerned about your baby sucking her thumb, no need to worry.  Sucking is a normal reflex in babies and thumb-sucking is a common activity among infants and toddlers. In fact, some babies place their thumb in their mouth even before they are born. Thumb-sucking, also known as non-nutritive sucking (sucking not relating to or providing nutrition), has several benefits:

  • It is an infant’s early way of controlling emotions
  • It offers comfort and security
  • It helps the child to relax and focus

For most children, the urge to suck their thumb decreases as they get older.  However, for some it becomes a habit and continues beyond toddler years, particularly when they are in need of soothing or going to sleep.  Most children stop the habit on their own between ages 2 and 4. For older kids who continue, peer pressure usually motivates them to stop when they start school.

When should you intervene?

Habitual sucking is hard on the skin of the thumb and increases the risk of problems such as callus formation or cracked skin on the sucked digit.  Prolonged thumb-sucking may also affect the way teeth line up, constrict the upper jaw, and open the bite resulting in a gap between front top and bottom teeth. The dental effects are related to the frequency, intensity, and duration of the habit. These changes are temporary with little likelihood of long-term effects if the habit is discontinued by age 3 to 4 years.

It is important for parents to help their child break the habit before the permanent teeth erupt, preferably beginning intervention by age 3. To help your child break the habit consider the following approaches:

  • Talk to your child in basic terms and tell them why you want them to stop.
  • Let them know that you believe they can do it.
  • Praise your child when they don’t suck their thumb and start a reward system such as stickers or extra bedtime story.
  • Start a calendar to track their progress and reinforce their success by placing a star on days when the habit was avoided.
  • Provide gentle reminders.
  • Find alternative ways of comforting and soothing such as a stuffed animal or other comfort object.

In children who express a desire to quit and just need a little help, parents can try physical interventions to serve as a reminder. Techniques include:

  • Covering hands with mittens or socks when the child goes to bed.
  • Dressing the child in a special shirt with the sleeves sewn closed.
  • Placing a bandage or specialty plastic guard on the thumb or finger.

If these methods are not effective, talk to your dentist. There are dental appliances that can be placed in the mouth when a child wants to stop but needs a constant reminder.

Homa Amini, DDS, MPH, MS
Homa Amini, DDS, MS, MPH, is Chief of the Section of Pediatric Dentistry at Nationwide Children’s Hospital and a Associate Professor of Clinical Pediatric Dentistry at The Ohio State University College of Dentistry. She graduated from The Ohio State University College of Dentistry with a dental degree and a master’s in public health. She received her specialty training in pediatric dentistry at the University of Illinois at Chicago. Her interest is public dental health and health policy.

One thought on “Thumb-Sucking: When Should Parents Intervene?

  1. Emilia on said:

    All of my kids either took a pacifier or nothing until our STBAS came along, and he is a thumb sucker. No amount of prodding led to detaching him from that habit. We have every pacifier that is sold in our area, and he never took any of them. I would leave the kiddo to his thumb. Our dentist said as long as he is still not sucking his thumb at 6 or 7, then we are good. The thumb suckers I know have not had speech issues either, so really it is no worse than a pacifier according to our pedi.

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