Thumb Sucking Habbit

8/6/2019 Thumb Sucking Habbit

1/23

Thumb suckingThumb sucking

Thumb suckingThumb sucking is defined as placement of theis defined as placement of the

thumb or one or more fingers in varying depths intothumb or one or more fingers in varying depths into

the mouth. Thumb and digit sucking is one of thethe mouth. Thumb and digit sucking is one of thecommonly seen habits that most children indulge in.commonly seen habits that most children indulge in.

Recent studies have shown thatRecent studies have shown that thumb suckingthumb sucking

may be practiced even during intra uterine life. Themay be practiced even during intra uterine life. The

presence of this habit is considered quite normal tillpresence of this habit is considered quite normal tillthe age of 3the age of 3--4 years. Persistence of the habit4 years. Persistence of the habit

beyond this age can lead to various malocclusions.beyond this age can lead to various malocclusions.


2/23

EtiologyEtiology

A number of theories have been putA number of theories have been putforward to explain whyforward to explain why thumb suckingthumb sucking

occurs. The following are some of theoccurs. The following are some of the

more accepted ones:more accepted ones:


3/23

Freudian theory: This theory was proposed byFreudian theory: This theory was proposed by

Sigmond Freud in the early part of this century.Sigmond Freud in the early part of this century.He suggested that a child passes throughHe suggested that a child passes through

various distinct phases of psychologicalvarious distinct phases of psychological

development of which the oral and the analdevelopment of which the oral and the anal

phases are seen in the first three year of life. Inphases are seen in the first three year of life. In

the oral phase, the mouth is believed to be anthe oral phase, the mouth is believed to be an

orooro--erotic & zone. The child has the tendency toerotic & zone. The child has the tendency to

place his fingers or any other object into the oralplace his fingers or any other object into the oral

cavity. Prevention of such an act is believed tocavity. Prevention of such an act is believed to

result in emotional insecurity and poses the riskresult in emotional insecurity and poses the risk

of the child diversifying into other habits.of the child diversifying into other habits.


4/23

Oral drive theory of Sears and wise: SearsOral drive theory of Sears and wise: Sears

and wise in 1950 proposed that prolongedand wise in 1950 proposed that prolonged

suckling can lead tosuckling can lead to thumb suckingthumb sucking..


5/23

Benjamins theory: Benjamin hasBenjamins theory: Benjamin hassuggested thatsuggested that thumb suckingthumb sucking arisesarises

from the rooting or placing reflex seen infrom the rooting or placing reflex seen in

all mammalin infant. Rooting reflex is theall mammalin infant. Rooting reflex is the

movement of the infants head and tonguemovement of the infants head and tongue

towards an object touching his cheek. Thetowards an object touching his cheek. The

object is usually the mothers breast butobject is usually the mothers breast but

may also be a finger or a pacifier. Thismay also be a finger or a pacifier. Thisrooting reflex disappears in normal infantsrooting reflex disappears in normal infants

around 7around 7 -- 8 months of age.8 months of age.


6/23

Psychological aspects: Children deprivedPsychological aspects: Children deprived

of parental love, care and affection areof parental love, care and affection are

believed to resort to this habit due to abelieved to resort to this habit due to a

feeling of insecurity.feeling of insecurity.

Learned pattern: According to someLearned pattern: According to some

authors,authors, thumb suckingthumb sucking is merely ais merely alearned pattern with no underlying causelearned pattern with no underlying cause

or psychological bearing.or psychological bearing.


7/23

Phases of developmentPhases of developmentPhase I: (Normal and SubPhase I: (Normal and Sub--clinically significant). The firstclinically significant). The firstphase is seen during the first three years of life. Thephase is seen during the first three years of life. Thepresence ofpresence ofthumb suckingthumb sucking during this phase isduring this phase isconsidered quite normal and usually terminates at theconsidered quite normal and usually terminates at theend of phase one.end of phase one.

Phase II: (Clinically Significant Sucking): The secondPhase II: (Clinically Significant Sucking): The secondphase extends between 3phase extends between 3--6 years of age. The presence6 years of age. The presenceofofthumb suckingthumb sucking during this period is an indication thatduring this period is an indication thatthe child is under great anxiety. Treatment to solve thethe child is under great anxiety. Treatment to solve thedental problems should be initiated during this Phase.dental problems should be initiated during this Phase.

Phase III: (Intractable Sucking) : AnyPhase III: (Intractable Sucking) : Any thumb suckingthumb suckingpersisting beyond the fourth or fifth year of life shouldpersisting beyond the fourth or fifth year of life shouldalert the dentist to the underlying psychological aspectsalert the dentist to the underlying psychological aspectsof the habit. A psychologist might have to be consultedof the habit. A psychologist might have to be consulted

during this phase.during this phase.


8/23

Effects of thumb suckingEffects of thumb sucking

Thumb and digit sucking are believed toThumb and digit sucking are believed to

cause a number of changes in the dentalcause a number of changes in the dental

arch and the supporting structures. Thearch and the supporting structures. The

severity of the malocclusion caused byseverity of the malocclusion caused by

thumb suckingthumb sucking depends on the trident ofdepends on the trident of

factors. They are:factors. They are:


9/23

a. Duration: The amount of time spenta. Duration: The amount of time spent

indulging in the habit.indulging in the habit.

b. Frequency: The number of times theb. Frequency: The number of times thehabit is activated in a day.habit is activated in a day.

c. Intensity: The vigor with which the habitc. Intensity: The vigor with which the habit

is performedis performed

The following are some of the effects

ofthumb sucking:


10/23

Labial tipping of the maxillary anterior teeth resulting inLabial tipping of the maxillary anterior teeth resulting in

proclination of maxillary anteriors.proclination of maxillary anteriors.b. The overjet increases due to proclination of theb. The overjet increases due to proclination of themaxillary anteriors.maxillary anteriors.

Some children rest their hand on the mandibular anteriorSome children rest their hand on the mandibular anteriorduring theduring the thumb suckingthumb sucking act. In such children lingualact. In such children lingual

tipping of the mandibular incisors can be expected whichtipping of the mandibular incisors can be expected whichfurther increases the overjet.further increases the overjet.

d. Anterior open bite can occur as a result of restrictiond. Anterior open bite can occur as a result of restrictionof incisor eruption and supraeruption of the buccal teeth.of incisor eruption and supraeruption of the buccal teeth.

e. The cheek muscles contract duringe. The cheek muscles contract during thumb suckingthumb suckingresulting in a narrow maxillary arch which predisposes toresulting in a narrow maxillary arch which predisposes toposterior cross bites.posterior cross bites.

f. The child may develop tongue thrust habit as a resultf. The child may develop tongue thrust habit as a resultof the open bite.of the open bite.


11/23

g. The upper lip is generally hypnotic while theg. The upper lip is generally hypnotic while thelower part of the face exhibits hyperactivelower part of the face exhibits hyperactive

mentalis activity.mentalis activity.The parents should be questioned on theThe parents should be questioned on thefrequency and duration of the habit. The childsfrequency and duration of the habit. The childsemotional status should be assessed byemotional status should be assessed by

enquring into such things as:enquring into such things as:a. Feeding habitsa. Feeding habits

b. Parental care of the childb. Parental care of the child

c. Whether the parents are workingc. Whether the parents are working

An intraAn intra--oral clinical examination should recordoral clinical examination should recordall the features seen such as proclination, openall the features seen such as proclination, openbite etc. The childs fingers should be examined.bite etc. The childs fingers should be examined.Presence of clean nails and callus on the fingerPresence of clean nails and callus on the finger

is commonly associated withis commonly associated with thumb suckingthumb sucking..


12/23

Management ofManagement ofthumb suckingthumb sucking

Psychological approach: It is usually said thatPsychological approach: It is usually said thatchildren lacking parental care, love and affectionchildren lacking parental care, love and affectionresort to this habit. Thus the parents should beresort to this habit. Thus the parents should becounseled to provide the child with adequate lovecounseled to provide the child with adequate love

and affection. The parents should also be advised toand affection. The parents should also be advised todivert the childs attention to other things such asdivert the childs attention to other things such asplay and toys.play and toys.

The success of any habit interception procedureThe success of any habit interception procedurelargely depends upon the subjects colargely depends upon the subjects co--operation andoperation and

willingness to be helped to discontinue his thumbwillingness to be helped to discontinue his thumbsucking habit. Thus the parents and the dentistsucking habit. Thus the parents and the dentistshould seek to motivate the child.should seek to motivate the child.


13/23

Mechanical aids: They are basically remindingMechanical aids: They are basically reminding

aliances that assist the child who is willing to quitaliances that assist the child who is willing to quitthe habit but is not able to do so as the habit hasthe habit but is not able to do so as the habit hasentered a subconscious level. These appliancesentered a subconscious level. These appliancesusually consist of a crib placed palatal to theusually consist of a crib placed palatal to themaxillary incisors. Habit breakers can be of twomaxillary incisors. Habit breakers can be of two

types:types:a) Removable habit breakers : They are passivea) Removable habit breakers : They are passiveremovable appliances that consist of a crib andremovable appliances that consist of a crib andis anchored to the oral cavity by means of claspsis anchored to the oral cavity by means of claspson the posterior teeth.on the posterior teeth.

b) Fixed habit breakers : Heavy gauge stainlessb) Fixed habit breakers : Heavy gauge stainlesssteel wire can be designed to form a frame thatsteel wire can be designed to form a frame thatis soldered to bands on the molars.is soldered to bands on the molars.


14/23

Other aids that can be used to intercept the

Other aids that can be used to intercept thethumb suckingthumb sucking habit include bandaginghabit include bandaging

the thumb, and bandaging of the elbow.the thumb, and bandaging of the elbow.

Chemical approach: Use of bitter tasting orChemical approach: Use of bitter tasting or

foul smelling preparation placed on thefoul smelling preparation placed on thethumb that is sucked can make thethumb that is sucked can make the thumbthumb

suckingsucking habit distasteful. Thehabit distasteful. The

medicaments that can be used include:medicaments that can be used include:

a. Pepper dissolved in a volatile medium.a. Pepper dissolved in a volatile medium.b. Quinineb. Quinine

c. Asfetidac. Asfetida


15/23

Parents usually start to worry too early, about how to stop thumbParents usually start to worry too early, about how to stop thumbsucking habit of their children. It is advised that you do not try tosucking habit of their children. It is advised that you do not try tomake a child to stop thumb sucking before the age of four (unlessmake a child to stop thumb sucking before the age of four (unlessyou notice a problem to teeth due to vigorous thumbsucking)you notice a problem to teeth due to vigorous thumbsucking)because it might have the opposite results.because it might have the opposite results.

Usually children stop the habit on their own, by that age. If they don't,Usually children stop the habit on their own, by that age. If they don't,here are some easy ways to get kids to stop thumbsucking :here are some easy ways to get kids to stop thumbsucking :

HOW TO STOP THUMBHOW TO STOP THUMB

SUCK

INGSUCK

INGEasy ways to get kids to stopEasy ways to get kids to stop

sucking their thumbsucking their thumb


16/23

Keep the child's hands occupied with a toy,Keep the child's hands occupied with a toy,

puzzle or other activity.puzzle or other activity.

Carefully remove your child's thumb from his orCarefully remove your child's thumb from his or

her mouth during sleepher mouth during sleep

Give the example of his friends that haveGive the example of his friends that have

managed to stop thumbsucking.managed to stop thumbsucking.


17/23


18/23

Avoid punishing or shaming the child.Avoid punishing or shaming the child.

Reward the child for not thumbsucking for aReward the child for not thumbsucking for a

progressively increasing time period.progressively increasing time period.

Ask the advice of a pediatric dentist. He willAsk the advice of a pediatric dentist. He will

explain to your kid what will happen to the teethexplain to your kid what will happen to the teeth

if the child does not stop sucking its thumb.if the child does not stop sucking its thumb.


19/23

Use a thumb sucking guard.Use a thumb sucking guard. -- In difficultIn difficult

cases, your dentist might suggest the usecases, your dentist might suggest the useof special devices to stop thumb sucking,of special devices to stop thumb sucking,called thumb guards. Acalled thumb guards. A thumb guardthumb guard is ais adevice with a plastic cover of the thumbdevice with a plastic cover of the thumb

that is attached to a child's wrist. Thethat is attached to a child's wrist. Thethumb sucking guard interrupts thethumb sucking guard interrupts theprocess by breaking the vacuum createdprocess by breaking the vacuum createdby sucking, thus removing the child'sby sucking, thus removing the child's

pleasure. Treatment with thumb guardspleasure. Treatment with thumb guardsusually lasts four weeks and helps childrenusually lasts four weeks and helps childrento stop thumb sucking succesfully.to stop thumb sucking succesfully.


20/23

How to Stop Thumb SuckingHow to Stop Thumb Sucking

Thumb sucking is one of the firstThumb sucking is one of the firstcoordinated acts a baby can do that bringscoordinated acts a baby can do that bringscomfort and pleasure. Most kids outgrowcomfort and pleasure. Most kids outgrow

the behavior by their preschool years andthe behavior by their preschool years andup until that point it's relatively harmless.up until that point it's relatively harmless.Though beyond preschool it can be aThough beyond preschool it can be aproblem once permanent teeth startproblem once permanent teeth start

coming in. The best way to get your childcoming in. The best way to get your childto stop sucking her thumb is to find waysto stop sucking her thumb is to find waysto help her do it on her own.to help her do it on her own.


21/23

Give your child extra attention andGive your child extra attention and

observe if conflicts or anxiety provokeobserve if conflicts or anxiety provokethumb sucking. If so, help him find morethumb sucking. If so, help him find more

healthful ways to deal with stress.healthful ways to deal with stress.

Reward your child for progress madeReward your child for progress made

towards her goal. Don't think of it as atowards her goal. Don't think of it as a

bribe because it's something she earnedbribe because it's something she earned

through effort.through effort.


22/23

Paint something that taste bad on hisPaint something that taste bad on his

thumb, like vinegar or pickle juice. Don't dothumb, like vinegar or pickle juice. Don't doit forcefully or without his permission, butit forcefully or without his permission, but

as a way of helping him achieve his goal.as a way of helping him achieve his goal.

Then when he's engaged in television andThen when he's engaged in television and

sticks his thumb in his mouth out of habit,sticks his thumb in his mouth out of habit,the bad taste will quickly remind him ofthe bad taste will quickly remind him of

what he's trying to accomplish.what he's trying to accomplish.


23/23

Distract your child when you see herDistract your child when you see her

putting her thumb in her mouth. If youputting her thumb in her mouth. If youengage her in an activity that requires bothengage her in an activity that requires bothhands, she'll have to take her thumb out ofhands, she'll have to take her thumb out ofher mouth to do the task.her mouth to do the task.

Invite friends over that don't suck theirInvite friends over that don't suck theirthumbs for frequent play dates. Peerthumbs for frequent play dates. Peerpressure is a powerful motivator and if hepressure is a powerful motivator and if hesurrounds himself with kids who don't sucksurrounds himself with kids who don't suck

their thumbs, it will be easier for him to nottheir thumbs, it will be easier for him to notsuck his.suck his.

Documents

Thumb Sucking Habbit