Thumb sucking and dental problems

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The mouth provides a baby's first contact with the external world, and sucking is an infant's first coordinated muscular activity. Scans have shown that babies even suck their thumb before they are born.

Prolonged thumb sucking can deform a child's upper dental arch, cause cross-bite, protruded teeth, and create an open bite. The extent of these negative consequences is affected by the duration of the habit, the daily frequency of the habit, and the manner in which the thumb is placed into the mouth.

Thumb sucking becomes a more serious problem however after the age of four or five, when the child’s permanent teeth come out. At this stage if the child is still sucking his or her thumb, it may lead to problems with the proper growth of the mouth and alignment of the teeth. It can also cause changes in the roof of the mouth. The intensity of the sucking is a factor that determines whether or not dental problems may result. If children rest their thumbs passively in their mouths, they are less likely to have difficulty than those who vigorously suck their thumbs. Some aggressive thumb-suckers may cause problems with their baby (primary) teeth.

Orthodontic treatment
Malocclusion however usually corrects itself when the child stops thumb-sucking. But the longer thumb-sucking continues, the more likely it is that orthodontic treatment will be needed to correct any resulting dental problems.

Prolonged sucking causes permanent deformation in some cases such as crowded, crooked teeth, or bite problems. The child may also develop speech problems or problems with swallowing properly. Often the nasal floor is also impeded from dropping down vertically during growth. The result is a narrow nasal floor and high palatal vault.

Protrusion and displacement of front teeth are usual results of thumb sucking. This can affect the child's appearance and potentially cause emotional problems. A child may also develop speech problems, including mispronouncing T's and D's, lisping, and thrusting out the tongue when talking.

Most young children engage in non-nutritive sucking. Generally sucking habits during the primary dentition years have little if any detrimental long-term effects. This is known as a meaningless habit and usually ceases as a child exchanges an accepted habit for an improved behaviour pattern suitable for his maturation status. Sometimes however if sucking persists it may be rooted in a possible behavioural problem in which the oral habit is only a symptom. The child retreats to the habit when his security is threatened, and exhibits increased anxieties when the habit is corrected. This is then a meaningful habit.

If sucking ceases at 3 or 4 years it is generally accepted that the restored cheek, lip and tongue muscle balance can re-instate the normal dental arch shape.

Breaking the habit
Attempts to stop the sucking habit should only be instigated when the following criteria have been met:

  • Assessing whether the child is mature enough to deal with a restraint of the habit.
  • The child has expressed a clear understanding and desire to be helped.
  • Gaining the support, understanding and cooperation of both parents.
  • Creating a platform where the child has been made aware of a “reward” situation rather than a punishment scenario.

Habit breaking methods are varied and include: Painting the thumb or digit with a commercially unpleasant tasting substance or taping the offending digit or using a glove. Appliances can also be used either as a removable or a fixed oral unit.

The options can be discussed with your orthodontists who will gladly give advice.

- (Health24)

Source: South African Society of Orthodontist

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