By David Hutto

All people are born with a natural sucking instinct, so that a newborn when placed to the mother’s breast is able to feed from birth. In addition to the pleasure and satiation of eating, breastfeeding can provide comfort and positive feelings from being held and caressed, as well as from the warmth and touch of the mother’s body.

Sucking may therefore become associated with a range of positive feelings, but there is no instinct to suck the thumb. Instead, the pleasure and comfort associated with sucking are often transferred to the thumb, or sometimes to the fingers. This is learned behavior, and because it does not involve feeding, it is sometimes called non-nutritive sucking.

Thumb sucking can also be an expression of a strong emotional impulse, one of the reasons it can be so hard to break the habit. Most people will suck their thumb before the age of two, and a young child will learn to suck their thumb when bored or distressed, trying to recreate the pleasure previously associated with sucking. We even recognize how common it is for sucking to provide comfort as we routinely give babies pacifiers (the word “ pacifier” literally means “to make peaceful”).

Most people suck their thumb when very young, especially before the age of two, but most also outgrow it while still young. If the habit continues beyond four or five years old, it can cause several problems. The most common complications are dental, but in addition a child may be more exposed to infections from putting the thumb in the mouth, or at an older age they may experience ridicule from their peers.

Dental problems can occur because the sucking pressure applied to the thumb when held between the teeth can distort the alignment of the teeth. Improper alignment is called malocclusion, and there are various kinds, but the most common from thumb sucking is when the teeth protrude forward. In other cases the sucking can negatively affect the shape of the roof of the mouth.

If a child simply holds the thumb in the mouth, there is less chance of damage than from a child who actively sucks on the thumb, though extended thumb sucking lasting for years is still a potential danger for harming the teeth. Generally, the potential for problems with the teeth is more of a concern only when the permanent teeth begin to come in, but in some cases a child with aggressive sucking may damage the baby teeth as well.

Since thumb sucking is normal and harmless for infants, but may become a problem in older children, parents can be uncertain whether a problem exists and whether they should intervene. The question is complicated as there is no exact agreement on when children should stop thumb sucking on their own. Some sources say a child will naturally stop between 2 and 4, others by the age of 5, and others between 3 and 6.

Some reasons for parents to become concerned over thumb sucking are when the habit lasts beyond four or five years old, if there are any noticeable dental problems, or if social problems begin to occur, such as the child encountering ridicule.

When parents decide to intervene to stop thumb sucking, they should remember that all habits can be hard to change, especially those that provide comfort or pleasure, and thumb sucking is no exception. The parents should also bear in mind that ridicule and nagging not only may not work, but they can be harmful psychologically. In some cases a child may even want to stop but be unable to.

Other types of negative reinforcement should also be avoided, including putting unpleasant substances on the thumb, such as vinegar or hot substances. A more useful approach is to reward positive behavior when the child is not sucking their thumb. It may also be useful to try to understand what triggers the thumb sucking behavior, such as stress or anxiety, and address those problems.

When more intrusive forms of intervention are needed, some parents have even gone as far as trying hypnotism to break the habit (Grayson 2012).  If the problem is severe enough and nothing else seems to be working, a mechanical device that interferes with sucking has been shown to help (Madiraju & Harika 2011). Devices that fit onto the hand will alter or prevent the pleasure the child receives from thumb sucking, and with time the thumb sucking habit can be abolished.

The most unique and recommended way to break the habit is to remove the pleasure that promotes it. TGuards have been shown to be over 90% effective in stopping the habit, and work by breaking the suction which creates the pleasure. The best remedy for thumb sucking is one that is not painful, does not cause any discomfort, and allows your child to continue with their daily activities unimpeded. Above all, it should work, and work fast. TGuards have been shown to be effective in all of these areas.

References:

 American Dental Association. (2013). Thumbsucking. Retrieved from http://www.mouthhealthy.org/en/az-topics/t/thumbsucking.aspx.

 Grayson, D. N. (2012). Hypnotic intervention in a 7-year-old thumbsucker: a case study. American Journal of Clinical Hypnosis, 54, 195–201.

 Madiraju, G. S., & Harika, L. (2011). Effectiveness of appliance therapy in reducing overjet and open bite associated with thumb sucking habit. Minerva Stomatologica, 60, 333–338.

 Mayo Clinic. (2012, Aug. 10). Thumb sucking: Help your child break the habit. Retrieved from http://www.mayoclinic.com/health/thumb-sucking/MY01262.

 WebMD. (2011, Dec. 20). Children’s Health: Thumb Sucking Topic Overview. Retrieved from http://children.webmd.com/tc/thumb-sucking-topic-overview.

by David Hutto

While the sight of a child sucking the thumb may evoke an image of innocence, the harmful effects of prolonged thumb sucking can be severe. If the services of a dentist or orthodontist become necessary to address the problem, those effects involve great effort, emotional impact, and high cost.

Dental devices to break the thumb sucking habit

Several techniques are available that attach a mechanical device by wires to rear molars, extending to the front of the mouth. These devices work behind the upper front teeth at the roof of the mouth to disrupt the pleasure of sucking on the thumb. One of these, the hay rake, has short “spikes” or prongs in the middle, just behind the front teeth, intended to cause discomfort when the thumb is inserted; namely, the sharp prongs literally hurt the thumb. A very similar device is the intraoral crib (also called palatal crib), but instead of spikes it uses a set of metal rings or bars behind the upper front teeth, also to disrupt the pleasure of sucking the thumb. Once the palatal crib is inserted, a dentist may leave it there for several months, so a child may have to live with these kinds of devices (and their subsequent discomfort) for long periods. The blue grass appliance(the name comes from being invented in Kentucky and used for horses) is a more comfortable variation on the hay rake. It is similar in the method of attachment, but instead of simply disrupting insertion of the thumb, this device also provides an alternative behavior. The bluegrass appliance contains either beads or a short Teflon roller, which can be rotated with the tongue. With this device, the child is expected to roll the tongue on the beads or roller instead of thumb sucking.

 Dental devices to correct damage from thumb sucking

If thumb sucking has not been stopped soon enough and damage occurs to the teeth or jaw, the expensive services of an orthodontist are required. Most people have seen braces, the standard method of straightening teeth. Although there are various kinds of braces, most use brackets,a component of braces consisting of small metal or ceramic objects placed on each tooth. The brackets transfer the pressure from an attached wire to gradually pull the tooth into the desired position. Various wire systems are also available, one of the newest of which is memory wires, made from “memory” metal (developed for NASA). This wire exerts constant pressure on the brackets without the need for periodic tightening by the orthodontist. Another wire device is the quad helix, attached to the upper teeth from behind and exerting pressure to expand them. When braces are applied, they may be worn on average from eighteen months to two years, though longer sometimes happens. During that time, periodic visits to the orthodontist are necessary.

Simpler and cheaper

Full orthodontic treatment, with the application of braces, may cost from $4,000 to as much as $7,000, and even a less comprehensive procedure, such as inserting a hay rake or crib, can cost hundreds of dollars. There is an alternative to requiring the services of an orthodontist because of damage from thumb sucking. It is possible to avoid hay rakes, cribs, braces and brackets, trips to the orthodontist office, and the notable expense of these services, not to mention the pain and discomfort the child will experience from having to live with these devices implanted in the mouth.

Stopping thumb sucking early means that none of this has to happen. TGuard is recognized by dentists, orthodontists, and pediatricians, as a painless and cheap method to stop thumb sucking and prevent the consequences that come from it.

 

Sources:   AOAaccess “Allesee Orthodontic Appliances (AOA)”

 

By David Hutto

The word “occlusion” is used to describe the way the upper and lower teeth fit together. The best fit is when the upper teeth slightly fit over the front of the lower teeth, with molars (the rear teeth) fitting together in a kind of grooved way. “Malocclusion” refers to a situation in which the upper and lower teeth come together incorrectly.

Malocclusion is divided into several types, but the most common from thumb sucking is when the upper teeth project forward, as though they are moving toward sticking straight out, a condition called “overjet” (different from “overbite,” which is the normal fit when not excessive)

There are various reasons why a person may have malocclusion of the teeth, including injury or birth defects. The teeth can also be subject to displacement from any kind of prolonged pressure, even from nursing bottles (Robke 2008). One of the possible causes of malocclusion comes from children applying pressure to the teeth and mouth from prolonging sucking on the thumb or fingers.

Quite a few potential problems may arise from malocclusion.

  • Tooth decay: risk of tooth decay may increase, in part because properly aligned teeth are easier to keep clean.
  • Periodontal disease: malocclusion may create an increased risk of periodontal disease from gingivitis (an inflammation or infection of the gums) or periodontitis (inflammation or infection that has spread to ligaments or bone, with possible loss of teeth).
  • TMJ problems: excess pressure on the tempromandibular joint (often referred to as TMJ) can lead to biting or chewing problems, pain in the jaw, headache or earache, or difficulty with opening and closing the mouth.
  • Facial distortion: the shape of the face can be distorted with malocclusion, which may even require surgery to correct (Guzel 2000).
  • Chewing or speech problems.
  • Social problems: embarrassment due to extremely crooked teeth can be a serious problem for some people.

Treatment for malocclusion depends on the type of secondary problems that are associated with it. The most common treatments involve braces, which are expensive and inconvenient. More extreme cases may even require surgery.

Preferable to treating problems afterward is to prevent them from happening. When malocclusion is caused by thumb sucking, the problem is entirely preventable. With the use of TGuard, the thumb sucking habit can be broken, preventing malocclusion and saving your child from later problems.

References:                                                                                            

Guzel, M.Z. (2000). One-stage approach to the correction of facial skeletal deformity with malocclusion. Journal of Craniofacial Surgery, 11(2), 128-36.

Malocclusion and Orthodontics: What Happens. WebMD. http://www.webmd.com/oral-health/tc/malocclusion-and-orthodontics-what-happens

Malocclusion of teeth. Medline Plus. http://www.nlm.nih.gov/medlineplus/ency/article/001058.htm

Robke, F.J. (2008). Effects of nursing bottle misuse on oral health. Prevalence of caries, tooth malalignments and malocclusions in North-German preschool children. Journal of Orofacial Orthopedics [Fortschritte der Kieferorthopädie], 69(1), 5-19. doi: 10.1007/s00056-008-0724-7.  [Article in English, German]

By David Hutto

Picture a child in first grade standing on a school playground, watching other children kick a ball. The child wants to play and moves toward the other children, then asks, “Can I be in it?”

Instead of an expected answer like “OK, you be on that side,” the child is told “No, you’re still a baby. You suck your thumb. This game isn’t for babies.” And then imagine how that child feels.

If you think such a scenario is unlikely, consider that no less an authority than the Mayo Clinic, in discussing how to break a child of the thumb sucking habit, writes “For older kids who continue to suck their thumbs, peer pressure at school usually ends the habit” (Children’s Health).

Peer pressure. In other words, ridicule and teasing. It is assumed that older children who suck their thumbs will be teased.

Children can be inherently cruel, zeroing in like a laser on any perceived differences. According to the Health and Human Services website stopbullying.gov, children most at risk of being bullied are “perceived as different from their peers, such as being overweight or underweight, wearing glasses or different clothing, being new to a school…” (Stopbullying.gov website). Children are looking for differences, and an older child sucking the thumb will certainly stand out.

Bullying has been recognized as a serious problem, something more than merely the negotiations with other people that everyone has to learn as we grow and mature. All bullying is abuse, and it can leave victims depressed, moody, or withdrawn. More serious effects can be a refusal to go to school or damage to self esteem.

Bullying can take a variety of forms. It may be physical but it can also be psychological, such as verbal teasing or what psychologists call “omission,” or leaving a child out of activities, as in the playground scenario above.

Recent statistics show that 1 in 7 students in grades K-12 is either a bully or a victim of bullying, and 15% of all school absenteeism is directly related to fears of being bullied at school (Facts and Statistics). Because thumb sucking is often a stress-coping mechanism, the stress of being bullied can even lead to greater thumb sucking, creating a harmful and difficult cycle.

A second type of potential social impact from thumb sucking comes not from being observed as a thumbsucker, but from the physical damage that may be done to the teeth. If thumb sucking goes on too long, it can lead to malocclusion or other damage to teeth, creating an appearance that may be embarrassing to the child. Such embarrassment, even without teasing, can be harmful to social interaction and comfort.

All of the consequences discussed above are due to excessive thumb sucking, beyond the stage that is normal for all young children. None of these consequences has to happen, however, as they can be avoided by breaking the thumb sucking habit. Along with psychological support and positive reinforcement, a proven way to help break the habit is by disrupting the physical pleasure of sucking the thumb, and T Guard has been shown over and over to be an excellent physical device to stop thumb sucking.

 

Sources

Children’s Health: Thumb sucking. Mayo Clinic. http://www.mayoclinic.com/health/thumb-sucking/MY01262

 Facts and Statistics, Make Beats Not Beat Downs, http://www.makebeatsnotbeatdowns.org/facts_new.html

 Stopbullying website. U.S. Dept. of Health and Human Services. http://www.stopbullying.gov/index.html

By David Hutto

As an adult you surely would not dream of running your hands over multiple surfaces and then licking off the collected bacteria and viruses. Yet children who suck their thumbs are doing exactly this.

As parents will testify, even without thumbsucking, young children consistently bring home colds and illnesses picked up from other kids. While part of that frequency of illness may be due to developing immune systems, children also become ill because of undeveloped health habits. With poor hygiene, children will transfer bacteria and viruses from nasal mucus or saliva to objects around them.

Those objects then become a source for other children to acquire infection. As WebMD points out, “Some viruses and bacteria can live several hours on hard surfaces like cafeteria tables, telephone receivers, computer keyboards, and doorknobs.” Children who suck their thumbs after such contact are at increased risk of infection from whatever has been left there.

Different types of bacteria have varying routes of transmission. Some use airborn routes and others are transmitted in food, but many can be acquired from the hands after touching a source of infection. Colds, for instance, mostly caused by rhinoviruses, can be transmitted from mucus on the hand. Viruses can also be transferred through contact with an infected person’s saliva.

There are many types of diseases that may be transmitted by hand: (from respiratory secretions) influenza, Streptococcus, respiratory syncytial virus (RSV) and the common cold; (from urine, saliva, or other body substances) cytomegalovirus, typhoid, staphylococcal organisms, and Epstein-Barr virus; (from fecal sources) salmonellosis, shigellosis, hepatitis A, giardiasis, enterovirus, amebiasis, and campylobacteriosis (Wisconsin Department of Health Services). There is even one study of thumbsucking children that found a shocking 80% of them had acquired parasitic infections (Idowu).

Most of these diseases can be avoided, since the route of infection is from the hands to the mouth, nose, or eyes, and intervention in this transmission is possible. According to the Centers for Disease Control and Prevention, “Keeping hands clean through improved hand hygiene is one of the most important steps we can take to avoid getting sick and spreading germs to others.” Or as the Minnesota Department of Health has described the situation, “Simply washing your hands can help prevent such illnesses as the common cold or eye infections.”

Realistically, in spite of the importance of hand hygiene, we cannot expect young children to quickly adopt the careful handwashing and good hygiene that come with age. Children resist washing their hands, do not always wash well, and are generally unaware of disease transmission from the hands.

In this complicated situation, thumbsucking poses an added risk of infection, beyond what other children normally experience. With a device like Tguard, however, thumbsucking can be effectively prevented without trauma to a child. By gently stopping children from sucking their thumbs, we are practicing good parenting and protecting them from a range of potential infections. Tguard is one more way to help keep your child healthy.

 

Sources

1. WebMD, http://www.webmd.com/cold-and-flu/cold-guide/cold-prevention-hand-washing.

2. Wisconsin Department of Health Services, http://www.dhs.wisconsin.gov/publications/p4/p42052.pdf.

3. Idowu OA, Babatunde O, Soniran T, Adediran A. “Parasitic infections in finger-sucking school age children.” The Pediatric and Infectious Disease Journal. 201; 30 (9): 791-92.

4. CDC, http://www.cdc.gov/handwashing/.

5. Minnesota Department of Health, http://www.health.state.mn.us/handhygiene/why/5ways.html.