Thumb Sucking & Pacifiers
Thumb or finger sucking is considered a natural reflex that often begins in utero or shortly after birth. It is called non-nutritive sucking, as it does not provide food or nutrition. However, it does provide a soothing sense of gratification. The digit sucking ratio is 2:1, it is more common for girls than boys, and is most often a more prolonged behavior. Most pediatric health providers agree that these habits have important formative and nursing functions and any can be overlooked the first few years of life (up to four years of age).

Pacifiers, like thumb sucking, are also non-nutritive. However, it does offer some advantages.

• Pacifiers can be kept cleaner.
• They are usually easier to give up once the child is 3-31/2 years old.
• A pacifier can act as a mouth guard by preventing injury if the child happens to fall.
• Orthopedic and orthodontic changes are usually less severe.

Non-nutritive sucking habits that persist after the permanent teeth have erupted, can cause problems with proper jaw growth and tooth alignment. The amount of orthopedic and orthodontic problems depend on how frequent the habit is and whether it is performed passively or vigorously.

Stopping a sucking habit, like a thumb or a pacifier, should be attempted before permanent tooth eruption (five or six years of age). Most children do not understand the need to stop before then. At age five, a child’s reasoning ability allows them to better understand why quitting it is important. With formal education beginning at this age, peer pressure is another reason a child may attempt to stop their habit.

Here are a few suggestions that may help you and your child stop the habit.

1. The pacifier is generally safe until about age three. At that time think of a creative way to trade the pacifier for another object. For example, holidays are a good time for a trade: The Easter bunny for eggs, Santa for stocking stuffers, Halloween for healthy treats or Birthday’s for special toy.
2. Do not attempt stopping a thumb or finger habit before 4 1/2 - 5 years of age. Everyone will be frustrated and the habit only tends to get worse.
3. Use positive reinforcement; do not belittle your child.
4. Start a sticker chart. You may want to start out by giving a sticker for each hour of no habit. A reward may be given after 12 stickers. Then gradually lengthen the demand for stickers.
5. Use gentle reminders such as a bandaid on the finger or a sock on the hand. Nail polish may also work.
6. During summer break girls may be motivated by manicures or acrylic nails.
7. A six-inch ace bandage placed snuggly, not tight, on the elbow prevents the child from bending their arm at night. If the child still manages to get their finger into their mouth, it usually “pops” back out once they fall asleep.
8. Your pediatric dentist or registered dental hygienist may recommend a thumb guard appliance that fits over the thumb and wrist.
9. As a final resort a fixed habit appliance, which is placed into their mouth, may be recommended.