By Shari Green, COM®

That adorable baby with their thumb in their mouth…truly a precious sight to behold. But, what happens when that habit continues a bit too long? Should parents become concerned? After all, they will grow out of it anyway, won’t they? Well, not necessarily.

Childhood sucking past age five is a habit. A habit that has roots in the very earliest days of life. Childhood sucking is a pleasurable activity from day one, often associated with early pleasurable innate physiological responses. This is the essence of why it is so hard for some children to stop their habit easily. What does a young child equate sucking behavior with? Those first sucking experiences often represent the pleasurable feelings associated with nursing such as warmth, cuddling, mommy, and milk. When children suck, beta endorphin, a powerful and calming chemical is produced,and attaches to the opiate receptors in the pleasure center of the brain. This strong biochemical reaction from the sucking behavior results in the pleasurable and often addictive-like feelings the thumbsucking child experiences. And, that association, and the pleasurable feelings it conjures up, is what makes an oral habit so hard to “kick”.

When does a child typically suck? When they are bored, they may use their thumb to stave off boredom. When a child is upset, they may seek to calm themselves by sucking. And, when they are falling asleep, the thumb goes in as they drift easily off to sleep. Again, all triggers related to the calming biochemical effect sucking often brings.

However, most of the time the thumb goes in and children don’t even realize it. It is mainly a subconscious habit. Well-meaning parents telling a child to “get their thumb out” often do not anticipate that this may actually weigh heavily on the child and encourage even more sucking behavior! How? This “encouragement” reminds the child that they have failed yet again in regards to a behavior they have little to no control over. This loss of control over their habit often encourages even more sucking as they seek to find comfort using their thumb. A negative spiral ensues. Basically, the thumb slips in…the child feels bad it went in…they get upset and seek comfort…and they ultimately suck even more. It often becomes a vicious cycle.

The obvious concerns many parents see are changes to the mouth. The act of sucking often creates pressure on the sides of the mouth, top and bottom front teeth and dental arches. The jaw remains excessively down during sucking, and the tongue is positioned down into the middle or floor in the mouth. Of course, pressure on the dental structures and roof and the ensuing poor tongue rest postures that are encouraged during sucking may lead to significant changes that have the potential to alter the bite, oral development, and growth trajectory of the facial structure over time.

After age 4, the tongue should rest within the roof, away from the teeth. Prior to that time the proper tongue resting position is gradually evolving. However, this is not the case in 99% of children who suck their thumbs after age 5.

Most children who suck beyond age five maintain a low or forward rest posture of the tongue. A common term for this is “tongue thrust”. All children start out with a “tongue thrust” pattern, but by age 4-6, it typically transitions if nothing like a digit habit impedes this process. The most efficient growth of the mouth and face, production of speech sounds, and swallowing occurs with a more upward and retracted motion of the tongue. However, this ability can be severely impacted in the thumbsucking child. Difficulty biting, chewing, or gathering food can also result. Some children may develop difficulties or even aversions to certain food textures just too challenging for them to handle.

Other lesser known concerns involve issues with self esteem. Some thumbsucking children may withdraw from social situations, especially if they have been previously caught off guard with their thumb in their mouth and they happened to have been seen by others and teased.

Socialization often becomes challenging if they fear further teasing or taunting. Some children, as a result of this fear, will further retreat to the comfort of their thumb and prefer the sidelines rather than the fun of playing with others. If speech or the appearance of their teeth have been unduly effected, this further effects their self esteem. A child who is not easily understood in conversation, or whose appearance seems “awkward” from teeth that have shifted out of place will often feel self conscious and socially retreat even further.

“Thumbprint” in the roof of a thumbsucking child

What can parents do? Well, first, keeping a child busy and not allowing boredom to set in is invaluable. Busy thumbs do not tend to sneak in. A bag of manipulatives is helpful for many…especially in places where a child may find themselves bored or alone. The car or TV are huge triggers. It is best to limit the TV and encourage more outside play. Of course, praise for not sucking is preferable to nagging as it increases the child’s self confidence that they can stop…if only for a moment. A small step can often lead to future larger gains if you put a positive spin on it. “Hooray.. You have not sucked since you have been playing with your toy car…I am so proud of you for keeping your fingers busy!” And, if the going gets rough, one should never hesitate to seek the help of a professional. Certified Orofacial Myologists® are specialists who are trained in gentle and positive behavioral techniques for successful thumbsucking elimination.

Children as young as four can successfully participate in a behavior modification program of this nature if they have the desire to want to stop…they just may need a little help, and as we all know, it is always OK to ask for help…In addition, the tongue can be encouraged to learn new patterns during this therapeutic educational process, which can lead to the encouragement of proper facial growth and development. And studies show, self esteem increases significantly following participation in these specific habit programs.

Yes, enjoy that adorable baby with their thumb in their mouth! Life is too short not to. And know that there are choices out there that you as an informed parent can make to help you and your child navigate this journey, which is what this article is all about!

Shari Green, C.O.M.

Certified Orofacial Myologist®
Past President, International Association of Orofacial Myology


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