Q&A With Dr Emma
Hi Dr Emma
We have a 6 year old who has sucked her fingers from birth. We have tried every method from gloves, reward charts, the special nail polish etc and nothing has worked. She has a desire to stop and does not seem to do so for anxiety reasons, just more out of habit when tired or in the car or watching tv.
We visited the dentist who said we are lucky as it has not caused an overbite and not to worry, but her adult teeth are coming through and the top front ones are very crooked, one is almost sideways. It is affecting her teeth. I had braces, she very well may need them anyway due to genetics (I'm assuming) but we know her finger sucking is pushing the teeth out.
Our last option is a plate? I am not sure if we even have an orthodontist in Karratha being regional so I am hoping for some advice. Mainly, does the plate hurt to fit in her mouth or take out? How long does it last for? We are at a loss at what to do and do not want to keep making an issue out of it with our daughter as it is not her fault and we don't want to create anxiety. Thanks for your time.
Kind Regards,
Keea from Karratha
Dear Keea,
It certainly is a frustrating situation, and it sounds like you're a great mum who has tried nearly everything! Finger (or thumb) sucking is actually very common, as sucking is a natural reflex for babies to allow them to feed. Most children will stop by themselves between the ages of 2 and 4 years old. However, 15-40% of kids will continue some sort of sucking habit, be it fingers, thumbs, or a dummy, so you're certainly not alone.
A behavioural approach to stopping the habit can work well if it's done in a positive way, such as with a reward chart. This won't work for everyone though, especially if the child has a strong-willed personality and doesn't want to give up. Try to look at your experience with this not as a failure, but as a great sign that your daughter is not going to be pushed around by the world!
Using aversion, such as bad-tasting nail polish, can be effective. If your child is digit-sucking for comfort though, it can cause some amount of distress. And again, a particularly strong-willed child will simply find a way to overcome the unpleasant sensation.
For someone who has tried all the simple solutions, a mechanical approach combined with a psychological element is likely the best way to go. What I mean by that is investigating seeing a child psychologist to make sure there's not some underlying anxiety causing your daughter to seek comfort this way. Even people who seem self-assured and have otherwise happy and stable lives can be affected by anxiety, in fact it's the most resourceful ones who find their own way to cope. You can combine this with an oral appliance (plate), which will physically stop your daughter from being able to fit her fingers in her mouth and get suction. Talking about her habit and the plate with a psychologist will help to make sure she doesn't come out of the experience with a negative attitude towards dental treatment.
Her stage of dental development will determine which design of plate is most appropriate, so a visit to your general dentist will be needed. It's up to him or her as to whether or not an orthodontist should be consulted, it's not a given. A general dentist can order and fit a simple orthodontic plate if it's something they are comfortable doing. The plate can be either removable, or cemented in place. It is not actively putting force on the teeth, so should not be painful at any stage, probably just annoying. Some research shows above a 90% success rate after just 3 months of plate use, but I know of orthodontists who recommend 12 months, so the duration of treatment will depend on the dental professional you see and the subsequent assessment of your daughter.
If she continues her finger-sucking habit, her permanent front teeth will keep being pushed out of alignment. Sure, this can be fixed with braces later in life, but the other concern is her jaw development. Continual digit-sucking can also cause the jaws to grow differently, which may end up with more complicated orthodontic treatment being needed in the future.
When patients ask the best time for their child to stop their digit-sucking habit, the answer is usually "as soon as possible!". It's not always possible though, children are people after all. They have their own needs, wants, desires, and motivations. If you can find a way to work with your child as an individual and help her to stop, rather than forcing her, you are much more likely to be successful.
Thanks,