Q&A With Orthodontist Dr. Anton Bass | Thumb-sucking



Q. Madhairday: My daughter sucked her thumb and has a 1cm overbite, very crooked top teeth and receding bottom jaw. She has seen an orthodontist but apparently nothing can be done until she has completely stopped sucking her thumb and all her adult teeth are through. She’s nearly 11. Is this true, and if so do you have any strategies up your sleeve for the thumb thing that we might not have thought of?

A. Anton Bass: I agree with your orthodontist that the thumb sucking has to stop before orthodontic treatment can start. In my opinion, the problem with thumb sucking is that it is usually a sub-conscious habit, so all the techniques I recommend are ones to make my patient aware of the thumb sucking.

Have you tried a ‘thumb diary’? Split the day in three: morning, afternoon and night. She can put a tick for when she doesn’t suck her thumb or a cross when she does (or use coloured stars, just get creative), this will make her aware when the thumb goes in and quite often this is enough to stop the habit.

Give it six months, and then if this doesn’t make a difference, then consider having an orthodontist make a ‘thumb plate’, this is a simple removable plate which fits in the roof of her mouth, just to make the thumb feel different and again make her aware that it’s in.

I would also be concerned about the receding lower jaw, which could be improved with an orthopaedic appliance to enhance the growth of the jaw. This is best used when patients are younger, but as long as she still has significant growth, there is a chance it could work and perhaps the presence of the appliance may even discourage the thumb sucking.

Q. NotSoRampantRabbit: 

I hate my teeth. I have sucked my thumb since I was baby and although I hardly ever suck it now, I have an overbite and very crowded lower teeth. In the last year or so I feel constant pressure in my front lower teeth as one tooth is being pushed back by two adjacent teeth falling in. It is not yet painful but it is uncomfortable. I also notice that I have increasing pressure on my molars at the back – seem to wake up having bitten down hard on them.

From both an aesthetic and a pain/pressure point of view I think I need to do something about this. The cost is a real worry – what is the ballpark figure I would be looking at? Is this something that can be corrected without surgery? And how do I find a really good orthodontist locally. The thought of having a good smile makes me feel quite tearful. I would really love to sort this out.

A. Anton Bass: Unfortunately, without seeing your teeth in the flesh it is difficult for me to advise fully, so I’m not sure if this is a tooth problem alone, or a tooth and jaw issue which would require surgery. The cost is something that would be very difficult to comment on too, as this is all dependent on the severity and how much you would like done. Simple treatment may cost surprisingly less than you anticipated. You should start with a visit to an orthodontist for an assessment and then you can discuss the treatment options. Best to get a referral from your general dentist or you can do an internet search for a local orthodontist and refer yourself.

Q. Gluttondressedaslamb: Obviously it is difficult to prevent very young babies from sucking their fingers or thumbs, but from what age does it begin to impact on the development of their gums/jaws/teeth? Is it better to try to encourage a baby to use a dummy?

A. Anton Bass: General rule of thumb (excuse the pun!) with digit or object sucking is to try to stop it around the time that the first adult teeth start to grow in, which is usually around the age of six, as it could start to impact tooth and jaw development at this stage.

When our older daughter started showing signs of thumb sucking at a few months old, we encouraged the pacifier (orthodontic type). Sure enough, on her third birthday, the ‘pacifier fairy’ came along and took all her pacifiers, after a couple of weeks she never asked for it again and it hasn’t been replaced by a thumb or finger.

Source: Mum’s Net interview.

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