Thumbsucking Past Age 4


It’s not uncommon to see a toddler walking around with her thumb in her mouth. However, once a child reaches school age, it is expected that she no longer sucks her thumb. When this isn’t the case, social consequences and dental problems become concerns.

For the child who continues to suck her thumb, the habit has become a crutch. Her thumbsucking is no longer a mere reflex. At this point in a child’s development, breaking the habit will take patience, understanding and a joint effort by both the child and her parents to eliminate the prolonged habit.

Why Do Kids Suck Their Thumbs? 

According to the American Dental Association (ADA), “Children suck on things because sucking is one of baby’s natural reflexes. It may make them feel secure and happy and helps them learn about their world to suck on their thumbs, fingers, pacifiers or other objects.”

An older child might still suck his thumb to relieve boredom or tension or because he is insecure. Also, according to the American Academy of Pediatrics, school-age children “might still use sucking as a way of going to sleep or calming themselves when they are upset. This is usually done in private.” 

When thumbsucking continues into the school years, it may cause problems with the proper growth of the mouth and alignment of the teeth.

Is It a Problem?

The American Dental Association reports, “Usually children stop between the ages of 2 and 4 years.” When thumbsucking continues into the school years, it may cause problems with the proper growth of the mouth and alignment of the teeth. The ADA warns: “When permanent teeth start to come in, thumbsucking could prevent proper spacing and tooth alignment. In severe cases, it can even change the formation of the roof of the mouth.”

When thumbsucking continues into the school years,
it may cause problems with the proper growth of the
mouth and alignment of the teeth.

Although most school-age kids suck their thumbs in private because other kids make fun of them, a small percentage continue thumbsucking during the day. For school-age kids, this habit can “reduce peer social acceptance, an important contributor to social development,” says the ADA.

How To Kick the Habit 

If your child sucks his thumb because he feels insecure, focus on eliminating the cause of the anxiety. If he tends to suck his thumb because of boredom, offer an alternative activity to distract him. If the habit only occurs during sleep, you might want to consider a “thumb guard” (an adjustable plastic cap that is secured to the thumb and not easily removed). Ask your child’s dentist to recommend a guard.

In their book, Good Behavior (St. Martin’s Paperbacks, $17.50), Stephen Garber, PhD, Marianne Garber, PhD and Robyn Spizman suggest that parents chart their child’s behavior and offer rewards for success. “A reward chart increases the chances that a child will practice a new behavior. Tell her she may print her thumb on a thumbprint chart every time she is successful.” Use a nontoxic vegetable dye for this purpose.

Most importantly, the older child must be part of the process. He must be ready and willing to quit and to take ownership of the plan. He’ll break the habit when he is convinced that he no longer wants to continue it.

The following tips can help an older child stop sucking her thumb:

• Don’t use harsh words or teasing. This will reinforce the habit.

• Praise her for not sucking her thumb. 

• Involve her in choosing the method of stopping. 

• Set up an incentive system to reward progress.

• Use a device (such as a thumb guard) — especially if the problem
occurs at night while she sleeps..

• Ask your dentist to explain the effects of thumbsucking to your child.

When To See a Specialist 

Most children will stop sucking their thumbs when they are ready. If your child continues to suck his thumb after several attempts at trying to kick the habit, you may need to seek outside help.

Your child’s pediatric dentist or pediatrician might suggest an appliance that will help facilitate the quitting process or recommend a therapist if you think the thumbsucking is related to an emotional or psychological problem.

Barton D. Schmitt, MD, author of Your Child’s Health, offers the following guidelines for seeking advice from a health care provider:

• Your child is over 4 and sucks his thumb constantly.

• Your child is over 5 and doesn’t stop when peers tease him.

• Your child’s teacher has expressed concern about thumbsucking in class.

• Your child also has emotional problems.

• Your child’s permanent teeth are affected.

Myrna Beth Haskell is a freelance writer.


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