Thumb sucking

Thumb sucking is one of the issue i often hear from the parents in the pediatric department. Here we see about the reason behind thumb sucking, its consequences on the prolonged practice, and how to manage it.

Why a child do thumb sucking?

Thumb sucking has a strong correlation with the child psychology. Let us see in detail.

Fear is the first emotion elicit by an individual ever after introduced to the world. It is a kind of inherent one. The rest all emotions are acquired slowly when the child grows. Sucking thumb psychologically provide a secured feel to the child as he/she is close to the mother. Thumb sucking is the positive reinforcement in child’s behavior upto the age of 3. By this time the child should have acquired trust and courage to face the outer environment/ society by his/her own and eventually the thumb sucking habit should wear off.

What are the reason for prolonged use of thumb sucking habit and when it is considered abnormal?

Any imbalance in the above process will lead the child to prolong the habit of thumb sucking whereby then it become the negative reinforcement. On or after the age of 4, thumb sucking habit is considered as abnormal and should seek for attention.

The unsecured feel that the child developed during their course of development causes to prolong the habit. The most probable reasons could be due to 

  • Child having less attention from their parents
  • Over protective child where he/she fails to learn self defense
  • Presence of sibling where he/she starts to compare the parents attention between each and become submissive
  • Child left with care taker in the first three years of life
  • Abused child
  • Child grown up in the closed environment with minimal exposure to the outer world
  • Dominant parents where the child gets minimal or nil chance to express his/her thoughts or requirements

What are all the consequences of thumb sucking habit ?

  • Deprived mental health of the child.
  • The child may become an attention seeker even for the basic things or will prefer to be all alone everytime or may become exceptionally imaginative
  • Dental problem includes, proclination of front teeth, narrowing of upper arch form and development of malocclusion

How to manage thumb sucking habit?

Management takes place by two intervention

Psychological intervention, where parents play a major role.

  • Sit and talk to your child as long as you can and try to grab out the hidden emotion that he/she is going through ( can take the medical counsellors support if you cannot able to find out )
  • Make your child to understand that how much he/she is important in your life, rather than simply advising to break the habit
  • Understand the child’s need and go accordingly
  • Spend adequate time with your children and treat the siblings equally and do not compare one with the other
  •  Provide them opportunities to decide by their own with good guidance.

Dental intervention,

  • Use of habit breaking appliance, which is to be wear for 7-8 months along with the muscle strengthening exercises.
  • To undergo orthodontic treatment to correct malocclusion.

Importance of restoring children’s tooth

One of the most frequent question we face in our regular practice.. Why to fill the tooth when anyways it is going to fall off at one point!!!! This is one of the valid question which need a responsible answer.

Before going into the main topic, It is very important to understand that…”tooth is a tooth”, irrespective of deciduous or permanent teeth, it has to be treated and restored. You may wonder why!!! And what is the necessary of doing so…but the truth is, every tooth has its own unique function like every organs in the body. On losing those, you may tend to lose its own funtionality along with its supporting structure which end up with a mess in oral cavity.

So now, let us focus on primary teeth ( also called as milk teeth or deciduous teeth)

what will happen if you dont restore the primary teeth???

  • Speech impairment or alteration in the phonetic or pronounciation:

Yes, it is a true fact that every position of the tooth(both front and back) plays a vital role in Kids speech ability and it is well known that it is the vital age to learn phonetics. Any missing tooth or an altered position of tooth leads to airflow imbalance causing mislead in phonation.

  • Misguidance in the eruption pattern of permanent tooth:

The eruption pathway of permanent teeth are guided by the preceding primary teeth. When there is a premature loss of primary tooth, more chances for the  succeeding permanent tooth to loss its path and may erupt either out of the alignment or do not erupt at all( which we call as impacted tooth).

  • Spread of infection to the succeeding permanent tooth:

When the primary tooth is left untreated for longer time, there are more chances for pus formation which inturn affects the underlying permanent tooth

  • Impairment in the jaw bone growth:

This is a rare scenario, when the child’s oral health is very poor causing premature loss of multiple teeth at the early stage of life, the growth of the supporting structures like gums , soft tissues and bones are affected and showing some sort of retardation later.

Now i hope it will be understood why it is so important to restore the primary tooth.

So how to manage them!!!! Let us have a brief of that.

It is not that easy to protect primary teeth as the primary teeth are more prone for tooth decay when compared to the permanent teeth.

  • Have regular follow ups with your child’s dentist
  • Hydrate your kid well with adequate water intake. This helps to prevent the PH drop in the oral cavity thereby helping the tooth from caries attack.
  • Maintain proper oral hygiene. Always help your kid to brush twice daily and make the habit of rinsing the mouth after every meal.
  • Whenever you spot a black or brown discolouration on the tooth, it is an alarming sign to start with the preventive interventions
  • Initial preventive methods start with the flouride application. Either by tooth paste or in office application as recommended by your dentist. (* It should not be taken by your own as overdosage of flouride has its own consequences)
  • Pit and fissure sealants. These are white coloured sealant material preferred for the initial caries attack which helps to prevent the tooth from further damages
  • When the decay is considerably deep, conservative management takes up the role. certain filling materials like silver amalgam( not preferred nowadays by most of the dentist due to the concern of mercury toxicity) , GIC and composites are used
  • When the kid elicits pain or sensitivity or mild swelling, it means the decay is on or close to the vital structure called pulp or sometimes the infection have crossed beyond the root (swelling condition). Here comes the next level of management where root canal treatment(pulpectomy) or pulpotomy are considered. Followed by stainless steel crown placement( so as to prevent the tooth from breakage).
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  • When the tooth is completely gone (grossly decayed), removal of the tooth followed by placement of space maintainer is recommended. This will help to retain the space for the permanent tooth to erupt.
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Likewise the milk teeth are prevented and restored. It is always better to take early intervention right from better oral hygiene.