management of thumb sucking habit

[tirath]

Thumbsucking, or the use of a dummy by a baby, is little cause for concern before permanent teeth appear. If the habit persists after permanent teeth appear, the thumb and dummy may force the teeth and jaw out of alignment. This may then need correction by a dental specialist.

If you use a dummy

Do not add flavouring
Check dummy regularly for rips and tears and replace it if these are found.
Keeping dummies clean. Dummies are frequently dropped, so always carry a spare. Before using it again, the dirty dummy should be placed in a sterilising solution to kill any bacteria. If you do not have a spare one, wash the dummy with running water.
Do not suck the child’s dummy, as this will transfer bacteria from your mouth to the child’s.
Never allow children to a share a dummy.

Suggestions for changing habits

Only give the child a dummy at sleep time.
Remove the dummy once the child is asleep.
Discourage your child from walking around with the dummy or thumb in his or her mouth.
If the child still has a dummy or thumsucking habit at around four years of age, make a date by which the child will have given up the habit eg, the child’s fourth birthday. Talk to the child about giving it up and work towards reducing the time the child has the dummy or sucks their thumb. By the fourth birthday, the child may be prepared to stop the habit.
If your child’s sucking habit causes you concern, discuss methods of breaking the habit with your local dental professional.

Remember

Never add flavouring
Discard the dummy as early as possible
The habit of thumsucking should be discouraged and stopped before permanent teeth appear in the mouth.

        

[nitink]

Most children stop sucking their thumbs on their own sometime between ages 3 and 6. They usually do not need treatment.

Children who suck their thumbs may need treatment when they:

Also pull their hair, especially when they are between 12 months and 24 months of age.
Continue to suck a thumb often or with great intensity after the age of 4 or 5.
Ask for help to stop the behavior.
Develop dental or speech problems as a result of the behavior.
Feel embarrassed or are ridiculed by other people because of the behavior.
Treatment to stop thumb-sucking works best if the child is involved in the process and wants to quit. Preferred treatments vary among experts. Some believe that any treatment that does not have the child’s cooperation is not likely to work and may even make the habit last longer. Others believe that it is sometimes necessary to try to stop thumb-sucking even when the child objects.
It is important to delay treatment for thumb-sucking if a child is facing a stressful time, such as after an injury, loss of a pet, moving, or when the family is having difficulties.

Some parents of thumb-sucking children are unable or unwilling to ignore the behavior even in a child younger than 4. In this case, parents may choose to talk to a doctor about their concerns, rather than focus on treating the thumb-sucking.

Caregivers disagree about whether it is best for infants to suck their thumbs or use pacifiers. One advantage is being able to control when your child uses the pacifier. But pacifiers may be linked to an increase in ear infections in some children.1 Prolonged thumb-sucking may cause serious dental problems, although most children stop on their own before entering school. This is largely an issue of preference.

Problem thumb-sucking is most often resolved with home treatment such as offering rewards and praise when the child is not thumb-sucking. When home treatments have not worked, other treatments may be necessary. These include:

Behavioral therapy. Behavioral therapy helps a child avoid thumb-sucking through various techniques, such as substituting tapping fingers together quietly. Behavioral therapy works best if all people involved in the child’s care follow the treatment plan.
Thumb devices. Thumb devices, such as a thumb post, can be used for children with severe thumb-sucking problems. A thumb device is usually made of nontoxic plastic and is worn over the child’s thumb. It is held in place with straps that go around the wrist. A thumb device prevents a child from being able to suck his or her thumb and is worn all day. It is removed after the child has gone 24 hours without trying to suck a thumb. The device is put back if the child starts to suck his or her thumb again. Thumb devices need to be fitted by a doctor.
Oral devices. Oral devices (such as a palatal arch or crib that fits into the roof of the mouth) interfere with the pleasure a child gets from thumb-sucking. It may take several months for the child to stop sucking the thumb (or fingers) when these devices are used. When the child stops sucking, parents may choose to continue using the device for several months. This may prevent the child from starting the habit again. Oral devices need to be fitted by a dentist.

        

[Anonymous]

Thumb sucking is very common in childhood. It provides children with a sense of security and comfort, subsequently some will have difficulty in giving up the thumb sucking habit and will need some assistance from parents. If the thumb sucking persists it can be a difficult habit to break. If you are concerned, it is important to remember that the key to addressing the thumb sucking habit is to have the child want to stop, without pressure.
The Little Bear who Sucked his Thumb is a book directed at children, for children. The book has been written and illustrated by Dr Dragan Antolos, an experienced dentist with a special interest in thumb sucking habits in children. He deals first-hand in management of dental, social, and functional problems which can arise with persistent thumb sucking. The book and chart are a non-invasive and effective strategy for stopping thumb sucking, and have received positive support from psychiatrists, speech pathologists, and pedodontic societies. He is very mindful that parents and practitioners should not place pressure on children to stop as this is only met with resistance and can entrench the problem.

Dr Dragan Antolos, “It is important to balance the psychological benefits of thumb sucking with the negative impact it has on developing, permanent teeth. If you read books to your child, and your child is a thumb sucker, The Little Bear who Sucked his Thumb is a book you should have. The child will relate to the story and it will deliver a positive message without pressure. The book empowers parents to pro-actively encourage their child to stop sucking on their own terms, when they are ready. I am totally against unremoveable restraining aids placed on children’s thumbs to forcefully prevent children thumb sucking, especially in young toddlers. If your child is a thumb sucker between the ages of two and seven, then The Little Bear who Sucked his Thumb is a simple, inexpensive and effective way to help your child address the habit.”

If you have a specific question regarding thumb sucking, or simply have a story you would like to share, email Dr Antolos at .

        

[drmithila]

– The ADA kicked off its annual meeting this week by having150 volunteer dentists, hygienists, and dental students provide 2,000 school children with oral health screenings, education, and treatment as part of the ADA’s Give Kids A Smile program.

The three-day Give Kids A Smile program started Monday at the Gordon J. Lau Elementary School in San Francisco’s Chinatown, with students first getting an oral screening in a mobile van provided by Colgate.

Bergen James, DDS, a pediatric dentist in San Francisco, said most of the children’s teeth are in good condition, with very little evidence of caries.

Dr. Bergen James spent Monday performing oral screenings at an elementary school in San Francisco’s Chinatown as part of the ADA’s Give Kids A Smile program.
“Of the 75 kids I’ve seen so far, only one was in a little pain from decay,” she told DrBicuspid.com as she screened a procession of young students in the van, perched on one of the city’s well-known steep hills outside the school. “I attribute that to the fluoride in San Francisco’s water. And the fillings I’ve seen look good.”

She was particularly looking for children who are good candidates to get sealants on their teeth.

Dr. James has been volunteering for years in an annual elementary school screening program coordinated by the San Francisco Dental Society and the city’s public health department.

Even children in working-class areas of the city have good oral health, she noted.

“In underprivileged areas with lots of immigrants, I’m always kind of shocked at how good they do look, better than I would have thought,” she said.

“I attribute the good overall condition of the children to the fluoride in San Francisco’s water.”
— Bergen James, DDS
Dr. James estimated that she encounters only about one in 40 children who has a “really bad mouth” during her annual screenings.

As the children awaited their turn in Dr. James’ chair, they watched cartoons on a TV monitor that encouraged them to have good dental health habits and avoid sweets.

Most of the kids said they see a dentist regularly and brush their teeth twice daily. They also said that going to the dentist is “no big deal.”

Fifth-grade student Rachel Wu, 10, said she brushes her teeth twice a day and has no cavities. When asked if she’s afraid of going to the dentist, she admitted, “Not really — well, maybe a little.”

Nina Jimenez, a Colgate coordinator for the mobile program, estimated that about 700 students would be screened at the school on Monday. The students also receive oral health education about brushing for two minutes and eating healthy snacks.

Colgate, which has been running the mobile van program since 1991, operates nine such mobile units nationwide daily. The company also gives the children dental kits containing a toothbrush, toothpaste, and oral health instructions.

        

[drsushant]

All the panelists agreed that organized dentistry must make coalitions with community groups and advocates for the underserved to effect significant changes.

In the view of policymakers, the situation has improved because more children are getting dental care, oral health is improving, and costs are being kept down, the panelists noted, so the dental profession has to carefully articulate its concerns.

Vujicic explained: “What is our argument for saying there is a problem if more kids in Medicaid are seeing a dentist, and the average cost of care is going down?”

Dr. Brown concurred: “We need strong evidence to get a sympathetic response,” adding that dentistry has been a victim of its own success. “The percentage of GDP [gross domestic product] for dentistry has plummeted because the profession has been so successful with prevention,” he added. “We need evidence that doesn’t look self-serving.”

More must be done to lobby lawmakers to provide or mandate coverage for dental care besides that mandated for children under the Affordable Care Act, the panelists said.

Dental care is going down among people between the ages of 20 and 64, according to Dr. Brown. “That’s where the big-ticket items are,” he said.

Many states have successfully sued the federal government to get increases in Medicaid programs, Dr. Bailit noted.

“We need to convince adults of the vital importance of oral care,” Vujicic said. “We need to convince legislators that it [dental coverage] is a good purchase. It saves emergency room costs, results in fewer days off from work, and increases wages.”

Another factor, he said, is America’s growing Hispanic population, which traditionally uses less dental services.

Changing attitudes about who should pay for dental care also has come into play, the panelists noted.

One Colorado dentist recalled a patient who balked at spending $1,500 for orthodontics after spending $6,000 on a new bike.

“The attitude has become, ‘We are entitled to dentistry,’ ” he said. “But it’s not an entitlement — it’s a need.”

In times of tight money, people think discretionary income shouldn’t be used on healthcare, especially dentistry, the panelists observed

        

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