Prolonged thumb-sucking can lead to dental, speech, and self-image problems.

In rare cases, thumb-sucking after age 5 is a response to an emotional problem or other disorder, such as anxiety. Children with this type of problem need to be evaluated by a doctor.

Continue to Why?

Thumb-sucking that continues for years may cause a child to develop dental problems. Thumb-sucking can cause a child's teeth to become improperly aligned (malocclusion) or push the teeth outward, sometimes malforming the roof (upper palate) of the mouth. Malocclusion usually corrects itself when the child stops thumb-sucking. But the longer thumb-sucking continues, the more likely it is that orthodontic treatment will be needed to correct any resulting dental problems.

A child may also develop speech problems, including mispronouncing Ts and Ds, lisping, and thrusting out the tongue when talking.

In addition, a child may be teased or shamed by others if he or she continues to thumb-suck as an older child.

Continue to How?

Motivate your child by talking to him or her about why it is important to stop thumb-sucking. Explain that stopping will help him or her have a beautiful smile and nice teeth. Let your child know that continuing will cause problems with how his or her teeth grow.

• Use a mirror to show your child the changes happening to his or her teeth or mouth shape.
• Talk about the unhealthy germs that are on our hands and how the child puts the germs in his or her mouth by thumb-sucking.
• Talk to your child about becoming a "big boy" or "big girl" by stopping thumb-sucking. Remind your child that he or she may be teased for continuing thumb-sucking.

Make sure you choose the right time to have this discussion. Children often suck their thumbs to relieve stress. Picking a stress-free time will help the child succeed. Also, a child probably needs to be 4 or 5 in order to understand your reasoning and to be able to co-operate in this process.

What are some practical ways to help my child quit?

• For the first week, keep your child's hands busy with puzzles, games, crafts, or other favourite activities. You may need to limit TV time since many children unconsciously suck their thumbs while watching TV.
• You may wish to use a bandage or a bad-tasting substance such as Thum that is painted on the fingernail to remind your child not to suck the thumb. If the bandage or coating comes off, replace it without being critical or embarrassing your child.
• Carefully remove your child's thumb from his or her mouth during sleep. Thumb-sucking at night is the most difficult habit to break. It may take up to 3 months before your child is able to fall asleep without thumb-sucking. Try offering a favourite stuffed animal or putting a hand puppet on your child's hand at bedtime as a reminder. Gently explain to your child that if he or she continues to suck the thumb during the night, the habit will not go away and the changes to the mouth will continue to occur.
• Avoid putting your child in situations that are upsetting while he or she is trying to break the thumb-sucking habit. Your child will likely turn to thumb-sucking for comfort. Make sure your child gets enough sleep and food during this time.
• Offer plenty of praise when your child goes without thumb-sucking during an activity that normally would have included that habit. Do not shame or punish your child for thumb-sucking. This will only lower his or her self-esteem.

Throughout this process, provide empathy and encouragement, and be available for your child. Acknowledge that this is a difficult habit to break. If you are consistent, patient, and positive, your child will be more likely to succeed. Remember this is your child's habit to break, and he or she must be willing to co-operate. Do not force your child to comply.

Should I give my child rewards?

Rewards are a great way to motivate your child. If you reward your child often and regularly for not thumb-sucking, he or she is more likely to succeed.

• Set a goal for how long your child will try to go without thumb-sucking. Start with one day, or even part of a day. Then aim for longer periods. Let your child pick a reward for reaching that goal.
• During the first week, reward your child on the first day. Then reward him or her every other day for good progress. Rewards might be small toys, markers, sugarless gum or candy, a favourite treat, or a privilege like watching a favourite video or a trip to the park.
• During the second week, use a calendar or a progress chart that identifies the days of the week. Let your child put stickers on or mark the days he or she has gone without thumb-sucking.
• After the first goal is reached, set a new, longer goal. For example, if the first goal was 2 weeks without thumb-sucking, the next goal could be 4 or 6 weeks. After this goal is reached, set another, such as 3 months. Make sure your child is rewarded for reaching every milestone.

What if my child can't break the habit?

• Some children have a more difficult time than others giving up thumb-sucking. It is important to use positive reinforcement during this process.
• Try using gentle reminders such as placing a bandage on the thumb so your child is aware when the thumb goes in his or her mouth. You can also try using fingernail coating made for stopping thumb-sucking, such as Thum. It tastes bad when the child places the thumb in the mouth. Be sure to let your child know the coating is not punishment but merely a reminder not to suck the thumb.
• If your child is insecure, has any emotional problems, or is under stress and needs comforting, you may need to resolve those issues first before your child will succeed at stopping thumb-sucking.
• If your child continues thumb-sucking, you may want to speak to your family doctor, pediatrician, or dentist to learn about devices (such as a thumb guard) that can be tried to prevent thumb-sucking.

Continue to Where?

Now that you have read this information, you are ready to help your child break the thumb-sucking habit.

Talk with your child's doctor

If you have questions about this information, take it with you and discuss it with your child's doctor. You may want to mark areas or make notes in the margins where you have questions.