When to be Concerned About Thumbsucking

Is there anything cuter than a baby sucking her thumb? Probably not. However, as adorable as it may be, thumbsucking is a habit (and, according to Psychology Today, the earliest addiction) that should be monitored very closely. A child who sucks their thumb for too long or too vigorously could grow up with misaligned teeth or, in rare cases, a malformed jaw.

How do I know this?

Because I, Jan Badger, Communications Manager for the Tooth Fairy herself, was a thumbsucking addict. The first thing I did after I was born was stick my thumb in my mouth, which of course made my mother say, “awwww!” But when my daughter did the exact same thing I said, “uh-oh.” My parents thought my habit was super-cute. What they didn’t know was that 28 years later I would be suffering from headaches that led to a year of orthodontic treatment and maxillofacial surgery that cost more than $20,000.

Am I saying that if you let your child suck their thumb it will cause them pain and cost you $20,000? No. My case is fairly rare, but it was enough for me to keep a close eye on my own kids and their thumb (and pacifier) sucking habits.

The author at the age of 2, sucking her thumb.
If your child sucks her thumb, monitor it but don't be too concerned. She may just grow up to work for the Tooth Fairy!

It’s important to understand that sucking is a natural reflex that all babies have. Many suck on their thumbs or other fingers even before they’re born! It’s not only a necessary reflex for feeding but is also soothing when they’re stressed or tired.

However, if thumb sucking is too vigorous (often apparent by a “popping” sound when the thumb is removed from the mouth) or allowed to go on for too long, problems can arise with the proper growth and formation of the mouth and jaw, and alignment of the teeth, making chewing and speaking clearly more difficult.

In my case, I slid my jaw slightly to the right to accommodate my left hand and I sucked my thumb a lot. As I grew my jaw formed to fit my little habit and continued to follow that growth pattern long after I quit. As a teen, I was very self-conscious about my “crooked” face and in my twenties I started waking with severe headaches caused by clenching my jaw as I slept, trying to align my upper and lower jaw.

Other negative consequences of thumbsucking can include skin and nail infections on the thumb or fingers, exposure to germs and bacteria, speech impediments and teasing if the child is older.


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How long is too long to allow your child to suck their thumb or use a pacifier?

According to the American Dental Association, most children gradually stop on their own between the ages of 2 and 4 years, but that doesn’t mean you need to wait until your child is 4 to help them break the habit. While you don’t want to turn it into a battle of wills, there are strategies you can employ that can help shorten their dependence:

  • Swap the thumb for a pacifier. While this is really only replacing one habit with another, it will be much easier to wean your child from a pacifier later. (Wait about one month to do this if you’re breastfeeding.) I did this with my daughter and, thankfully, she quickly lost interest in both. Avoid giving the baby a pacifier unless they absolutely need it to self-sooth or fall asleep or if you see they’re sucking their thumb or fingers.

  • Make subtle changes. Then, at around the age of two, start to make little changes to help nudge your child into break the habit. Keep it out of sight whenever possible and only give it when the child requests it. This is also a good time to establish rules about when the pacifier should be used. When my son would ask for his I would say, “You want your pacifier? You must be sleepy. Is it time for a nap?” Most of the time he would rather play (without the pacifier.) Sometimes he chose his bed, which usually lasted for about five minutes—or he would fall asleep! (Yay–bonus nap!) But no matter what, to get out of bed he had to hand over his pacifier. Consistency is key.

  • Say bye-bye. When you feel your child can go without there are many ways to say “bye-bye” to the pacifier:
    • Cut the tip off the end. This makes it unappealing. (This did the trick for my son.)
    • “Mail” it to the Tooth Fairy to give to new babies.
    • Dip it in white vinegar.
    • Build-a-Bear® Workshops will sew the pacifier inside the stuffed toy your child chooses. Plus they get a new buddy as a reward for giving up their habit!

What can you do if it’s too late to switch to a pacifier?

  • Every child should visit the dentist by their first birthday or when their first tooth erupts (whichever comes first). Let your dentist know about the thumbsucking so she can keep a close eye on the development of your child’s jaw and alignment of teeth. Your dentist can also make suggestions on effective strategies to discourage the behavior when it’s no longer developmentally appropriate.

  • Don’t put a lot of pressure on your child to quit unless your dentist deems it necessary. The stress of quitting before they’re ready to let go may cause them to suck their thumb even more! Don’t ridicule or tease. However, there are children’s books available that may help persuade them to give up the habit including David Decides About Thumbsucking, by Susan Heitler Ph.D.

  • Be supportive and encouraging. When your child decides that thumbsucking is for babies and they’re ready to give it up, they may still need a little help breaking the habit. Positive reinforcement and encouragement will go a long way. If small rewards for avoiding sucking their thumb don’t do the trick there are many products that can help. Let your child decide which might help them the most:
    Nipit is an elbow brace that prevents the hands from reaching the mouth.
    Mavala or other bitter-tasting nail polishes act as a good reminder to stop. (Do NOT try the home remedy of using hot sauce or pepper juice as this can be rubbed into the child’s eyes or cause blisters.)
    • Put a bandage around the thumb as a reminder not to suck. Or try mittens, gloves or socks at bedtime.

Finally, be aware that although rare, prolonged thumbsucking after the age of five can be a sign of an anxiety disorder and should be discussed with your child’s doctor.

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This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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