In Part I of this blog series, I mentioned that my toddler sucks her thumb.  The question I always get is “so, when are you going to make her stop sucking her thumb?” Truthfully, I kind of love it right now because it’s both cute and it’s a really effective soothing mechanism. At some point, though, thumb sucking can cause some bad things to happen in the mouth (see Part 1 for more on that).

This blog post will offer some guidance on when to stop thumb sucking while also explaining why this can be a difficult question to answer with a one-size-fits-all answer. One more thing before I continue: for the purposes of this blog, “thumb sucking” includes other finger sucking or habits like cheek/lip sucking or sucking on a piece of clothing.

Let’s get to some answers. First of all, it’s important to start by saying that the negative consequences of thumb sucking depend on many factors, but it basically boils down to how much time is spent with the habit.  Does it only happen at night or also during the day?  What is the frequency of the habit? How long has the habit been ongoing?  

 

With that said, here are some recommendations for when a child should try to kick the habit.

  • Age 3: Thumb sucking is widely considered “normal” until age 3.  This is because it is around age 3 when children develop normal swallowing patterns.  Some clinicians may argue for cessation at age 3.

 

  • Age 6: This is where I fall. At age 6, the permanent front teeth are usually erupting.  If you can stop a thumb sucking habit by age 6, the eruption of those teeth should be more normal, the chance of open bite decreases, the chance of a nasty tongue thrusting habit decreases, and there is enough growth still to come to make up for whatever growth patterns had, to that point, been altered.  Furthermore, whatever growth patterns that have been altered can be corrected by an orthodontist in the future (side note: the American Association of Orthodontists recommends that children first see the orthodontist at age 7-8, precisely so that modifications to growth are possible while growth still remains).

 

  • Age 11: This is a “backstop” age for me – it is certainly better to stop thumb sucking before this age, but…sometimes life is complicated. As any parent of a thumb sucker knows, for some kids, thumb sucking is a really important soothing mechanism! Forcefully stopping the habit can be dangerous psychologically. Forceful cessation may negatively impact sleep quality (which has a whole other set of ramifications).  Sometimes, there are other, more important things going on in a child’s life than fighting a finger sucking habit. I do not believe in trying to forcefully stop the habit until the child desires to stop the habit; otherwise, cessation may be unsuccessful or even traumatic. With that said, the longer you wait past about age 6 to stop a thumb sucking habit, the greater the likelihood of some of the bad things that result. This is where my age 11 backstop comes in. By age 11 there is some growth still remaining and that gives me, the orthodontist, a better chance to correct the negative consequences of the habit.

 

In a nutshell, thumb sucking can be considered “normal” until age 3.  I recommend attempting to stop any thumb sucking by age 6, if possible, and by age 11 almost definitely, but one should consider each individual circumstance. In my next blog post, I’ll discuss some strategies for stopping thumb sucking.