Thumb and finger habits make up the majority of oral habits. However two thirds of children who engage in thumb and finger habits outgrow them by age five. The dentofacial changes will vary with the intensity, duration and frequency of the habit and the position of the digit in the mouth.
The dentofacial changes include:
1. Anterior open bite.
2. Facial movement of the maxillary incisors
3. Lingual movement of the mandibular incisors.
4. Maxillary constriction
The earlier the habit is discontinued the greater the likelihood of dentofacial changes self correcting. However, the child should be allowed to stop the habit spontaneously. Most habits stop in school due to peer pressure so definitive treatment is not initiated until ages 4-6 years. If the child or the parent does not want to discontinue the habit do not force the issue. The type of treatment prescribed is dependent on the child’s willingness of the child to stop the habit.
The simplest treatment is counseling the patient. The success of this approach is dependant on the child’s ability to understand the consequences of continuing the habit. This approach is most successful in older children. A second approach is reminder therapy. This is effective in a child who wants to stop the habit but needs additional help. The technique involves placing a cue on the patient’s finger as a reminder not to place their finger in the mouth, especially while sleeping.
The technique involves placing a cue on the patient’s finger as a reminder not to place their finger in the mouth, especially while sleeping. The cues may be a bandage, a sock or mitten, a bitter substance or a commercially bought appliance. It is important to emphasize to the child that the treatment mechanism is not a punishment but just a reminder.