Thumb Sucking Habits in Children

Have you seen childrens sucking their thumb anywhere ? Today we will be discussing various aspects of it. So what is thumb sucking ? Lets define it first,

Thumb sucking is defined as the placement of the thumb in varying depth into the mouth.

Classification:

1) Normal Thumb Sucking: The thumb sucking habits is consider normal during first and half years of the age.This habit disappears as the child matures.

2) Abnormal Thumb Sucking: When Thumb sucking habits persists beyond pre-school age, then it is called as abnormal thumb sucking. This need to be treated and it may causes deleterious effects in the dentofacial structure.

3) Psychological: The habits may have deep rooted psychological factors involved. It may be due to neglet and loneliness expression by child.

4) Habitual: This habit does not have psychological bearing, child only perform a act.

5) Nutritive Sucking Habits: This habit can be because of Breastfeeding , bottle feeding etc.

6) Non- Nutritive Sucking Habits: This can be because of Thumb or finger sucking, pacifier sucking etc.

Classification According to Subtelny (1973):

1) Type A: 

1. Mostly seen in 50% of the children.
2. Whole digit is placed inside the mouth and peval of the thumb is pressing over the palate.
3. Here, the mandibular and maxillary contact is present.

2) Type B:

1. Mostly seen in 13% to 24% of cases.
2. Thumb is placed inside the oral cavity.
3. At the same time, maxillary and mandibular contact is maintained.

3) Type C:

1. Mostly seen in 18% of the cases.
2. Thumb is placed into the mouth just beyond the first joint.
3. There is contact of hand palate and maxillary incisors but not contact of mandibular incisors.

4) Type D:

1. Mostly seen in 6% of cases.
2. Thumb is placed only in little portion into the mouth

Etiological Factors Associated with Thumb sucking Habits:

1) Socio-Economic Status: In high economic status, a mother is in a better position to feed the baby and baby's hunger is satisfied. While in low socio-economic status, a mother is unable to feed the baby sufficiently and in this case baby starts sucking his/her thumbs for long time.

2) Working Mother: In case of working mother, child are left in hands of caretaker and due to this child develops feeling of insecurity and develops thumb sucking habits.

3) Order of the child birth:  Later the ranks of the siblings, more the chance of developing the habits.

4) Social Adjustment and Stress: Emotion and stress leads to digit sucking.

5) Age of the child: Time of appearance of digit-sucking also has role.

1. In the nenate: Insecurities related primitive demands as hunger.
2. During the first weeks of life: Related to feeding problems.
3. During the first eruption of primary teeth: It relieves teething.

Diagnosis of Thumb Sucking:

1) History: Once the habit is determined, question regarding the frequency, intensity and duration of habits is determined.

2) Emotional Status: It is necessary to determined habit is empty or meaningful.

3) Extraosal Examination: Digits or fingers involved in the habits appears redened, chapped, clear and short fingernail, a clean diphan thumb.

4) Lips: A short hypotonic upper lips is a characteristics of chronic thumb suckers. Hyperactive lower lips that causes proclination of the upper anterior teeth.

5) Profile: Convex profile.

6) Intraoral Examination: The type of malocclusion produced by this habits depends on various features such as position of digits, associated with orofacial muscle contraction, mandibular position during sucking, facial skeletal pattern, intensity, frequency and the duration of the habits.

Dentofacial changes Associated with Thumb Sucking: 

1) Effects of Maxilla:

1. Proclination of maxillary incisors.
2. Increased maxillary arch length.
3. Increased crown length of maxillary incisors.
4. High Palatal depth.
5. A typical resorption of primary central incisors.
6. Increased trauma to maxillary incisors.

2) Effects of Mandible:

1. Retroclination of mandibular incisors.
2. Retrusion of mandible.

3) Effects on Interarch relationships:

1. Increased overbite
2. Decreased overbite
3. Posterior crossbite
4. Anterior openbite

4) Effects on Lips Placement and function:

1. Development of tongue thrust.
2. Lower tongue position.
3. short hypotonic upper lip.
4. Hyperactive lower lip.