Guidelines For Resolving A Thumb Sucking Habit

It is normal for infants and very young children to suck their thumbs, fingers, pacifiers and other objects.  It’s one of nature’s gifts to these children and their parents.  Most children give up their habit early in life but some cling to their habit to comfort and enjoy the feeling of personal security.  Gradually as they mature, the habit becomes less necessary and most will stop on their own.  If a child continues to enjoy his/her habit beyond age four, giving up the habit becomes more difficult.  It almost becomes an identity symbol, and in need of a little gentle guidance to help them get beyond their desire to continue the habit.

Willingly giving up a habit that has been with you since birth provides a tremendous psychological boost for a child.  It is a big step toward growing up for them, knowing they can resolve difficult problems on their own.

Over the years, I have perfected a simple process whereby any child can stop their habit on their own if they simply choose to do so.  The keywords are choose, decide, elect and stop.  My habit program is divided into segments designed to put the child totally in charge of the decision making process regarding their habit:

1)   They must recognize that they alone decide everyday whether or not to suck their thumb, finger or body part.  No one forces them.  They do it on their own and no one can make them stop.

2)   They must make the decision on their own to stop and follow-up on that decision.

3)   They need a way to monitor their progress. A way to keep score.

4)   The parents must allow their child to do it on their own.

5)   Successful completion of a job well done must be wisely recognized.

6)   Reward the victory appropriately and move on.

This is how it works:

You recognize there is little you can do to help your child stop sucking his/her thumb, finger etc. and you call my office for an appointment.  You (mom &/or dad) and your child come to the office and are happily greeted by a highly trained and compassionate patient advocate staff member whose job is to make you comfortable and feel right at home.  She then leads you into the conference room and talks with you about the reason for your visit and introduces your child to me.  After we get to know each other, I ask your child why they are here.  Not many children are willing to admit that they have a habit problem to a perfect stranger.  So, I ask mom/dad why she/he brought her/his child to me.  After she/he responds, I tell the child “your mom/dad says you have a thumb habit problem, is that right?  At that point, the child usually responds “yes”.  I then ask “would you like to give up your habit?”  Most children respond “yes”.  I then tell them, “Congratulations, you will never suck your thumb ever again” and we shake hands.  Then I tell them “it’s your habit and you can stop whenever you decide.  No one makes you suck your thumb.  You decide on your own.”  Then I ask them “when do you suck your thumb?”  No answer usually.  “When you go to bed?”  “Yes”.   “Why is that?”   They usually don’t answer, so I tell them “you do it because no one can see you.  So, you choose to suck your thumb only when you decide to do it, most often when no one is looking.”  “Why is that?”  I answer for them, “because you don’t want anyone to see you sucking your thumb.  You only suck your thumb whenever you decide to do it”.  I ask the same question regarding nursery school, kindergarten and elementary school and reinforce the idea that they suck their thumbs only when they decide.  “It’s your habit and you can stop whenever you decide.  Are you clear about your decision to stop?”  If their response is “yes”, I tell them “now that you have decided to stop, I’m going to show you how to monitor your progress and keep score as a reminder of your decision to stop.”  I then take a tongue blade and break an inch or so off each end to make a thumb splint.  I then ask “which thumb do you suck?”  When they show it to me, I remark “oh yes, this is the really clean thumb”.  Then I carefully place the tongue blade parts around their thumb and show them how to wrap tape over it to hold it in place. “This splint is just to remind you of your commitment not to put your thumb in your mouth.  Put one set by your bed and another near the TV if you need it”.

The good thing about this technique is that it puts total responsibility on the child.  I tell them “this puts you totally in control of your habit.  If you want to suck your thumb, just take the splint off and suck away.  But you told me you were not going to suck your thumb anymore, so tell yourself when you go to bed, ‘I no longer suck my thumb’.

If a child says, “I don’t want to stop”.  I tell them “it’s your habit and you are free to do as you please.  Someday you will stop the habit and you get to choose the day.  So, what I’m going to to do, is show you how to stop and how to keep score.  You call me when you are ready to give up your habit”.  I then make them a thumb splint and show them how to keep score.

Keeping score:

Keeping score involves a calendar of at least two consecutive months printed on 8×10 paper with a ½-inch box for each day.  “Every day that you go all day and all night without sucking your thumb you draw a smiley face in that box” (I draw a smiley face in a box a week ahead of today’s date).  “If you mess up, even for five seconds, what do you put in that box?”  They will answer “a sad face”. “Right” and I draw a sad face.  “If you go 60 days in a row with all smiley faces, I will give you a reward.  This is known as the ‘Win Win Game’.  You win by giving up your habit and get a reward to boot.  In addition, we will also give you THE GOLDEN THUMB AWARD.  We take an impression of your thumb and mount it on a wooden block and paint it a golden color.  Be honest.  This is also a test of your honesty.  If you mess up and have a sad face, it’s OK.  You just start over again.  Sixty days in a row is the goal.

“Do you want to play the game?”  They all want to play the game even those who said they were not interested initially.  “Congratulations!  You will never suck your thumb again.  I will see you in sixty days to give you your rewards.  Bring your score card and call me when you reach 30 days.”

Instructions to parents

These are your instructions:

1)   You can help build the splint but your child is the one who must put it on and wear it.

2)   You are free to buy a thumb guard if you wish but a homemade device is preferred.

3)   If your child elects to continue sucking his/her thumb it’s OK.  One step at a time.  Do not be discouraged.  Everything in it’s own time.  If you feel you must reprimand your child, go to the bathroom and beat your head against the wall until you understand, YOU ARE NOT IN CHARGE.

4)   If your child has stopped sucking their thumb, you are encouraged to tell them you are proud of them for giving up their habit.  No bribes please.  That’s my job!

You are encouraged to make comments and ask questions.

Dr Prashant RaoCedar Walk Dentistry
704-542-9923