Pacifier Use Thumb Sucking

Pacifier use and thumb sucking are natural coping mechanisms for babies and young children which, when extended into the pre-school years or longer, often cause concerns for parents about the potential harm to their child’s teeth and general oral health. The sucking reflex in infants, which begins in the womb, gives children a sense of security, especially when they are in unfamiliar surroundings or separated from their parents.

Thumb sucking or pacifier use can:

• Calm a child who is upset
• Comfort a scared child
• Soothe a child in uncomfortable circumstances
• Create a feeling of happiness and security
• Relax a tired or sleepy child

The natural sucking urge generally decreases after 6 months of age; however, many children still get great comfort from using a pacifier or thumb sucking. Typically, most professionals agree that, up until about age 4, thumb sucking and pacifier use do no harm.

When to Stop Thumb Sucking and Pacifier Use

Many parents experience concern if their child continues pacifier use or thumb sucking into the pre-school years.

Common questions parents ask include:

• At what age should I wean my child from thumb sucking/pacifier use?
• Is thumb sucking/pacifier use harmful to my child’s teeth?
• What can happen if my child uses a pacifier or sucks his/her thumb too long?
• How do I stop my child from thumb sucking or using a pacifier?

The good news is that most children naturally stop thumb sucking/using a pacifier on their own between 2 and 4 years old. During this time, children develop other methods to comfort themselves (such as language skills), and are usually so involved exploring and playing that they no longer need to use a pacifier or suck their thumbs. Once a child starts attending school, there is often a desire to fit in with other classmates and thumb sucking naturally stops.

If a child is still using a pacifier or thumb sucking at age 4, parents may want to begin exploring methods to help their child break the sucking habit, as it can be damaging to the permanent tooth eruption.

Dental problems that can be caused by prolonged thumb sucking or pacifier use include:

• Overjet: Upper incisors (front teeth) are pushed outward while the lower incisors are pushed inward
• Cross bite: Top molars bite on the inside of the lower molars
• Open bite (bad bite): Upper and lower teeth cannot fully come together when the jaws are closed

Prolonged thumb sucking/pacifier use can also create pressure which can cause harm to the roof of the mouth and upper jaw.

When the oral cavity is changed due to excessive sucking, speech problems can occur such as:

• Lisp
• Difficulty saying certain letters, such as Ds and Ts
• Tongue thrusting while speaking

Children who suck a thumb or pacifier vigorously and/or for more than 6 hours a day after age 2 are more likely to experience problems from the habit.

How to Stop Thumb Sucking or Pacifier Use

Most children gradually stop thumb sucking or using a pacifier on their own or with a little coaxing from their parents. Often, parents can simply explain the reasons for stopping the habit and give gentle reminders when needed.

Pacifier use is typically easier to stop for the obvious reason, that you can take it away. Breaking the thumb sucking habit works best when the child is involved and is a willing participant. So, to this end, positive reinforcement usually has much more success than shaming, scolding, or excessive pressure – all of which can do more harm than good. For children who have a harder time kicking the habit, parents can implement a gradual method that involves encouragement, comfort, and patience. Remember, thumb sucking is a coping mechanism, so refraining from it is just as much mental as it is physical.

Tips to help your child stop thumb sucking or using a pacifier include:

• Start with a conversation: Explain the importance of healthy teeth and how thumb sucking/pacifier use can cause problems with the new “big girl” or “big boy” teeth come in. Use a mirror if necessary to show where and how the teeth will erupt.
• Remind your child that unhealthy germs can be transferred from the thumb/pacifier to the mouth.
• Choose a stress-free time to start the weaning process: Children who feel anxious will want to suck their thumbs or pacifiers even more.
• Start small: Limit the time your child can use a pacifier or suck his/her thumb (such as only at home or at nap time). Gradually lengthen the period between sessions until your child no longer needs to use his/her thumb or pacifier.
• Use praise not criticism: Be sure to compliment your child on small successes. Breaking a habit is hard, so your child needs encouragement.
• Provide distractions: If your child uses a pacifier or sucks his/her thumb during specific activities, try to divert attention away from the need to use a comforting mechanism. Spend extra time doing fun activities to keep your child’s mind occupied.
• Enlist your dentist: Your pediatric dentist can encourage your child by explaining how teeth come in and the importance of stopping the habit.
• Remove your child’s pacifier or thumb during sleep: While your child may “need” the sucking action to fall asleep, taking it out later will help lessen the amount of sucking time and begin the weaning process.
• Discard attachment items: If your child typically holds a specific toy or baby blanket that is associated with the sucking habit, put it away during the weaning process.
• Remind your child: It’s okay to point out when your child is sucking his/her thumb. Children often suck their thumbs unconsciously, so a gentle reminder will help them realize when they are doing it and help them stop.
• Be flexible: If something upsetting occurs or your child is hurt, relax the rules a little, as thumb sucking is often a go-to for comfort.
• Give extra hugs: Keep in mind, your child is giving up his/her security device. Be ready to help when the time comes.
• Replace the pacifier or thumb: Give your child another object if he/she needs something tangible for comfort.
• Use a reward system: Set goals and offer small tokens (such as stickers) for achievements. Let your child participate in planning the method of reward and how you will celebrate when the final goal is reached. Use a chart or calendar to track progress.

Remember, while breaking the thumb sucking or pacifier habit may seem like a difficult milestone to reach, your child certainly won’t be going to high school or college still sucking his/her thumb. Be patient and encouraging and your child will soon be on to bigger and better things; and before you know it, thumb sucking will be in the distant past.

If you have questions or concerns about your child’s thumb sucking or pacifier use, please contact Dr. Zarmin Lalani and her team at Discovery Kids Pediatric Dentistry Frisco, Texas, by completing an online appointment request or phone 469-365-5437.

​Dr. Zarmin Lalani is a board certified pediatric dentist in Frisco dedicated to helping her patients develop and maintain good oral health habits that last a lifetime.

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