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Thumb sucking: pediatricians' guidelines
1Department of Pediatric Psychiatry, Children's Hospital of Philadelphia, PA 19104.
Insights
Persistent thumb sucking can cause dental and psychological issues. Treatment is typically unnecessary before age four, and intervention should only occur if problems are imminent or the child requests help.
Area of Science:
- Pediatrics
- Child Psychology
- Dentistry
Background:
- Thumb sucking is a common childhood behavior.
- Persistent thumb sucking can lead to dental, dermatological, orthopedic, and psychological problems.
Purpose of the Study:
- To determine when to treat persistent thumb sucking.
- To provide guidance on managing thumb sucking behavior in children.
Main Methods:
- Review of potential risks associated with persistent thumb sucking.
- Assessment of age-related factors and the necessity of intervention.
- Evaluation of treatment strategies when intervention is required.
Main Results:
- Problems from thumb sucking rarely occur before age four.
- Treatment is generally not recommended unless physical/emotional sequelae are imminent or the child seeks help.
- Ignoring the behavior is often the primary recommendation for parents.
Conclusions:
- Intervention for thumb sucking should be risk-based and child-centered.
- When treatment is necessary, a phased approach including a parental attention moratorium, monitoring, incentives, and external cues is advised.
Abstract:
Thumb sucking is a common, generally harmless child behavior whose persistent practice occasionally leads to dental, dermatological, orthopedic, and psychological problems. When to treat thumb sucking should be determined by risk potential. With a few rare exceptions (e.g., hair pulling), thumb sucking related problems do not occur until after the age of four years and therefore, treatment is rarely necessary before then. Even after this age, treatment is not recommended unless physical and/or emotional sequelae are imminent or a thumb sucking child requests help in quitting. Thus, in most cases parents should be instructed to ignore thumb sucking. When intervention is necessary, it should be preceded by a 1-month moratorium on parental attention. Treatment should include a combination of monitoring with charts, incentives for successful days and various external cues to remind the child who forgets.