Usually there is little harm in a baby sucking on a thumb or soother. It certainly helps to sooth a fussy baby and give a frazzled mother a break. It is the long-lasting form of the habit that can be worrisome.
When a child sucks a thumb or soother long enough and with enough intensity, the pressure from the object itself and the muscles used in sucking can cause distortion of the facial bones and push the teeth out of position. This can lead to abnormal swallowing patterns, even when the object is not in the mouth. The damage may be severe enough to change the shape of both the upper and lower jaws.
A child's sucking habits are certainly not the only cause of problems with the formation and shape of the mouth and teeth. If you are concerned about your child's habit and the possible harmful effects, your family dentist or orthodontist can advise you if there is a need to stop the habit. No parent wants a child's teeth and jaws distorted nor to have the child teased by others who see thumbsucking as babyish.
The most effective way to avoid problems from sucking is to prevent it in the first place. This advice applies to soothers - thumb sucking will begin without you buying a thumb and pinning it to your child's sleeper. While a soother can help a baby and parent over some bumpy times, it should not be used around the clock as a silencer. If you must use a soother, use it only when necessary. If it is becoming a habit for you, it is becoming a habit for your baby as well.
There are a variety of soothers on the market. They come in different sizes and shapes, all of which must meet strict safety standards. Some of them claim to have no ill effects on your baby's teeth and jaws. The size and shape of the soother may have some effect on the end result. However, there are many other factors involved, such as the strength of the baby's sucking action. Other factors include the length of time the soother is present and underlying tooth or bone abnormalities.
If you decide to let your baby have a soother, pick the type the baby seems to prefer in an appropriate size. Try to keep its use to a minimum. This will make the habit easier to stop. The baby may even give it up without prompting when he or she no longer feels a need for it or loses interest.
If you are trying to stop your child's habit of sucking, there are several steps to be taken. For some children, the cold turkey approach may work. That's only if you can stand the piteous wails and several sleepless nights. You may be able to achieve a more gradual, less stressful result by removing it from daytime use and allowing it only for setting your child when other efforts fail.
If your child is teething and wants the soother to chew on, use a teething ring instead. It is more effective and safer. Soothers are really only meant for toothless babies (under six months). Preventing its use after infancy will prevent difficult times later.
Thumbsucking is much harder to manage. Your child will need plenty of attention and understanding to get through this. If your child is over four, try to reward and praise non-thumbsucking behaviour. Spend lots of time with your child encouraging other uses of the hands such as finger play, puzzles, coloring, crafts - anything that will keep your child busy. At difficult times such as naptime or bedtime, offer him or her a small toy to hold and cuddle as a substitute for the habit. For habit-free times, you could offer a reward such as extra story time or a back rub to allow the child to get sleepier.
By age six, if your child is unable to give up the habit and the teeth and jaws are changing, your dentist may suggest an appliance or 'crib' to inhibit the sucking. Most often this appliance is attached securely to the upper teeth and can not be removed.
There are a number of styles of cribs. Some have a wire fence hanging down behind the upper front teeth. Others have a plastic bead in the same position. All of these appliances have the same goal - to prevent the thumb being placed in the roof of the mouth. All of them are custom-made to fit your child's mouth and cause little interference with chewing, swallowing or speaking.
If you consider an appliance such as this, do not use it as a threat. The appliance is meant to be a help. It is an aid to a child who understands that the habit is negative and who is ready and willing to quit.
Most children who wear a crib do very well with it. There may be some minor discomfort at first and the child may be cranky and irritable for the first day. Remember that the inside of the mouth is a very sensitive place and anything new takes time to get used to. A habit-inhibiting appliance is no exception. Once a crib is in the child's mouth, the habit will end almost immediately because the thumb can no longer be placed in the roof of the mouth. The appliance, however, must be left in place for a number of months to be sure there is no recurrence.
There is no evidence that children who wear a habit-inhibiting appliance will develop other behaviors such as nail biting to compensate for the loss of the first habit. It is important to note that children who understand what the appliance is and how it works will have the most success. A patient (or parent) who is unwilling to stop the habit, or unwilling to wear an appliance, should not be forced to do so. The end result in that case cannot help but be a negative one.
Following habit inhibiting therapy, a child may require treatment to reshape bones and reposition teeth. For some, this treatment may be extensive and continue into the teenage years. Keep in mind that your child may have dental or orthodontic problems that are made worse by a habit or that would be present regardless of it.
Most importantly, you should avoid making this issue a power struggle between you and your child. No one is a winner after this struggle. See your dentist or orthodontist if you think that you or your child need help.