Stop it William! The clinic for thumb-suckers, but can it change a child's mind?

Thumb sucking

Thumb addict: William with his mother Annabel

Some children twirl their hair, some snuggle with a blanket. Others – 23 per cent of all children – suck their thumbs.

They learn the habit as a baby, when sucking is a natural reflex. For parents it can seem like a godsend at first. More hygienic than a dummy, the thumb comforts, soothes and sends them off to sleep.

Most children have stopped thumb-sucking by the age of five, but a hardcore minority persist and, if they do not stop before their adult teeth come through, the shape of the jaws and position of the teeth may, some orthodontists believe, be affected.

My son William, seven, began sucking his thumb in the womb, as a picture of his 20-week scan attests. His thumb has scarcely left his mouth since. He sucks it to get to sleep, he sucks it at breakfast, lunch and tea, while watching TV, reading or playing soldiers.

If he is tired or bored he sucks it, but when he is happy too. He is, in short, a thumb addict.

At school, thumb-sucking has become a major issue. It soothes him so effectively he is, says his teacher, ‘zoned out’, barely aware of what is going on around him.

Operating one-handed also makes writing difficult. Aside from the scholastic problems, I have begun to worry that his thumb is pushing out his upper teeth, or worse, that he will end up with the protruding upper jaw and receding lower jaw of a chinless wonder.

I have tried sticking plasters on his thumb, painting it with evil-tasting concoctions, nagging and threats (‘You’ll look like Bugs Bunny’). Nothing has worked.

Most of the time he doesn’t even know he is doing it, but he is keen to stop. When he lost his first tooth a fortnight ago, I decided to act before his big teeth appeared.

As luck would have it, weeks earlier a London orthodontic practice, the Metamorphosis Clinic, catering specifically for children and teenagers, had opened a thumb-sucking clinic.

I booked an appointment immediately. I had visions of seven-year-olds sitting in a circle confessing ‘My name’s Jack and I’m a thumb-sucker’, but each child sees the orthodontist individually.

The crucial thing, according to Dr Neil Counihan, the clinic’s founder, is that the child is ready to stop.

‘If he wants to stop, we will help him. It’s about positive support, not punishment.’

Thumb sucking

The remedy: This thumb guard is the latest solution to the problem of thumb-sucking

Dr Counihan has a daughter who sucked her thumb for many years, and his practice partner, Dr Runa Mowla-Copley, is a reformed thumb-sucker herself, so they are hugely sympathetic, but equally firm that the habit should be broken.

‘The growing jaw is soft,’ says Dr Counihan. That means it can be moulded by the consistent pressure applied by intense thumb-sucking. If the upper jaw already has a tendency to protrude, thumb-sucking can exacerbate it.

It can also cause the upper front teeth to stick out, making them more ‘trauma-prone’ – more likely to get broken. He describes the thumb as acting like a crowbar, pushing the lower teeth backwards, hence the ‘goofy’ overbite.

Dr Counihan points to a recent study by dental hospitals in Northamptonshire showing digit-suckers were significantly more likely than non-suckers to have a reduced over-bite, meaning the upper and lower incisors do not overlap properly. Such problems can be hard to correct.

However, Dr Les Joffe, chief executive of the British Orthodontics Society, cautions against over-reacting to thumb-sucking, especially in children younger than nine.

‘Most problems of jaw-alignment are hereditary,’ says Dr Joffe. ‘Many people who suck their thumbs don’t have protruding teeth. External factors like thumb-sucking rarely overcome an inherent growth pattern.


Thumb-sucking can start in the womb

‘It might affect teeth, making the front ones stick out or preventing them from coming through fully, but it seldom affects the jaw. The study did not show conclusively that thumb-sucking caused overjet – a protruding upper jaw – and there was no evidence to suggest it causes asymmetric open bites [wonky jaws].’

However, he agrees with Dr Counihan that the sooner thumb-sucking stops the better, to cut the chances of developing a reduced overbite, although both agree that quitting thumb-sucking does not rule out the possibility of needing orthodontics for other, unrelated problems.

The good news for William is that thumb-sucking has not yet affected his teeth or jaw. Dr Counihan says this is because he does not yet have adult teeth. At seven, his dental age is nearer five. ‘Before the (dental) age of six, thumb-sucking is not an issue. If both adult top front teeth were through, it would be a problem.

People say it is cruel to stop thumb-sucking, but it is crueller to let children ruin their jaw,’ he insists.

Because of the effect on his schoolwork and the risk of later problems, we decide to start treatment, with William’s enthusiastic consent, especially after Dr Counihan suggests he be rewarded with a toy of his choice after three months of abstinence.

Many of Dr Counihan’s young patients quit the habit after a few gentle chats with him. More committed thumb-suckers are given a thumb-guard – a plastic cone to fit on the thumb, secured around the wrist – that denies them any pleasure from thumb-sucking. William gets one and regards it as a badge of honour.

If the thumb-guard fails to do the trick within four months, a ‘habit-breaker’ can be fitted: a small plastic ball sitting behind the front teeth and secured to the back teeth by wires.

The ball revolves when touched, so the thumb gets no purchase in the mouth. Although these have been around for some time, the Metamorphosis Clinic has adapted the design to make them more comfortable.

William wants one immediately, but at £550 each they are something of a last resort, if far cheaper than the £3,000 to £4,000 of orthodontistry misaligned teeth might later require.

Some thumb-suckers persist well into adulthood but, after our visit to the clinic, William and I are both confident he will have cracked the habit before the year is out.

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