April 22nd, 2019
Are thumb and finger appliances necessary?
Protruded upper front teeth, can easily be damaged in accidents plus the child can suffer from social teasing. Crossbites of the back teeth, can cause excessive wear and fracture of the permanent molars.
If the habit is stopped prior to 3 years old the deformation will usually reverse itself without orthodontic intervention. A sequence of treatment is recommended for the greatest success. First-Talk with your child, let them know that their habit is “hurting their teeth.” Set up a calendar of positive reinforcement (prizes can help meet goals) For example, 2 days without the habit, 5 days without, 10 days, 20 days, 40 days, then 60 days. After that, it is rare to get relapse. I know you’re going to say, “but my child can’t count to 60,” that’s the reason you set up a calendar in a prominent place like the refrigerator. Have them place a mark on the calendar for each day of success. Pre-pick a prize for each goal reached.
If you can tell your child is trying, but not successful then you can try “Stops it,” (make sure no allergies!) from the pharmacy. This when put on the offending digit, gives it a bitter taste which acts as a reminder not to put the finger in the mouth.
Second-If not successful in 2 months with the above protocol, then an orthodontist can help. At our office, I repeat the above regimen with new additions as an outside authority figure, that may be all that is needed to stop the habit. If not successful in 2 months, then we proceed to the fixed (not removable) upper guard.
I find if we try the “benefit method” first then the child is much more accepting of a fixed guard. The appliance is left in for 6 months.
What if the child’s upper jaw has been permanently deformed? At the office of Dr. Michael Sebastian, we combine a thumb/finger guard with an upper expander to not only resolve the habit, but also to correct the skeletal deformation which occurs.
The last thing to consider is a tongue thrust (October 10/2018 Blog). Often, a tongue thrust will result after a thumb or finger habit deforms the upper jaw so even after the habit is resolved the tongue thrust will continue to deform the upper jaw. That is why is imperative to treat the tongue thrust while treating the upper jaw deformity. We have developed a special upper expander which treats all of these considerations.
At the office of Dr. Michael Sebastian, we emphasize the treatment of thumb and finger habits for successful development of the teeth and face.