Question from a thumbsucker with braces

[jennandtonic]

Hi jennandtonic (nice...who's tonic (jus' kiddin'!)),

Yes, I'm biased but that doesn't negate the truth of what I wrote.

Recall, I indicated that, "The fact is, thumbsucking, when not resulting in negative health consequences, is a good habit, not a bad one." When I stated negative health consequences I meant the kind of maloclussions that either objectively result in health problems, like infections and gum disease or subjectively do, as in psychological handicaps directly attributable to the maloclussion, etc. So, in the case where that isn't true I proposed that by anyone's sensible criteria, there isn't any problem.

With the exception of ill conceived notions about immaturity which results in social stigmatization, thumb sucking is a good habit for its benefit/cost ratio, a way of looking at most things when determining if they are deleterious or not.

And, yes, it's true that digit sucking can move teeth. Where that's an issue braces may help but this doesn't affect most thumb and finger suckers, especially the great majority of those that take this habit into adulthood for both the reasons I hinted at in my previous post as well as many other reasons.

The point is this. Instead of automatically reflexing when the subject of thumb/finger sucking comes up, perhaps it's closer to the truth to consider the local situation while keeping an open mind. This principal works in the majority of any issues one may be privy to. I just noticed that it wasn't operating very well here, in most of the previous posts.

Harvey

I got from your last paragraph in your previous post that you don't think it will cause a problem, but you don't know this situation, and neither do any of the posters here. And who knows, maybe her previous thumbsucking affected her teeth, this is why she needs to fully disclose this to her orthodonist.

Her orthodonist is the person to discuss her issues with in this situation. No one on here should either encourage or discourage her thumbsucking because they don't know her history.

BUT, she did ask this in the 'Ask the Doc' forum and she got the doc's opinion--to tell her orthodonist.

[HarveyLMiller]

Hi Meryaten,

Sorry if I appear defensive, I thought I was merely presenting another way of looking at the issue.

I agree that, whatever the affect, it should be discussed with her orthodontist. Still, orthodontists deal with biased samples, meaning, mostly the negative affects of digit sucking. It stands to reason that, if a thumb sucker's habit doesn't affect their occlusion they won't go to an orthodontist and the doctor will not generally know, by experience, that there are many thumb suckers who have acceptable occlusion. This means that, chances are, her orthodontist will give advice from the party line. The website I linked to in my initial remark has been instrumental in educating the public at large, and the profession in particular, about this other bit of knowledge.

I don't see where I reacted automatically. Fact is, the original poster asked for advice, clearly stating her intention to continue her gentle habit, yet people, instead of dealing within that reality, gave advice that ignored the parameters that were given so clearly. Because this is true, my reaction was appropriate since the issue wasn't about stopping her thumb sucking, it was how to deal with the aftereffects of successful orthodontia when one continues sucking their thumb. I think this is an interesting issue that, due to my thumb sucking bias (further due to the fact that I'm quite aware that the habit may not affect dentition while it retains all its other benefits), affects enough people to be worthy of serious consideration.

So, it's not automatic that, if one continues to suck their thumb after orthodontia, that their teeth will absolutely return to some previous level of maloclussion. This fact has been cataloged, at that previous site, by over 3000 filled surveys. There are methods that can be used to prevent that possibility without resorting to habit cessation. This is something that the original poster wanted to know, and something that is worth answering on its own merits, exclusive of cessation advise, because for many, cessation is not an option.

These methods can be anything from the way the thumb is placed, to the frequency and strength of sucking, to the customized design of retainers, and possibly other answers.

And, please, don't misunderstand me. Thumb sucking does cause maloclussions, no doubt. Thumb sucking can result in rare forms of infection, absolutely. I'm merely referring to the great numbers of cases where none of these factors operate, among the stealthy, mature adults of all walks of life who, secretly, continue to suck their thumbs, without negative affect, because of the positive benefits they've gotten from a habit that doesn't interfer with the rights and space of anyone else, unlike many other more "adult" habits.

Harvey

[HarveyLMiller]

Hi Meryaten,

Your point is well taken and makes sense. Soon after orthodontia, the teeth are very susceptible to movement, due mostly because the underlying bone foundation has not had the time to solidify its newly formed position. In younger, growing, patients this fact is prolonged due to the growth remaining regardless of brace use or not. I would have to think, that though (in answer to your question) there is no study, to my knowledge, of the affects of thumb sucking after orthodontia, if a patient sucks their thumb without the proper use of the retainer the odds of a reversion to maloclussion are very high. The retainer is the key I feel. Well, there's one study idea, eh?!

As to how I came upon this post. I was researching orthodontia, via Google, as related to my own, personal, goals and this site impressed me as relatively unique in that there's a wide range of topics discussed, in laymen terms but with professional input, with ease of navigation, very user friendly, no subscription fee, etc. and after meandering through many subjects, I saw the search engine and plugged in "thumb", since it's of interest to me and I wondered how it was handled, if it was handled at all, here. Not much going on, but this thread was the most relavent and so, "POP", heah ah was!

Harvey

[dr.j]

True it's better than lighting up a cigarette...

But, Freudian issues aside, as an orthodontist I can tell you that all thumbsucking should be discouraged. The prolonged digit sucking can cause malocclusion and then even secondary tongue thrusting which perpetuates it and affect speech. It even can draws in the palatal halves and can constrict the maxilla. If thumb sucking is carried out many hours of the day continuously it promotes over eruption of the back teeth and could even change the profile of a growing pre-teen or teen.

Man - What a firestorm this thumb thread has caused!

[HarveyLMiller]

Hi Dr. J,

Yes, a storm, but a small one and at least it hasn't affected the roads...I still can go out cycling anytime I want! Now, back to the subject....

Why "all" thumbsucking? Do you include thumb sucking in children aged 0-4? Isn't cessation not considered a good idea at that age amongst the great majority of professionals? How about thumb sucking in an adult who hasn't had any apparent health and/or dental affects? Perhaps you meant something else?

And though it's true that prolonged digit sucking can cause malocclusion and worse, there's a lot of people that aren't significantly affected, enough to count. This is, typically, due to their method of sucking (not putting pressure on the occlusion, not sucking for very long, using a "passive" sucking technique, etc.) or robust biological design. In fact, it's agreed among most professionals that the majority of digit related dental problems are hereditary based, where the thumb sucking, if it had any affect, only made it more pronounced. Even among those that do have some affect, there are many where the problem is minor, hardly worth mentioning and in many cases, where it ceases, the dentition returns to a more normative state, by itself. This isn't to say that there aren't many cases where digit sucking does do damage, it does, but not to the extent that most people think, not by a long shot.

So, yes, it "CAN" but doesn't always. And, for those well passed the age where anticipatory concerns would matter, if it ain't broken, don't fix it...yes?

Harvey