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The question

My five-year-old still sucks her thumb. What do I do?

The answer

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Thumb-sucking is often due to stress, anxiety or boredom. The child uses this comforting habit to soothe herself. It may be simply a habit that will pass at some point, usually before she goes to school.

If thumb sucking continues beyond early childhood, in this case age five, I would be concerned enough to get a dentist's opinion. There may be risk of dental maldevelopment. Teeth may shift and the way the mouth grows may be affected negatively. When permanent teeth are involved, it certainly requires the skill of a pediatric dentist.

As the child gets older, peer pressure may motivate her to stop. However, she may still be doing it privately when friends are not around. Some parents have tried bribery or positive reinforcement, which may work if it is sufficiently motivating. Other parents resort to putting vinegar on a band aid and applying it to the thumb, or covering the hand with a sock. Desperate parents have been known to splint the elbow in such a way that it can not bend.

When a dentist sees a child with thumb-sucking, the goal will be to establish how much this habit has caused a shifting of the teeth. If it is significant enough, or if it affects the permanent teeth, a crib can be used (a device that is placed in the palate to occupy space so that there is no room for the thumb).

If thumb-sucking is associated with stress, then the root of the problem must be discovered. To do this properly, a child psychologist may be useful. For more information on children and stress see

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The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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