Thumb and Finger (Digit) Sucking: Problems and Solutions

teething thumb suck

When an adult needs to de-stress they often turn to a variety of coping mechanisms—whether that be exercise, a hobby, reading a book, a nice glass of Pinot Noir, etc. But when an infant or toddler needs to de-stress, very often children turn to thumb or finger-sucking for comfort.

Yes, that’s right, your child—even at the age of one or two—may need a de-stressor. Stress can start that early in life. We all know that growing up is tough and navigating the world around us can be really difficult for these little ones. Since your child is not old enough for most of our “adult” coping mechanisms, they may resort to thumb or finger sucking.

Digit sucking is normal for young children. Early on, they develop a positive association between sucking, comfort, and satisfaction—think about breastfeeding, pacifiers, bottles and sippy cups. So, naturally, when children need comfort or a de-stressor, they turn to sucking something. While this is totally normal for infants and smaller children, if they fail to grow out of it in time, it can negatively impact their oral health, growth, airway and speech development.

Thumb Sucking Complications:

Open Bite
Open bite occurs when the top and bottom front teeth begin getting pushed outward. This misalignment causes the front two teeth to not touch, not even when closed. This can make many sounds difficult to articulate and also can make it so biting or incising into things is nearly impossible!

Speech and Airway Issues
One common and concerning issue associated with thumb or finger sucking at too old of an age is narrowing of the jaw or palate. This is where the roof of the mouth develops too narrowly due to the pressure from sucking a thumb, finger or pacifier. Intensity and duration affect this, too, with children who suck on digits all day and with lots of suction-power having worse outcomes. Palate narrowing often result in improper speech patterns such as lisps, including an inability to pronounce hard consonant sounds like “D” and “T.” It also affect tongue positioning and can create a narrow nasal floor which can lead to difficulty with nasal breathing and may lead to sleep apnea issues down the road. If the habit doesn’t stop by the time the adult dentition begins to erupt, patients often need orthodontic interventions including expansion, headgear and possibly even traditional braces. Myofunctional and/or speech therapies are often needed, too.

How Old is Too Old?
If you think your child is too old to be sucking their thumb or fingers or have concerns with their growth and development secondary to a digit habit, feel free to contact us at NoPo Kids at (971) 978-0009 to get an appointment and some personalized recommendations. Most children will drop a digit habit on their own, usually around kindergarten (likely due to social pressures…ie: their peers make comments about it). A nice way to begin the conversation is to start and discuss germs on our hands and how we do not want to put our dirty hands into our mouths as it can make us sick. Kids will understand germs, but not necessarily that they are changing the way they are growing or their airway development. We also sometimes recommend a bitter ointment, Mavala Stop, which really can help to break the habit, but often we do not advise this until kids are a little older…say 3 to 4 years old.

If your child resists giving up their habit and continues to suck their thumb or fingers past the age where they should be stopping to avoid long-term issues, here are a few tips to encourage them to grow out of the habit.

Use Positive Reinforcement
Be proud of them and reward them when they use other healthy coping mechanisms for comfort. Comment when you notice they aren’t sucking their digits (instead of only focusing on when they are). We have charts here and on our website for “No Thumb-Sucking” that kids can fill out and return for extra prizes. Charts seem to really motivate children and are a great way to keep track of their progress!

Limit Times
You can try and establish rules like trying for no thumb or finger sucking in public or they can try to only suck digits in the morning or right before bed. Cutting back of time (duration) can really help them to break out of the habit.

Give Them a Few Reasons to Suck Their Thumb/Fingers
Remember that digit sucking is a comfort and de-stressor for them. While you cannot remove every stressor, if you see your child about to suck their thumb or fingers, you can distract them with a game or something that occupies both of their hands and help them find better ways to cope.

Raising a young child is rewarding, but also often challenging. Trying your best to wean them off thumb or finger sucking at the right time can help avoid extra challenges and issues later down the road. We do know it can take 21 days to break or start a habit, so trying to keep your child digit free for a full month will ensure the most success with reprogramming their brains and helping to alleviate the habit.

If you come and see us at NoPo Kids, the team will spend more time discussing all of these thumb and finger sucking solutions with you. Remember…at NoPo Kids we believe the mouth is not a separate body part from the rest of the system and strive to educate with a Whole-Body Approach. We teach kids to ”Eat A Rainbow” for optimal oral and systemic health and will work with you to find suggestions, tips, and tricks that fit into your specific family needs. We’d love to chat more! Book an appointment with us today to help prevent future developmental issues!

Love and Health,

Doctor Staci and the NoPo Kids Team xo

The information provided on this site is not intended as medical or dental advice and should not be interpreted as such. The intent is to provide as much scientific information as possible on different dental materials and aspects of dentistry where controversy exists and scientific clarification would be of benefit to patients, staff, dentists, physicians and scientists in making informed judgments. If you seek medical or dental advice, please consult with a health care professional. You must always exercise your own best judgement when using the services of any health care practitioner.

MTHFR Gene Polymorphism: A Closer Look

kid mom hold hands

As many of you may have been hearing about from your naturopathic physicians or reading about on social media or various blog posts, MTHFR gene polymorphism is a pretty hot topic, especially when it comes to using nitrous oxide or receiving sedation at the dental office.  Dr. Ryan Allred, a board-certified dental anesthesiologist that I trust so much (he is a seriously brilliant and incredibly kind human) is as close to an expert on this topic that I have yet to discover and was gracious enough to share his very informational and educational presentation on MTHFR with me recently.  Here I breakdown and summarize his main take-home points in an attempt to clear the air about MTHFR and hopefully ease some parents minds about this condition.

  • MTHFR (Methylenetetrahydrofolate reductase) is the rate limiting enzyme in the methyl cycle. MTHFR catalyzes the production of the active form of Methylfolate which is used for DNA production and homocysteine regulation.
  • Genetic alterations in the MTHFR gene are relatively common. These are called SNPs (single nucleotide polymorphisms).  Individuals with MTHFR SNPs have a decreased ability to regulate homocysteine levels.
  • Patients with MTHFR SNPs are likely at a higher risk for various problems: Increased risk of vascular inflammation (increased cardiac risk), Neural tube defects , Neurological deficits (mylenation defects), and Autism.
  • KEY POINTS! 1) Severe MTHFR SNPs are rare 2) Risk Factors are children under 1yo, severe vitamin B deficiency, and severe MTHFR SNP  3) AAPD (American Academy of Pediatric Dentistry) states that Nitrous Oxide is contraindicated for those with a severe MTHFR SNP         4) Signs and symptoms for severe MTHFR SNPs are hypotonicity, motor dysfunction, mental delay
  • Patients can be heterozygous or homozygous. Homozygous mutations are usually considered more severe.  Be leery of self-diagnosing from tests like 23 and Me or from markers only.  These can certainly highlight potential issues, but if you have true concerns, please see your doctor where proper testing can be completed to differentiate between severe or mild mutations (or any at all!).
  • Mild variations of MTHFR are fairly common in America.
  • Severe MTHFR mutations are rare and lead to a serious medical condition called hyperhomocysteinemia. There are currently only around 50 patients worldwide diagnosed with severe MTHFR mutations.  Signs and symptoms of severe MTHFR include:  developmental delay, motor and gait dysfunctions, seizures, and neurological impairments.
  • Recommendations if your child would truly benefit from Nitrous Oxide or General Anesthesia Sedation at the dentist and has diagnosed mild MTHFR…
    • B12 supplementation before and after procedure
    • Increase green leafy vegetables (methylfolate) before and after procedure (Green Smoothies!)
    • Avoid Nitrous Oxide use in any patient with a known Vitamin B12 deficiency or who is known to have a severe MTHFR SNPs-particularly a homozygous SNP
  • Conclusion: MTHFR polymorphisms are common, but it is controversial as to how important mild SNPs are to a patients overall health.  Nutritional intake of folate and vitamin B12 is important to help improve MTHFR activity in the event your child need Nitrous Oxide or other forms of anesthesia sedations.
  • Remember…major problems from MTHFR SNPs are really rare and Nitrous Oxide use remains a safe modality for patients with no mutations or only mild mutations.

If concerned with your child metabolizing (methylation) of medications and to speed up any residual neurological effects of anesthesia, it is recommended to supplement with B12, leafy green vegetables, and Methylfolate a few days prior to your appointment and a few days after.  Epson salt baths (magnesium sulfate) can help expedite the processes as well.

If you still have concerns, we are always here to listen and to help to offer more information and potential alternatives.  Getting your child properly tested is the best place to start, however.  Going off markers alone is not generally conclusive in differentiating the degree of mutation your child may (or may not) have.

Call us today at NoPo Kids Dentistry to schedule a consultation and to discuss your options or talk more to your doctor about your concerns.  We always want parents to feel informed in their decisions and encourage you to reach out to all sources possible to gain as much information about this topic as possible.  Visit www.nopokids.com to book an appointment of to see more of our office’s offerings.

Love and Health,

Doctor Staci and the NoPo Kids Team xo

The information provided on this site is not intended as medical or dental advice and should not be interpreted as such. The intent is to provide as much scientific information as possible on different dental materials and aspects of dentistry where controversy exists and scientific clarification would be of benefit to patients, staff, dentists, physicians and scientists in making informed judgments. If you seek medical or dental advice, please consult with a health care professional. You must always exercise your own best judgement when using the services of any health care practitioner.

Crackers and Other Dried Snacks: Hidden Cavity – Causers

girl eating

I have been struggling with the fact that cavities are on the rise in pre-school aged-children, and it has often left me scratching my head…why? I cannot tell you how often I have to face a guilt-ridden parent to tell them that upon their child’s first set of dental x-rays (usually around 4 years old), that their child has EIGHT hidden cavities in between all of the back molars. We call these “flossing” or “surprise” cavities, and while not the type of surprise any parent wants, it can be a big eye-opener that something in the child’s routine and diet needs to change.

In dental school we are mostly taught to attribute cavities to poor hygiene and too much “sugar” (ie: candy, soda, juice…the obvious bad stuff). For years I personally always attributed these “surprise” cavities to lack of flossing, and while I do strongly feel flossing is incredibly important for your oral and overall systemic health, I still had so many parents say to me…”But, we floss almost every night?! We eat no sugar! Why does my child have cavities?”

Last May, I attended a conference where a very like-minded dentist lectured on how it is not all about hygiene, but rather diet. He inspired me beyond words. His biggest concern…CRACKERS. Yes, crackers. The main snack or food choice for many toddlers, children, and teens (adults, too!!). These dried bread/highly processed/refined flour foods are not only sticky, but break down into sugars extremely quickly in the mouth. Plus, kids tend to graze on them all day long or at least for long bouts of time and we know that the stickiness of the foods we eat (do they stick in the chewing surfaces of your teeth long after you eat them?) paired with the duration of time we eat them (ie: kids who graze, rather than eat organized meals at specific times) is what really makes the cavity-causing bacteria in our mouths thrive. Plus, during this process, acid is created, and these bacteria love an acidic environment.

Parents do look at me like I’m crazy when I say…”I really think you should significantly cut back or even eliminate processed foods from your child’s diet. Specifically: crackers, pretzels, dried cereals, dried fruits, granola bars, fruit snacks, etc.”

“But they are organic? Non-GMO?”

Turns out, cavity-bacteria do not care. They may even prefer organic sugar?! The point is, sugar is sugar, organic or not, and if it sits on the teeth longer, it is more likely to cause cavities.

“So, how can I do this? They are hooked on Cheddar Bunnies?”

I certainly don’t expect some magical over-night miracle to occur at your home…I am a mother first and foremost and get the parenting-survival-game. But if you can just slowly start buying fewer of these items and start bringing less of these foods into the home, you will get there. I promise. If they don’t get them at home, but still at school, OK. It is still an improvement. It may take time and there may be a few fits of rage from your kiddos, but I know you can do it. Stay strong! Remember, you are setting them up for a lifetime of success!

Parents often ask, “So what on earth do I feed my child for snacks if not crackers?” I am here to help. For those with children around 1-2 years old, use this information to help shape your child’s palate (don’t even offer crackers or dried grains or fruits! They will never know they exist! (until birthday parties or at school, but that’s another topic.). For parents of older kids, just try to gradually offer more real food. Things I offer my kids are: cheese sticks, TONS of vegetables, hummus or guacamole, seeds and nuts, nut or seed butters or avacado on whole-grain bread, real fruit (but be sure to limit fruit daily, too (not all day long) and be mindful of fruits lower on glycemic index, like berries and green fruits (apples, grapes, less-ripe bananas), tofu chunks, meat chunks, seaweed snacks (lower sodium ones better), pickles, olives, or other fermented foods, eggs, steel-cut oatmeal, plain yogurt (you can add real fruit to it), cottage cheese, and WATER or plain milk. One thing that really sets us apart at NoPo Kids is we spend a lot of time discussing diet with you and your child and less time nagging everyone about hygiene. Don’t get me wrong…hygiene IS important, especially flossing, but I truly believe our diet is the main cause of almost all human disease. If we have a clean, whole-food, low-acid diet we will live a happier, healthier life.

If you come and see us, my team and I will spend much more time discussing all of these dietary suggestions with you, as well as help you to find ways to motivate your child with their oral hygiene routine. Remember…at NoPo Kids we believe the mouth is not a separate body part from the rest of the system and strive to educate with a Whole-Body Approach. We teach kids to ”Eat A Rainbow” for optimal oral and systemic health and will work with you to find suggestions, tips and tricks that fit into your specific family needs. We’d love to chat more! Book an appointment with us today to help prevent future decay! #Nomorecavities #eatarainbow #wholebodyapproach

Love and Health,

Doctor Staci and the NoPo Kids Team xo


The information provided on this site is not intended as medical or dental advice and should not be interpreted as such. The intent is to provide as much scientific information as possible on different dental materials and aspects of dentistry where controversy exists and scientific clarification would be of benefit to patients, staff, dentists, physicians and scientists in making informed judgments. If you seek medical or dental advice, please consult with a health care professional. You must always exercise your own best judgement when using the services of any health care practitioner.