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THUMB SUCKING!

Thumb sucking can be defined as placing the thumb at various dept of the mouth.

CLASSIFICATION- 1) normal thumb sucking- normal during the first and second years of life.These habit seems to disappear when They mature

2) Abnormal thumb sucking- when thumb sucking persist beyond the preschool
a) psychological
b) habitual

Sucking habits could be classified as

A) Nutritive- eg breastfeeding, bottle feeding
B) Non nutritive – thumb sucking or pacifier

CLINICAL FINDINGS
increased proclamation of the maxillary incisors
Increased maxillary length
Increased anterior placement of apical base of maxilla
Increased clinical crown of maxilla
Decreased palatal arch width
Increased atipical root resorption in primary central incisors
Increased trauma to central incisors
Rotated maxillary incisors
Retruded mandible
Increased overjet
Decreased overbite
Increased posterior crossbite
Increased lip incompetence
Increased tongue thrust
Increased lower tongue position
Risk to psychological health
Increased risk to poisoning
Increased risk to digit deformation
Increased risk of speech defect

DIAGNOSIS INTRAORAL EXAMINATION-
Tongue position during swallowing and at rest have to be noted

EXTRA ORAL EXAMINATION
Digit- redness,clean chapped and with short nails,clean dishpan thumb
Upper lip short and hypotonic
Check the profile , maxillary protrusion and mandibular retrusion

MANAGEMENT-* Feed the child whenever hungry in a natural way +breastfeeding)
Never let the habit to start it must be stopped at its inception

*Psychological therapy – nagging ,scolding
Beta-hypothesis or Dulnops theory- if a child is forced to concentrate on the performance of act at the time of activity,they will stop performing the act
*Chemical methods like- quinine, pepper and castor oil
*Mechanical methods -thumb guard and appliances such as removable or fixed palatal crib
Oral screen
Hay rakes
Blue Grass appliance
Quad helix
Modified Blue Grass appliance www.emeralddental.in

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