thumb-sucking-orthodonticThumb sucking: The reason more than a few of your young patients are seeing you for treatment of an overjet, over bite, or cross bite. And their parents are paying the price—literally.
For those parents who are struggling to help a child stop sucking their thumb, Karen Reisner, DDS, an orthodontist in private practice in Cresskill, NJ, has written a book to help parents do exactly that. Thumbs Up for Thumbs Out is a 32-page practical guide for families to help their child break the habit. In it, Reisner shares the strategies and techniques she’s developed over the course of her 20-plus year career that have helped the parents and children in her practice.

Orthodontic Products talked to Reisner about her book and what an orthodontist can do to help these young patients break the habit.

Karen_Reisner_Thumbs-Up_book-coverOrthodontic Products: What motivated you to write the book?

Karen Reisner, DDS: It really started out as an office manual, and something that could be circulated to patients as I had some really good success with helping kids stop sucking their thumbs. Parents, particularly moms, would say to me, “I’ve tried everything and nothing worked. I can’t believe you got my child to stop.” And then it kind of evolved into a guide for parents. While this book is for every age really, I make it quite clear in the book that this is really for the parents of 4-, 5-, 6-year olds who are having a hard time kicking the habit.

It’s a very easy read. I talk about my technique, as well as about why kids suck their thumbs and why it’s bad. I have some great pictures of open bites, buck teeth, and cross bites that resulted from thumb sucking. All of the pictures come from my patients.

OP: How do you approach the thumb suckers in your practice?

Reisner: You can tell who the thumb suckers are—they have a bit more of an open bite on the right or left side. You can even tell what thumb they suck just by looking at the thumbs. Once I establish that they suck their thumb, I don’t say to them, “Hey, you suck your thumb. You have to stop.” Instead, I say to them, “Yeah, sucking your thumb feels good, doesn’t it?” Immediately, they’re like: Whoa! This is the first time someone’s ever actually acknowledged why I suck my thumb. And then we start talking. With a 6-year-old, for example, I’ll say, “Ok, so when do you suck your thumb? Let me guess….” And I’ll joke around with them a bit and say, “You suck it at school, don’t you?” And they’ll say, no. If I ask, why not, they won’t answer. Usually it’s because they’re embarrassed. They don’t want to answer because on some fundamental level, they know that it’s kind of socially unacceptable to suck their thumb in public. So they really do it at home when they are bored, stressed, or about to go to bed.

I’m dealing with a 6-year-old on a 6-year-old level. They don’t really understand or want to understand that by sucking their thumb they’re going to have a big overjet that’s going to require therapy and an expander or whatever. What they understand is that they suck their thumb because it feels good.

OP: What’s the key to helping a child stop thumb sucking?

Reisner: Everybody has to be on board. I can’t have a parent come here and say, “Nothing will happen. Everything I do doesn’t help.” You’re setting the patient up for failure. Everyone must be on board. From there, it’s about the parent or caregiver keeping the child’s hands busy. Buy Silly Putty to keep the child’s hands busy. Buy a kid’s cookbook because that child is going to help cook to keep their hands busy. At bed time, read and read and read with your kid, sit with them, until they fall asleep. The first few nights are going to be a little tough. The child’s going to be a little clingier than usual and that’s ok.

And, if it doesn’t work, it’s not that the kid has failed; it’s just that they may not be emotionally ready. Then you wait another 3 months and try again.

Yes, there are other alternatives, like putting that horrible toxic stuff on the nails; but the truth is, a kid has to want to stop sucking their thumb. Right? Whether it’s that the 6-year-old finds it’s socially unacceptable or they don’t want to be teased—and it’s usually the case that they don’t want to be teased by their friends, they have to want to stop. They don’t understand the malocclusion aspect. A kid who is not on board will suck their thumb around an appliance. I’ve seen it. They’ve done it.

OP: What’s the orthodontist’s role?

Reisner: You really have to encourage them every step of the way. Any little accomplishment is a big deal. In my practice, they’ve responded really, really well to that praise.

What I also do is I give the 6-year-old my business card with my number on the back and tell them to call me to tell me how they did. They feel important and special when they get that card. And they call me the next day—the child, not the parent. Honestly to hear a child, who you know is nervous, call to say, “I stopped sucking my thumb last night,” is great. We always call them back and say congratulations. More than anything, it’s being a friend and helping them to stop the habit.

Of course, setbacks occur, and there are those children who have other emotional issues that require a therapist; but, for the average tenacious thumb sucker, this is a great guide for parents.

Reisner’s book, Thumbs Up for Thumbs Out, is available on Amazon. OP