Children's Dentistry

Thumb Sucking and Tongue Thrusting: Effects on Your Child's Bite

Understand how prolonged thumb sucking and tongue thrusting can affect dental development, when these habits become a concern, and how they can be gently corrected.

7 min readReviewed by Dr. Amit Sharma, Oral & Maxillofacial Surgeon

Understanding Normal Versus Problematic Habits

Thumb or finger sucking is a natural reflex present in infancy and early childhood, often used as a self-soothing mechanism during sleep or stress. Most children naturally discontinue the habit between the ages of two and four without any lasting dental impact, as the jaw and teeth are still developing and forgiving of temporary pressure.

Tongue thrusting refers to a swallowing pattern where the tongue pushes forward against or between the teeth rather than against the roof of the mouth. When either habit persists beyond the age when permanent front teeth begin to erupt, typically around age six, it can start to exert lasting pressure that affects tooth position and jaw development.

Dental Effects of Prolonged Habits

Persistent thumb sucking can lead to an anterior open bite, where the upper and lower front teeth do not meet when the back teeth are closed, as well as protrusion of the upper front teeth, a narrowed upper jaw, and altered speech patterns, particularly affecting sounds that require the tongue to touch the front teeth or palate.

Tongue thrusting often accompanies or follows prolonged thumb sucking and can perpetuate an open bite even after the sucking habit stops, since the tongue continues to push against the teeth during swallowing hundreds of times a day, gradually shifting their position over time.

Gentle Strategies to Break the Habit

Positive reinforcement tends to be more effective than punishment or shaming. Praising a child for periods without thumb sucking, using reward charts, and identifying and addressing underlying triggers such as anxiety or tiredness can help reduce the habit gradually and without emotional distress.

Covering the thumb with a bandage or bitter-tasting, child-safe nail polish as a physical reminder can be helpful for motivated older children, though this should be discussed with your dentist or paediatrician first. Addressing the habit before the permanent front teeth erupt generally leads to better spontaneous correction of any dental changes.

Professional Intervention When Needed

If a habit persists beyond age four or five despite gentle efforts at home, or if dental changes are already becoming apparent, your dentist may recommend a habit-breaking appliance, a removable or fixed device placed in the mouth that discourages thumb sucking or tongue thrusting by making the habit less satisfying or physically more difficult to continue.

In cases where tongue thrusting persists, referral to a myofunctional therapist may be considered to retrain swallowing patterns and tongue posture, working alongside orthodontic treatment if the bite has already been significantly affected.

Questions patients ask us

At what age should I start worrying about my child's thumb sucking?
Occasional thumb sucking up to around age four is generally not a cause for concern, as most children stop on their own. If the habit continues intensely beyond age four or five, particularly once permanent front teeth are erupting, it is worth discussing with your dentist.
Can a pacifier cause the same problems as thumb sucking?
Yes, prolonged pacifier use can produce similar effects on tooth position and bite as thumb sucking, particularly if used well beyond infancy. Choosing an orthodontically designed pacifier and aiming to wean off it by around age two to three can reduce this risk.
Will my child's bite correct itself once the habit stops?
If the habit stops before the permanent front teeth fully erupt, mild dental changes often self-correct naturally. However, if the habit persists longer or the changes are more significant, orthodontic evaluation and treatment may be needed to guide the teeth into proper alignment.
How does tongue thrusting affect speech?
Tongue thrusting can interfere with the clear pronunciation of sounds such as s, z, and th, since correct articulation depends on precise tongue placement against the palate and teeth. A speech therapist working alongside your dentist can help address both the swallowing pattern and any associated speech difficulties.
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Please note

This article is general education and does not replace an in-person examination, radiographs or a diagnosis by a qualified dentist.

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