4 tips to help your child break a thumb-sucking habit, according to a pediatrician

• If your child hasn't stopped sucking their thumb by the age of 5, you should intervene.
• Thumb-sucking at that age could cause breathing problems, speech issues, and crooked teeth.
• To stop thumb-sucking, reinforce positive changes, set attainable goals, and use bitter-tasting gel.

Most children typically ditch their thumb-sucking habit between the ages of 2 and 4, with some quitting earlier, by 6 or 7 months old.

But if they're still sucking at 5, the American Academy of Pediatrics says it's time to intervene.

Thumb-sucking can cause long-term dental issues

By age 5, continued thumb-sucking can start to cause damage. Sometimes there's no damage, and other times it can change the shape of a child's mouth and their face. How severe that damage is, mostly depends on how aggressively your child sucks their thumb.

"Children who rest their thumb in their mouth and occasionally suckle gently are less likely to have issues than children who continuously and rhythmically have a strong suckle," says Esther Liu, MD, chair of Pediatrics at the University of Maryland Baltimore Washington Center.

The reason, she says, is the constant pressure can alter the shape of the roof of the mouth and upper jaw leading to narrowing of the jaw or palate. This can decrease the airway and create changes in breathing patterns and tongue position. It can also cause speech issues.

Yet the most common consequence of prolonged thumb-sucking is malocclusion, or misaligned, crooked teeth, says Adam S., Harwood, DMD, an endodontist in New York.

What's more, many of these problems, Harwood says, can lead to future dental problems that could cost hundreds to thousands of dollars to fix. Some of these problems include:

• Anterior open bite: a type of overbite that can cause problems with grinding food and articulation.
• Overjet: a condition that's commonly known as "buck teeth" and is when your front two teeth extend far beyond your lower two teeth. Some parents may seek treatment for aesthetic purposes.
• Gapped maxillary incisors: the spacing of maxillary incisors is wider than normal, causing a gap between the teeth.
• Lisps and other inflection anomalies

How to help your child stop thumb-sucking

For the most part, thumb-sucking is harmless, unless it goes on for several years.

If you and your pediatrician feel that it's necessary to take extra steps, here are some ways to encourage your child to quit sucking their thumb.

1. Identify situations in which your child is sucking their thumb. Are they tired, bored, or anxious? "Teach them how to verbalize their feelings so they can learn to identify those situations, and then, offer an alternative," says Liu. For example, if they suck their thumb when tired, offer alternatives such as a stuffed animal to help them fall asleep.

2. Set attainable goals. Harwood recommends initiating a candid discussion with your child explaining the consequences of continued thumb-sucking. The goal is to gain their "buy-in" on the plan to change what's become a bothersome habit. Of course, the success of this approach will depend on the age of your child. The older they are, the more likely they will be able to understand why they should stop.

3. Reinforce signs of positive change with small rewards. "Keeping a whiteboard or progress chart with a list of goals and rewards is particularly useful," says Harwood. And don't be overly critical of any setbacks. "Explain how setbacks are a part of habit breaking and that the idea is to move on and get back on track with positive behaviors."

4. Appliances may be used as a last resort. These include ventilated devices that attach to the thumb and prevent the actual sucking from taking place, which takes the pleasure out of the action, Harwood says. He also says that using an approved, bitter-tasting gel applied to the thumb can be helpful for some children.

Insider's takeaway

In general, Harwood says that the goal is to keep everything positive.

"I suggest sticking with the traditional methods of breaking the habit until it's clear such procedures aren't working," Harwood says.