The mother of a 5-year-old patient is concerned about the child’s thumb-sucking habit. Six months ago, the patient had 5-mm overjet and a 3-mm anterior open bite. Today, the patient has 10% overbite and 3.5-mm overjet. The mother says that the child only sucks his thumb every night when falling to sleep. Of the following, which is the best advice?
The patient’s overbite/overjet improved from the previous examination and therefore it is likely that the patient’s digit-sucking habit had decreased significantly. The mother did state that the patient only sucks his thumb while falling asleep. When digit-sucking occurs for a limited time per day, not only is tooth movement normally associated with digit-sucking unlikely, it is possible for teeth to return to a more normalized position. Remember that the risk of malocclusion as related to habitual activity is a function of amount of time per day the habit is practiced, the duration of the habit in terms of weeks and months, and the intensity of the habit. Because the occlusion seems to be improving and because the habit has significantly decreased, the best treatment is to counsel the parent regarding thumb-sucking, and recall the patient in 3 months.
Refer to a speech pathologist.
Recommend tongue thrust therapy.
Recommend a thumb-sucking appliance.
Counsel the parent regarding thumb-sucking, and recall the patient in 3 months.