Blue Bell Orthodontist

If you are parent to a child who has a thumb or finger habit, you are in good company. One study indicated that 15-20% of children under age 6 engage in thumb or finger sucking habits. Even orthodontists' children suck their thumbs! (See cover photo to see my daughter in action).

Below are 4 considerations for parents with a child who engages in thumb sucking. All of the following are evidence-based and established by clinical research, to help your child avoid dental health problems while building self-confidence associated with overcoming a challenging task.

Impact on Dental and Facial Growth and Development

After age 6 and with the corresponding eruption of the first permanent teeth, sucking habits will begin to have an irreversible negative effect on the development of the jaws, bite relationship, and positioning of teeth. In most cases, the habit will contribute specifically to a narrow upper jaw (causing crossbite), protruded upper teeth (overbite), and a failure of the front teeth to bite together properly (open bite).

Stopping By Age 6 or 7 Will Minimize Most Long Term Effects

In my experience as an orthodontist, I find that most children begin to establish social awareness of thumb sucking around age 5-6 and develop an internal motivation to cease the habit when it is observed that peers at school are not engaged in the habit. Fortunately for children and parents, this period coincides with the time in development at which irreversible negative effects can by prevented. Research has shown that cessation of thumb and finger habits prior to the eruption of the permanent incisors (central teeth) at age 6 or 7 will prevent lasting negative impacts on the development of the upper jaw and permanent teeth. This key age to stop also aligns with the American Association of Orthodontists' (AAO) recommended age for the initial evaluation of your child (age 7) by an orthodontic specialist.

Techniques for Stopping Thumb and Finger Sucking

The single most important aspect in helping a child to stop sucking a finger or thumb is to determine self-motivation. In the clinical setting, I typically begin by simply asking the child if he or she would like to stop the sucking habit. If your child is not ready and motivated, then it is not time to attempt to stop the habit. It will only lead to frustration and negativity. The focus, instead, should be on education. Explaining to your child how it would be helpful to them to stop and pointing out that others in their social group or class at school may be in the process of stopping. Acknowledging the difficulty in stopping is also very important. For example, if either parent had a sucking habit as a child, explain to your child how you recall how hard it was to stop, but how rewarded you felt once you were able to tackle the  difficult challenge.

Once established that the child is motivated, I recommend the following techniques to positively reinforce stopping the habit:

1. Continuously reaffirm the child's self-motivation and goal to stop. Examples: "That is so great that you set this goal." and "You can do this, we are so proud of you."
2. Set up a reminder system to help the child stop when the body may be unconsciously initiating the habit during sleep. This can include sleeping with glove or bandaid on the sucking hand and using nail polish on the sucking finger (Mavala Stop is one brand name).  The goal is not to physically prevent your child from performing the habit, but helping to provide reminders so they can willfully stop the habit in a positive, supportive environment. Positive reinforcement is the key.
3. Use a reward calendar on the refrigerator. Every full day/night your child goes without engaging in the habit, place a star on the calendar. Arrange for a reward after 14 consecutive days are achieved without the habit. After 14 consecutive days, the chance of relapse of the habit is very small. (Link: I Can Do It Reward Chart)
4. In many cases, early orthodontic intervention will help your child if he or she is actively engaged in a sucking habit over age 7. Most often, a constricted (narrow) upper arch and possible associated crossbite will indicate the need for a maxillary expander to orthopedically widen the upper jaw. In this case, this very common appliance will change the dynamics of the thumb habit just enough to serve as a reminder and aid the child in stopping the habit.

Consider the BIG PICTURE

Your child will overcome this habit. Your role as a parent is to educate, to motivate, and to provide a positive and supportive environment. Keep in mind that this may be the very first conscious, difficult sacrifice your child makes to improve his or her health and well-being. It must be our goal as adults (parents and healthcare providers alike) to foster self-motivation, encourage that little girl or boy that they are up to the challenge, and celebrate with them when they achieve what they set out to do. Comments like "how am I going to get him to stop" or  "she will never stop this" do little to motivate and will undermine the child's self-expectations. This habit should be looked at as a profound opportunity that can be used as a very important confidence builder for a young child. We adults must create an environment that encourages children in our sphere of influence to learn, to set goals, and to succeed- in thumb-sucking and beyond!!

The DCO Team is here to help you. Please email me at any time (info@dco-ortho.com) if I can provide any additional information to help you or your child.

"Everybody has a plan until they get punched in the mouth." -Mike Tyson

(Montgomery County, PA)- Many parents ask whether their child in braces or Invisalign needs to wear a mouthguard while playing sports. Below are some guidelines to help you ensure your child's teeth are protected while playing sports.

Advantages of Mouthguards

1. Cushion any forceful contact to the face, lips, or jaws to prevent injury
2. Prevent teeth from being chipped, broken, or injured when heavy contact is sustained
3. Evenly distribute force when contact is sustained to the mouth, lips, or teeth

Types of Mouthguards

1. Custom Fit Mouthguards (the cream of the crop, best fitting and performing, made by your dentist or orthodontist)
2. Orthodontic Mouthguards (designed to fit around braces, expanders, and other orthodontic appliances and to give teeth the freedom to move while still providing great protection)
3. Boil and Bite Mouthguards (DIY at-home customization, gets the job done but may not fit as well and will be more bulky when compared to a custom fit mouthguard)

When should my child wear a mouthguard?

1. Any sport or activity where forceful contact to the face could be sustained
2. More obvious sports are: football, hockey, lacrosse, field hockey, boxing, martial arts
3. Less obvious sports where facial injuries can occur but mouthguard wear is typically inconsistent and/or not required to be worn amongst players are: basketball, soccer, baseball, softball. In my practice, I have seen the highest amount of significant dental trauma stemming from basketball in instances where a mouthguard was not being worn
4. If there is any chance for contact to the face or teeth, then a mouthguard = your best friend

If you have any questions about mouth protection or prevention of trauma while playing sports, please feel free to email me at info@dco-ortho.com. We are committed to helping you! I hope you found this short article helpful!

(Blue Bell, PA) Nearly all adult DCO patients treated with Invisalign share a common regret: “I wish I had done this sooner.”  For many working professionals, lack of time is the key deterrent to reaching the smile and healthy bite they have long been seeking. Because time is your most precious resource, we have optimized our treatment systems to allow for a flexible, efficient treatment process for all of our adult patients.  We have designed our processes to utilize high-level technology to drastically reduce your number of appointments while achieving the best outcome. This makes treatment more convenient for you.  We have strategically harnessed the power of innovative technology and careful patient-specific treatment planning and staging. We set the exceptionally high target of having your decision to be treated with Invisalign at DCO be the best decision you have ever made. Below are four ways we deliver this to our patients:

1. Treatment experience: We prioritize personalization and customization to specifically accommodate your needs.  Travel out of the country for work?  No problem. Busy schedule? No problem. Going on an extended vacation? No problem. Our Experience Concierge will ensure that your needs are being met, every step of the way.
2. State-of-the-art technology and facility: DCO was designed from scratch to specifically give privacy and comfort to adult patients.  Read more details about the DCO Digital Experience and how we have selected technologies to enhance your treatment results and make the process more streamlined for you.
3. Exceptional clinical care: Dr. Cassarella is highly trained and skilled orthodontic specialist with over 10 years of experience practicing orthodontics exclusively. He is a graduate of the Penn State Schreyer Honors College and trained at Harvard University (4-year DMD degree) and UCLA (3-year Orthodontics Residency).  Dr. Cassarella also holds an appointment as a clinical orthodontic faculty member at the University of Pennsylvania.
4. We begin by listening:  Our most important source of information throughout your treatment is YOU. Our most important metric for success is your happiness.

The pathway to your perfect smile in a manner that fits your lifestyle is clear. We can’t wait to meet you!