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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.

TMJ pain (Temporomandibular Joint Dysfunction or TMD) affects over 3 million people each year in the United States. It consists of pain in the jaw joint and/or surrounding muscles and associated difficulty opening. Some patients experience mild pain and discomfort, while others can experience severe pain that drastically interferes with normal function and quality of life. Individual patients may experience a wide range of severity at different times. TMD is highly correlated with stress. The majority of those who experience TMD are over the age of 20, however, it can occur in children and teenagers.

What is the cause of TMJ Pain (Temporomandibular Joint Dysfunction- TMD)?

1. The majority (almost 70% according to most research) of TMJ Pain is caused by overuse and inflammation of the muscles around the jaw joint.  TMJ pain can also less commonly be caused by functional problems within the joint itself.
2. TMJ pain is often caused by muscle overactivity that occurs during times of stress, and as a result of clenching and/or grinding.
3. A significant portion of the population will experience TMJ pain at some time throughout life and symptoms tend to improve with time through conservative measures (see below):

Seven Simple Solutions for Relief of TMJ Pain:

1. DIET: Soft foods (prevents over activity of chewing muscles)
2. MOTRIN: Motrin/Advil (doses as indicated on bottle) periodically when pain is at its worst (reduces both pain and muscle inflammation)
3. HEAT: Use a heating pad to apply heat to the side of the face near the TMJ for 15 minutes on both sides each night before bed.
4. STRETCH: Stretching exercises to open your mouth as wide as you can without pain to stretch muscles around the jaw and facilitate muscle lengthening and relaxation (2x/day for 5 min each)
5. NIGHTGUARD/RETAINER: A clear nightguard or retainer on upper and/or lower teeth to be worn while sleeping to help to keep your teeth apart and relax the muscles around the TMJ. This should be made and adjusted by an orthodontist or dentist.
6. HABITS: Avoid repetitive chewing habits that cause your muscles to function continuously like chewing on pen caps, chewing on nails, or chewing gum all day long (chewing gum for a few minutes several times per day is ok).
7. RELAXATION: Studies show that TMJ pain and muscle overuse is highly correlated with general life stress. Exercise, good sleep habits, and finding time during the day to mentally and physically relax helps to improve symptoms significantly.

**All therapies above should be monitored by your orthodontist or dentist.

We are committed to help you feel better! This protocol is effective in providing significant relief for a large percentage of patients. If these conservative methods are not effective, we can refer you to a facial pain center for more advanced diagnosis and treatment.

We are here to help you!  Call us at DCO (610-615-3166) with any questions- we would love to assist you!

DCO: The Humanized Digital Experience

We are all deeply familiar with the capability of digital technology to revolutionize the way we do things. Twenty years ago, we all would have had trouble believing that most of society would be connected via mini, hand-held computers that magically merged with our phones.  At that point, we were still grappling with the concept of the internet and hoping that the world did not end on “Y2K.”  As we know, in many arenas and in many ways, digitization has spelled dehumanization of experiences for customers.

At DCO, we are constantly seeking to combine the awesome capabilities of digital technologies to enhance the personal experience patients have while in treatment.  Each patient is assigned to a DCO Experience Concierge whose sole mission is to guide individuals through the treatment process. The DCO Experience Concierge ensures seamless coordination, high-quality service, and a personal connection throughout treatment.

Our practice has carefully and deliberately selected technologies that add value to the personal experience of each patient.  Below are three examples:

1. 3D Printing-  A true win-win for patients is technology that improves treatment quality, enhances treatment efficiency, and provides a more comfortable experience. Three-dimensional scanning and printing has allowed us to be extremely precise in creating a digital 3D model of our patients’ teeth to aid us in accurate diagnosis and treatment.  We are able to work with laboratories to 3D print and create accurate appliances like expanders for children and Invisalign aligners for teens and adults.  The upsides to this technology are a huge increase in patient comfort through the elimination of the need for impressions and the improved accuracy of our diagnosis and treatment.  The downsides are none.

1. Digital Workflow- Your healthcare experience will no longer be defined by having to fill out 15 paper forms while the reception staff sits behind a glass partition.  At our practice, from beginning to end, the DCO Experience Concierge is always with the patient along the way, answering questions and lending support. Our digital treatment experience is built around elimination of unnecessary steps, clear communication, and paperless management of each patient’s personalized treatment. We use sophisticated digital diagnostic, practice management and treatment planning software that allows us to make things simple for our patients while leaving a green footprint.  Among these technologies are digital radiographs and three dimensional model generation which provides enhanced comfort to patients, appliances that fit more precisely, and creates efficiencies to allow for fewer visits during treatment for each patient.

1. Invisalign- Clear aligner treatment (Invisalign) has enabled us to make treatment virtually invisible. Additionally, it allows for flexible for adults and has improved the quality of life, function, and confidence for many who would not pursue orthodontic treatment otherwise.  Invisalign’s innovations are centered around using 3D models to virtually move teeth and manufacture clear aligners to be worn sequentially at each stage of tooth movement.  Invisalign's digital technology dovetails perfectly into 3D printing and scanning technological advancements that we have harnessed in other areas of our practice.  Adults are now free to pursue orthodontic treatment with extremely little impact on their lifestyle or work schedule.

The future is here and it is exciting!  At DCO Orthodontic Specialists, we have harnessed the power of digital technology to enhance human interactions, not replace them.

Our dogs can be our greatest teachers. Personal and professional lives are often crafted around service and making a positive impact on the lives of others.  Many volunteer their time and efforts in service to others for the immense reward of knowing they made a difference.  Some also see service as a means by which they are answering a higher calling and fulfilling a greater mission larger than any one person. Ask a member of our military or those of faith and they will tell you. At DCO Orthodontic Specialists, we continually ask the question- “How do we best serve our patients?”  We always dig deep to look in unconventional places to find innovative and unconventional answers.

My wife Sarah and I are animal lovers and we have two rescue dogs named Genco and Riley who are at the beginning and end of their life journeys at ages 1 and 15, respectively. Dogs are extraordinary animals and their core ability to instinctively love and to feel is remarkable.  One day, I was walking Genco and saw his tail beginning to wag and felt subtle tension on the leash as he gazed across the street.  In the distance, he spotted a young child holding a balloon walking with her parents.  He was so excited to cross the street to say hello, he sensed the child’s energy and curiosity that matched his own and was also excited to try to play with the balloon she was holding. This small moment gave way to the profound realization that there is a great deal that we can learn from our dogs about serving others. Below are three lessons that our four-legged little friends teach us on a daily basis.

The Beauty of Simplicity

William Martin’s poem entitled Make the Ordinary Come Alive illustrates the beauty in teaching children to unlock the magic that exists in ordinary life instead of encouraging them to search for that which is extraordinary.  Here is an excerpt:

“Help them instead to find wonder

and the marvel of an ordinary life.

Show them the joy of tasting

tomatoes, apples and pears…”

A dog teaches us to appreciate the powerful joy that can be delivered by the mere sight of a person- whether that be a loved one or a new person to meet.  They illustrate the beauty of nature, the wonderful smells of leaves on a crisp fall day, and the great fun that can be had by bounding through an open field. They show us the art of digging one’s nose into fresh snow and then sneezing and rolling around in it just before eating a few mouthfuls.  For us humans, dogs show us the beauty that lies in the simple things we often take for granted.  They make the ordinary truly come alive.  If we can learn this lesson, we can serve others by showing them something incredible and powerful that lies within them that they may have previously assigned as simple or ordinary. By doing so, we may also turn simple aspects of our own nature into superpowers.

Unconditional Love

Unconditional is defined as that which is not limited by conditions; absolute.  In a dog, we find the lesson of a truly unconditional bond.  A dog sees you at your absolute best at all times and wastes no time in the contemplation of your flaws. You are a companion, a friend and somebody who is deeply missed the moment when you leave the room.  If you have a bad day or are down on your luck, a dog will respond by making you instantaneously feel treasured and important. If we can demonstrate that we feel this way, we can provide an uplifting positive spark to others.

Energetic Greetings

The art of the greeting has been perfected by our four-legged friends. Although dogs lack the opposable thumb required for a firm handshake, they make up for this and more. Dogs miss you when you are gone and put that sentiment on full display when you return. Your value to a dog is expressed in the energy and enthusiasm that is shown when you enter the door after being away. We have all heard stories of dogs walking for miles to navigate back home to reunite with their owner. The same phenomenon exists when a dog explodes with excitement to meet a new friend.  How we greet each other can set an uplifting tone for a positive relationship. A dog can teach us much about the value of enthusiastically greeting customers, friends, family and new acquaintances in a manner that truly brightens their day.

In Closing...

At DCO, we believe that gratitude is reciprocal and we tirelessly strive to make our patients feel valued.  We seek to learn the lessons our dogs can teach us to continually improve in being supporters of our patients and their families.  We hope to demonstrate to each of patients how much we value all the simple things that make them an extraordinary, unique individual to us.  At the recommendation of an orthodontist colleague, I recently read a book entitled The Art of Racing in the Rain.  It is story completely told from the perspective of the family dog Enzo and it seamlessly mixes observations ranging from the mundane to the deeply philosophical.  One of Enzo’s most memorable observations in the book is:

“That which we manifest is before us.”

We cherish our dogs because they cherish us.

Have a wonderful day!