THUMB SUCKING AND DUMMIES - A Parent's Guide to a Common Concern

Sucking is a natural reflex; some babies begin sucking on their fingers before they're even born. Sucking provides a sense of security and soothing comfort. It's a form of tension release.

While sucking is a very natural experience, sucking on thumbs and dummies can cause some parents concern (particularly when relatives, friends, and co-workers weigh in with advice!). Parents fear that their babies may develop a habit that's tough to break when it's no longer so natural or cute. Another concern is the impact that sucking, whether thumbs or dummies, has on the child's teeth.

Is Sucking Harmful for Teeth?

Normally, children stop sucking on thumbs or dummies between two and four years of age when they become much more active explorers of their world. This is before the permanent teeth appear. No harm is done when the child gives up sucking on thumbs and fingers before the permanent teeth come in. However, if the child is a chronic or aggressive sucker, the constant sucking may cause problems with the permanent teeth in the future. If you think your child's baby teeth are being affected, consult your dentist.

Sucking after the permanent teeth begin erupting can cause problems with the proper growth of the mouth, alignment of the teeth, and the development of the roof of the mouth.

Is Sucking a Dummy Preferable to Thumb Sucking?

Both can affect teeth the same way. However, children seem to have an easier time in giving up sucking on dummies than thumbs. A dummy can eventually "go away" but a thumb is always around! Also a thumb can create more torquing force on the teeth and jaws - actually moving the bones over time.

What Can Parents Do to Help Their Child Give Up the Sucking Habit?

By the time many children reach school age, they often stop because of peer pressure. However, if the habit continues, there are some strategies that encourage giving it up.

• Older children often continue the sucking habit because it's a stress-reliever for them and offers comfort. Look for any cause of their discomfort or anxiety and seek solutions to correcting them, rather than making sucking the issue.
  
• Praise your child during the times when they're not sucking. Reward them when they don't resort to sucking, especially during anxiety-prone times.
  
• Your dentist can explain to your child what can happen to his or her teeth if they continue the habit. Getting this information from a "tooth doctor" (and someone other than parents) can provide needed motivation.
  
• Involve older children as part of the S.W.A.T. team (Sucking Will Affect Teeth!). Finding solutions together by planning the actions (or rewards) lets them know they're on the family "team" and not part of the surveillance squad!
  
• If your child has difficulty breaking a thumb-sucking habit, try bandaging the thumb or putting a sock over the hand at night. Your dentist or paediatrician might also prescribe a bitter-tasting medication to coat the thumb or dummy. A mouth appliance can also be used to block sucking habits.
  

THE LONGEVITY OF CROWNS
People often assume that once they have a crown placed on a tooth, it will last the rest of their lives. Although crowns may last for a very long time, it is not correct to say that they will last forever.

How Long Do Crowns Last?
This is one of the most difficult questions asked of a dentist because, in essence, no one can be sure. However, there are a few resources available that can give us an idea of how long crowns may last.
The dental research has some extreme variability in this area. It provides information that ranges from a 20% failure rate in 3 years all the way to a 3% failure rate in 23 years. So, which is correct? The answer actually has to be looked at on a case-by-case basis. To do this, we need to look at why crowns have to be replaced.

Why Do Crowns Need to Be Redone?
There are many reasons why crowns need to be redone. Fracture is one example. The fracture incidence of crowns can be related to either the type of restoration (gold, metal ceramic, all-ceramic) or where the restoration is placed in the mouth (anterior vs. posterior). Another risk factor is if a person has a grinding habit at night. A crown will have a higher risk of fracture in a mouth that applies more forces to the teeth by grinding than in one that does not have any incidence of grinding.

Decay can be another reason why a crown needs to be replaced. Just because a tooth receives a crown does not mean it is less prone to decay. In fact, because it has more areas that may trap plaque, it needs to be cleaned as well, if not more meticulously, during home care.

Aesthetics can be another reason why crowns are replaced. Aesthetics is one of the main reasons people choose to have a new crown made in the anterior part of the mouth. This occurs because as we get older, our teeth will change colour and progressively get darker while the tooth with the crown will stay the same colour as the day it was placed. A discrepancy between the colour of the teeth will become more evident over time. In addition to colour, aesthetic changes in the position of the gum tissue over time can also affect the look of the crown.

Which one of these areas may be a factor in a patient's mouth is uncertain. An idea can be obtained by evaluating the reason a crown was needed in the first place (such as a fractured tooth, decay, etc.). In conclusion, it is unclear how long a crown will last. Their life span may be anywhere from a few years all the way to 20 years and beyond. A lot of it will depend on the need for the crown in the first place and how well the mouth is taken care of after the crown is placed.