When I see a child for the first time, I can tell immediately, without even asking, if they suck their thumb or fingers. This is because of the tell-tale signs: protruding upper incisors and a large gap, or open-bite, that has been created by the thumb or finger forcing the upper and lower front teeth apart.
By the time they get to see an orthodontist, usually from the age 8 upwards, most parents will have tried the home remedies like sticky plasters or painting a bitter taste on to the offending thumb/finger. Where these haven’t worked, the next thing I recommend is ThumbguardTM. When parents have bought and used this excellent device as instructed by the manufacturer, the vast majority report that it has cured their child of the habit. This is good news as the teeth and jaws can now recover and resume developing normally. It takes about 4-6 months for the front teeth to straighten and for the open bite to close.
In a tiny minority of patients, ThumbguardTM does not seem to do the trick. This is when we then suggest that we fit a “Bluegrass Appliance” (presumably named after an orthodontist named Bluegrass although a Google search did not make me any wiser. Please email us if you find out!). The appliance consists of a plastic roller connected to supporting bands or rings which are fastened to the upper back teeth. The roller fits behind the child’s upper front teeth and is barely visible in normal view.
Once the “Bluegrass” is cemented, there is nothing to adjust and no moving or removable parts. The roller prevents the thumb or finger from touching the gums behind the front teeth and on the roof of the mouth, turning a pleasant experience into an unpleasant one. With no satisfaction, the child has no incentive to continue. The brace is left on for only as long as it takes to stop the habit.
Finally, a word of caution about thumb-sucking habits and orthodontic treatment with train tracks…if your child is about to have train tracks fitted, make sure they really have stopped their thumb or finger sucking COMPLETELY. If patients continue the habit without their parent’s knowledge after train tracks have been fitted, the train tracks loosen the teeth and then the thumb/fingers push the teeth all the way forward, making them much worse!