Article title: Thumb-sucking: Literature review
Author(s): Eric D. Johnson DDS, Brent E. Larson DDS
Journal: Journal of Dentistry for Children
Month, Year: November-December 1993
Major topic: Thumb-sucking
Type of Article: Literature review
Author(s): Eric D. Johnson DDS, Brent E. Larson DDS
Journal: Journal of Dentistry for Children
Month, Year: November-December 1993
Major topic: Thumb-sucking
Type of Article: Literature review
Main Purpose: To review the literature relative to the causes, risks prevalence, and contributing factors of Non-Nutritive Sucking (NNS) habits.
Overview of method of research: Reviews of literature
Findings: Two theories of behavior that address the problem of NNS are the psychoanalytic theory of psychosexual development and the learning theory. The psychoanalytic theory holds that the response arises from an inherent psychosexual drive, and that digit sucking represents a type of anxiety management by the child and abruptly extinguishing it could be detrimental to the normal emotional development of the child. The learning theory advocates that NNS stems from an adaptive response and assumes no underlying psychological cause to prolonged NNS. It assumes all forms of NNS had adaptive value at some earlier developmental stage and the response was subsequently rewarded and eventually became a “learned habit.” Although overwhelming evidence supports the learning habit it has been suggested that an increase in stress or anxiety in a child’s life can convert an empty thumb habit into a meaningful stress-reduction response. Therefore it is important as physicians to screen patients with an NNS habit properly for possible psychological disturbances before initiating treatment.
Findings: Two theories of behavior that address the problem of NNS are the psychoanalytic theory of psychosexual development and the learning theory. The psychoanalytic theory holds that the response arises from an inherent psychosexual drive, and that digit sucking represents a type of anxiety management by the child and abruptly extinguishing it could be detrimental to the normal emotional development of the child. The learning theory advocates that NNS stems from an adaptive response and assumes no underlying psychological cause to prolonged NNS. It assumes all forms of NNS had adaptive value at some earlier developmental stage and the response was subsequently rewarded and eventually became a “learned habit.” Although overwhelming evidence supports the learning habit it has been suggested that an increase in stress or anxiety in a child’s life can convert an empty thumb habit into a meaningful stress-reduction response. Therefore it is important as physicians to screen patients with an NNS habit properly for possible psychological disturbances before initiating treatment.
Key points/Summary: Prolonged digit-sucking habit can have significant effects on dentofacial development. Malocclusion caused by thumb-sucking is more a matter of individual response to stimuli than a highly classified cause and effect syndrome. Some spontaneous corrections of the dentofacial effects can be expected, if the NNS habit persists until nine years of age and is then stopped. This spontaneous correction takes place primarily during the first year after habit cessation and is involved with dentoalveolar changes – a decrease in dental openbite and retroclination of the upper incisors. Studies demonstrate a decrease in digit-sucking habits with an increase in pacifier use, less than 3 percent of children who used a pacifier developed a thumb-sucking habit. The prevalence of digit-sucking in North American children at ages two and five is approximately 23 and 18%. The thumb sucking habit has been found to be stronger, more persistent, and more widespread in girls than in boys, however there are no sex-linked factors that account for the sex differences in thumb-sucking habits. The majority of children with an NNS habit began the habit during the first three months of life. Every study that linked thumb-sucking with age demonstrated a decreased prevalence of NNS habits with increased age. There has been no correlation found between thumb-sucking and mode of feeding. Also it has been found that children who sucked their thumbs were less likely to have a care-giver present as they fell asleep. Children from a “high socioeconomic group” demonstrated oral habits (finger-sucking, fingernail biting, tongue habits, and lip or check habits) more frequently than children from a middle or low socioeconomic class. Children of parents with an extensive education were more likely to develop a finger-sucking habit whereas children whose parents had little or no theoretical education were more likely to develop a pacifier habit.
Assessment of article: Good article – a great literature review on numerous thumb-sucking studies
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