Thumb sucking: pediatricians' guidelines.

Thumb sucking is a common, generally harmless child behavior whose persistent practice occasionally leads to dental, dermatological, orthopedic, and psychological problems. When to treat thumb sucking should be determined by risk potential. With a few rare exceptions (e.g., hair pulling), thumb sucking related problems do not occur until after the age of four years and therefore, treatment is rarely necessary before then. Even after this age, treatment is not recommended unless physical and/or emotional sequelae are imminent or a thumb sucking child requests help in quitting. Thus, in most cases parents should be instructed to ignore thumb sucking. When intervention is necessary, it should be preceded by a 1-month moratorium on parental attention. Treatment should include a combination of monitoring with charts, incentives for successful days and various external cues to remind the child who forgets.