Thumb sucking — meet the dentist whose career has been moulded by digits


Cast your mind back to your childhood and those common rites of passage shared by millions.

Learning to sleep without the lights on and mastering the skills of riding a bicycle with the stabilisers off are just two key milestones in that ‘growing up’ period.

Children often develop habits in those early years, too, from nail biting and hair twirling to the more socially unacceptable behaviours of nose picking and speaking with their mouth full — all of which are pretty innocuous and which they usually grow out of rather quickly.

But, for some, old habits die hard or, at least, have a long-lasting effect — and thumb sucking remains one of the top 10 most common habits in which children indulge and which parents wish to break, fearful of the harmful impact it may have on the development of the child’s teeth.

An American survey reveals there are an estimated 2.4 million children in the States who suck a thumb or finger, with some experts suggesting the habit can even begin during pregnancy — babies furiously sucking away for many months before leaving the womb.

For those of us who were thumb suckers as kids — and now have children — it can be a conundrum, not knowing how best to tackle the habit or indeed whether to address it at all. But understanding the detrimental legacy the habit can leave is important.

For dentist Runa Mowla-Copley, who has a background in paediatric dentistry and orthodontics, it’s all too common a story. Treating young children and teens, Runa developed a very keen interest in how digit-sucking habits affect a developing dentition.

As a reformed thumb sucker herself, and with a daughter who followed her in the habit, she also had personal experience of breaking the behaviour that can misalign teeth and lead to dental problems in the long-term.

So much has ‘the thumb’ shaped her professional career that she’s even written a hugely successful children’s book on the subject — more of which later.

Runa explains: ‘Working in paediatric dentistry and orthodontics offered me the opportunity to really understand and treat developing dentitions. It allowed me to study first-hand how environmental factors, including digit-sucking habits, impact on the development of a malocclusion.’

With clinical insight on how the habit can be an unhealthy one — and that professional intervention is sometimes needed with children who fail to grow out of the habit — Runa co-founded London’s first Thumb Sucking Clinic in 2010.
She also launched and its accompanying campaign, ‘Thumbs up for Thumbs Out’, in the strong belief that prevention is better than cure. The site offers advice and tips to parents and children wishing to break the habit, a forum for parents to share their stories and product recommendations.

She explains: ‘Thumb sucking is a very common childhood habit and most children grow out of the habit by the time they start school. My Thumb Sucking Clinic is aimed at children older than 7 who are having difficulty breaking the habit and whose thumb-sucking habit is adversely affecting their teeth or, in some cases, their speech.

‘Like nail biting and hair twirling, thumb sucking is a very common childhood habit. I would say that most childhood habits start off as very useful self-soothers. Parents often become concerned by the impact of the habit when it starts affecting the appearance of the teeth. Our aim is to help children break the habit as the adult dentition becomes more established in order to avoid a complex malocclusion (bad bite) developing.’

Thumb sucking can cause:
Protrusion of the top front teeth
Narrowing of the upper dental arch which can lead to a crossbite as well as an openbite where the upper and lower front teeth do not meet
A backward tilting of the lower front teeth.

A visit to the dentist can often be very helpful if parents are concerned. Not only will the dentist spot changes in the dentition, but also a word from a member of the dental team to the child is sometimes all that is needed to break a thumb-sucking habit. It can often be the first time the child is made aware of how their habit is affecting their teeth.

Runa is specific about the best age to address the problem. She says: ‘When the child is about to start school at 4 or 5, it’s a great age to begin gently encouraging them to stop. If a child breaks the habit by age 7 or 8 — before the adult teeth begin to erupt — it is unlikely any long-term damage to the teeth will have taken place.’

Additionally, an orthodontic evaluation at the age of 7 or after is a great time to assess the developing dentition — because it coincides with the period when adult teeth begin to erupt. The orthodontist can spot early problems with jaw growth and emerging teeth.

Early treatments can benefit some children to prevent more serious problems from developing and may make treatment at a later stage shorter and less complicated.

She says: ‘Each child is different and so too are the solutions for dealing with the problem. What works for one child may not work for another. And as with all solutions, they will only work combined with positive encouragement and support from the parent(s) and a dentist or orthodontist.

‘Habits can only really be broken once the child has decided enough is enough. Children often feel quite empowered once they have broken a long-standing habit.’

In 2013, she added another dimension to her campaign to wean the nation’s children off sucking their thumbs with the publication of her illustrated children’s book, ‘Charlie’s Thumb’, which has since been recommended by the Oral Health Foundation, Tatler, Prima Baby and numerous other parenting magazines.


She explains: ‘It’s good having the clinical knowledge and expertise to deal with the dental problem but experiencing the problem from a parent’s viewpoint gives you the empathy and compassion in dealing with what is, after all, a comforter for a young child. Parents sometimes feel guilty they haven’t encouraged their child to give up thumb sucking when they were younger, but it’s important not to cast blame and instead focus on providing support and positive solutions.

‘If the story has in any small way captured the imagination and sense of fun of a young reader or listener, then that’s a success! It’s always lovely to receive positive comments from parents and children about the story. I am very grateful for it.’

And, in a world that is become increasingly aware of the value of a healthy smile as well as a straight one, parents are now keener than ever to avoid their children suffering the health implications that having crooked teeth can create.

Runa concludes: ‘We are definitely becoming a more health-conscious nation and I think many parents realise now that having straight teeth is not just about having a pretty smile. There is so much research and evidence emerging about the long-term health risks of gum disease — straight teeth are easier to keep clean — that educating our patients about the health benefits of well cared-for teeth is key, and thumb sucking is an important part of that.’

- If your child sucks their thumb and you are looking for a practitioner to help search

Charlie’s Thumb is available to purchase from Waterstone’s, and the Oral Health Foundation — For those who have already bought it, they’ve welcomed the results.
One grandmother writes: ‘I bought this for my five-year old granddaughter who just will not stop sucking her thumb and it actually worked! ‘ and another mother delights: ‘My five year old loves this book. She was a very committed thumb sucker, I've read this book to her every night at bedtime combined with lots of encouragement during the day. And we have so far had three weeks of no thumb sucking. Hurrah!’

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