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Q
My daughter's almost 10 and she still sucks her thumb when she's sleeping or stressed out. It clearly provides a lot of comfort for her and she is somewhat high-strung. Should I be concerned and encourage her to stop?
A
At this age I don't recommend forcing a child to stop sucking her thumb. She has to decide when she wants to give it up, and if you start nagging her or forcing her, it will only generate more resistance. She's old enough to be able to decide when she wants to recognize that it's a problem, and to determine when she's ready to do something about it. That said, it's perfectly fine for you to put a few limitations on it (she can't do it in public and, while at home, she needs to go to her room if she wants to suck her thumb).

There are obviously some physical consequences of prolonged thumb-sucking, primarily its effects on the alignment of the palate (roof of the mouth) and the teeth. At this point, don't obssess about that because the damage has already been done. Consult with an orthodontist if you think any treatment is needed.

As you stated, thumb-sucking does provide comfort to children, and in order for them to stop, they usually need to figure out some other way of comforting themselves at stressful times. If it seems as though your daughter is very stressed, and she is spending large amounts of time sucking her thumb, then counseling with a therapist may be useful -- if some of the anxiety can be limited, the thumb-sucking may then decrease.

Once your daughter expresses an interest in trying to stop this habit, be sure to encourage her every step of the way. Relaxation therapy can be useful, and some families have used hypnosis with good results. Dentists can make an appliance that is fitted into the mouth that makes it virtually impossible to suck the thumb. If your daughter feels she can handle this and you can afford it, it usually works quite well. Some of the simple remedies (bitter tasting solutions to paint on, covering the hand with a sock, etc.) that are used for young children who thumb-suck tend not to be as effective in this older age group, but still may be worth a try.

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