Management of Persistent Thumb-Sucking Habit Using a Modified Thumb Guard Appliance: A Case Report

Abstract

Thumb sucking is a common oral habit during early childhood and is generally considered normal during infancy. However, persistence of the habit beyond the preschool years may result in adverse dentofacial changes, including increased overjet, anterior open bite, and altered oral function. Early intervention is often required to prevent the progression of these malocclusions. A 5-year-old boy presented with a persistent thumb-sucking habit of one year's duration, predominantly during daytime hours. Clinical examination revealed a high-arched palate and the presence of a callus on the thumb, consistent with chronic digit-sucking behavior. Considering the child's age and the parents' preference to avoid a fixed habit-breaking appliance, a modified removable thumb guard appliance was designed and fabricated. The appliance was delivered along with appropriate counseling and positive reinforcement strategies to facilitate habit cessation. The child demonstrated good acceptance and compliance with the appliance throughout the follow-up period of six months. A gradual reduction in the frequency of thumb sucking was observed, with complete cessation of the habit achieved within three months of appliance use. The callus on the thumb showed progressive regression and had significantly resolved by the end of the follow-up period. No further episodes of thumb sucking were reported by the parents. The appliance was well tolerated, and no complications or adverse effects were observed. Owing to the relatively short follow-up duration, no appreciable changes in the high-arched palate were noted. In the present case, the modified thumb guard appliance was associated with successful cessation of the thumb-sucking habit and was well accepted by the child throughout the treatment period. This appliance may be considered a non-invasive and patient-friendly option for managing persistent thumb-sucking habits in young children. This approach may be considered a viable alternative when conventional fixed habit-breaking appliances are not preferred by parents or caregivers. However, further studies with larger sample sizes are required to evaluate its long-term efficacy and broader clinical applicability.