Medicine: Thumbs Out!

Thumb-sucking is a hotly controversial subject. Most psychologists believe (and most dentists strongly disagree) that the danger of mental damage in breaking a child of the habit is greater than the danger of dental damage from allowing it. The experts' quarrel leaves the mother in a dilemma.

In the July Journal of the American Dental Association, Dentist Edward S. Mack of San Francisco puts in a strong case for the do-something-about-it school. He admits that interfering with the habit causes frustration. But, he argues, so does toilet training or teaching a child not to lie and steal. "Compared to the intensity of frustration involved in [these] necessary frustrations," says Dr. Mack, "the correction of thumb-sucking hardly bears mentioning . . . And . . . this habit . . . produces a penalty of subsequent deformity out of all proportion to the crime." Besides pushing the teeth out of place, he says, thumb-sucking may lead to poor development of either or both jaws, and to permanent deformities.

Dentist Mack goes more than halfway to meet the psychologists: psychological treatment should come first, he says, and local treatment should be tried only if thumb-sucking still persists. Nagging the child, he says, painting the thumb with ill-tasting medicines, guards, gloves and closed sleeves are not good. Neither are plates and bars which the child can remove from his mouth.

Dr. Mack's prescription for thumb-suckers over 3½: the nonremovable "hay rake" (see cut), cemented to the child's teeth. This, he concedes, "has the double misfortune of looking vicious and being called by [a] distasteful name." But it has the double virtue, he argues, of keeping the thumb out and the tongue back. (Many children, denied the joy of thumbsucking, seek solace in pushing the tongue against the front teeth.) The hay rake, says Dr. Mack, is always successful within a few months, and most young patients bear no grudge against the man who installs it.