KIDS APNEA.COM   The website of Allen J.Moses, DDS




It is very important to set the record straight.  There are two distinct thumb habits.  This is also true of other finger habits – two distinct types of finger habits.  SUCKERS and PROPPERS.  There is a very important difference. 

Sucking implies suction.  Thumb or finger suckers are nose breathers.  The lips seal around the digit to suck, so the nose must work properly for the child to breathe.  Thumb or finger sucking is non nutritive and gives the child a feeling of warmth, comfort and security.  Note the lip seal and apparent suction on the photo of the child sucking his thumb.

Closed lip posture and nasal breathing is normal and healthy.  A child with nasal obstruction to his/her breathing must separate the lips and lower the tongue to be able to breathe air through their mouth.  The natural condition for a nose breathing child is to close the lips when asleep.  When a young mouth breathing child gets tired, the natural impulse is to close the lips, but they would then have difficulty breathing.  The adaptive tendency of a mouth breathing child is to hold the thumb or other fingers in their mouth to keep it open when they get tired.  The habit in mouth breathers is thumb or finger propping.  They do not suck.  The lips are not sealed.  Sucking is very difficult when the nose is not working.  Note the dry lips and open mouth on the above photo of a thumb propper. 

Mouth breathers are thumb proppers.  This is an important and fundamental difference the finger or thumb is a prop to keep the mouth open so the mouth breather can continue breathing.  The thumb sucker has a welt on the back of the thumb on the inner digit and the pad if the thumb may be creased.  The thumb proper generally has no welt but the pad with the fingerprints is chapped or creased.  The welt determines the sucker and the nose breather.

A search of the dental literature reveals that thumb suckers, if they stop before age 2, usually have no ill effects in the developing dentition.  Children who suck past the age of 4 however, have twice the risk of malocclusion in the permanent teeth than children who stop sucking before age 2.  The thumb can be a negative influence on the developing teeth if it lasts too long.

In thumb or finger proppers the digit or digits act as deleterious orthodontic device.  Thumb proppers will almost always have a malocclusion noticeable by the time the baby teeth come in and it persists into the permanent dentition unless nasal patency is achieved.  Examples of malocclusions resulting from thumb propping and mouth breathing are shown in the “Photo Gallery” section of this website.

Not treating thumb propping increases the child’s risk of later developing apnea or may be one indicator of apnea.  Propping increases the risk of malocclusion, snoring, temporomandibular disorders and headaches.  The consequences of thumb sucking are not as serious and usually reverse if the habit discontinues by age 2 or possibly 3.

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