A simple elastic bandage wrapped around the elbow can gently help children to avoid thumb-sucking at night. To avoid damage to the teeth, children should stop sucking their thumbs (or fingers) sometime between the fourth birthday and the appearance of the lower permanent teeth.

Parents can help youngsters who want to stop thumb-sucking by giving them small rewards, such as gummed stars, and using an inexpensive elastic bandage, such as an Ace bandage, as a reminder. The program involves nightly use of an elastic bandage wrapped across the elbow. Pressure exerted by the bandage removes the digit (thumb) from the mouth as the child tires and falls asleep. For the program to succeed, a child has to want to quit, and should not have experienced a recent trauma, such as a parental divorce, death of a pet, or starting a new school.

The child should be given most of the responsibility for quitting. After the first few nights, the youngster should be responsible for bringing the bandage to the parents at bedtime. The bandage is then wrapped snugly but not tightly from mid-upper arm to mid-forearm on the arm the child prefers for sucking. The bandage does not cover the hand or interfere with blood flow in any way. Therefore, it is only slightly more difficult for the child to suck their thumb and the thumb tends to drop out of their mouth as they sleep. Parents should also provide a calendar for tracking the child's success as well as lots of positive reinforcement. The success rate for this method is about 60%, less than other methods that use appliances to prohibit thumb-sucking. However, children tend to like the program because they can control their own behavior and avoid the uncomfortable appliances.

Pediatric Dentistry November/December 1999;21:451-454.