Thumb Crib

Also know as a “Palatal crib” and it may come in all shapes and designs, but it is basically an appliance that sits in the roof of the mouth. The thumb is prevented from reaching the roof of the mouth and the “sucking” action becomes less effective. The Flat Crib thumb sucking appliance is used to restrain the patient from sucking their thumb. A . 040” support arch wire first is soldered to bands on the first molars similar to other appliances. Wires are placed across the palate parallel to the occlusal plane to prevent the thumb from contacting the rugae.

Thumb-sucking habits are normal reflexes from birth to three years of age. Most children naturally outgrow their thumb-sucking habit between two and four years of age. We aim to encourage halting the habit by age three. The “palatal crib” appliance usually stops thumb sucking immediately


Treatment & Care

Lets started by saying that habits place unwanted forces on the teeth and the role of the orthodontist is geared toward stopping the habit to prevent further damage to the bite. When a thumb sucking habit is present, the habit creates three force systems: Front to back, vertical and side to side. The thumb can add a force to the back of the front teeth and cause them to flare forward. A vertical force caused by the thumb creates an anterior open bite because the thumb physically prevents the teeth from coming together. Posterior crossbites are some of the most common complications resulting from a thumb sucking habit. During the sucking motion, the cheek muscles constrict almost like a girdle and prevent the upper jaw from growing wide enough to fit all the teeth.

This appliances will normally stop the habit immediately, but it will then be in place for an additional six months to confirm discontinuation of the habit. The crib is crafted and cemented behind the teeth, making it less visible. Preventing the thumb from reaching the roof of the mouth reduces gratification and breaks the habit very quickly.

This appliance should be cleaned every day with toothpaste and a soft toothbrush, morning and night. Encourage the patient to give enough time to clean thoroughly around the appliance, gums, teeth, and bands to maintain proper hygiene and prevent inflammation. 3 minutes is recommended.

  • Wire: American Orthodontic Chromium Cobalt
Attachment and Band Options:
  • AO Maximum Retention Bands
  • Leone Web Bands
  • AO .022 Slot w/Hook
  • AO Headgear and .022 Slot w/Hook
  • AO MBT w/Hook
  • AO Double Slot w/Hook