Pacifiers: the basics

As pediatric dentists, we follow certain guidelines for when we recommend our patients to discontinue usage of the pacifier. It’s okay to introduce a pacifier to your baby if they have a sucking need. However, the persistent sucking motion can apply unfavorable forces to the teeth and jaws, causing abnormal development.

As the mom of a baby who absolutely loves her pacifiers, I can understand the potential impact this could have on a child and family if taken away.

NOTE: Many of the concepts of pacifier usage + pacifier weaning can also be applied to ANY oral habit: thumb, finger, fabric/toys, etc.

What should I know about pacifiers and dental health?

Not every child who uses a pacifier will have bad teeth. 

Pacifiers have so many pros:

  1. They provide extra comfort and reassurance for newborns and satisfies a baby’s need for non-nutritive sucking
  2. They prevent Sudden Infant Death Syndrome (SIDS) early on
  3. Dentists actually PREFER them over sleeping with a bottle or a thumb sucking habit. Bottle can increase the risk for cavities, and thumb sucking can be a more difficult habit to discontinue.

However, frequent pacifier use over a longer period of time can affect the way a child’s teeth bite together and the growth of the jaws.

  1. Negative effects on the teeth include:
    • anterior open bite
    • posterior crossbite
    • misalignment of the teeth
    • protruding front teeth
  2. Negative effects on the jaws  include:
    • restriction of proper growth of the jaws, potentially leading to a narrow upper jaw
    • improper development of correct swallowing pattern and tongue positioning

are orthodontic pacifiers better for the teeth?

Traditional pacifiers have a rounded top and stem, and are most similar to a nipple. Orthodontic pacifiers have a rounded top and flat bottom, and are marketed to be better for teeth. However, both pacifiers shapes are correlated with bite problems as the child gets older.

how can i safely use pacifiers?

  1. Do not rely on a pacifier just for convenience
    • Do not use pacifiers to replace of delay meals
    • Do not force the pacifier into your child’s mouth
  2. Avoid choking and strangulation risk
    • Two-piece models can come part and become a choking risk
    • Never tie a pacifier to your child’s crib, or around their neck unsupervised
  3. Clean properly to avoid spreading germs
    • Sterilize before each use (when your child is under 6 months), and clean with hot, soapy water (when your child is older than 6 months)
    • Replace the pacifier every 2 months
  4. Avoid cavities with healthy teeth habits 
    • Do not use your mouth to clean the pacifier, especially if you have cavities. Bacteria from your mouth can be transferred to your child’s mouth.
    • Do not dip the pacifier in sugar or honey

When is a good time to start pacifier weaning?

The AAP recommends to start weaning at 6 months, and the AAPD recommends to wean by 3 years.

What does this mean for me and my child?

▫️You can use a pacifier when your baby is young without worrying about changes in dentition. Pick a pacifier with a shape or texture that fits you and your baby’s needs.

▫️Start weaning early by limiting DURATION of pacifier use. Even if you begin by limiting the amount of time the baby spends with the pacifier, this can minimize the risk of future dental complications, and make the transition smoother later on.

▫️Be proactive and work together with your dentist to thoughtfully incorporate a plan for weaning that works for your child & family structure.

Did your child take a pacifier?

Did it come naturally? Let me know in the comments!

1 thought on “Pacifiers: the basics”

  1. I am so happy that I came across this amazing article that you have shared with us as one of my friends recently got a baby and I am sure these tips will surely help them. Thank you for the amazing information.

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