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Dr. Nick - Lone Tree Pediatric Dentistry - Pacifiers: What’s the Harm in Them?


By Lone Tree Pediatric Dentistry - September 12, 2019

My wife and I have three young children.  One was born while I was buried in literature to read and memorize during my pediatric dentistry residency; the other two were born soon after we moved across the country, became small business owners and lost virtually all of our free time (the life of parents, am I right?!).  Our eldest refused the pacifier but our two younger ones loved their binkies and we loved the peace and quiet that the pacifiers provided.  This begs the question when can too much of a good thing (pacifier use and its associated peace and quiet) create a bad thing (unfavorable changes to the way their teeth fit together)?

Nonnutritive sucking behaviors is a blanket term that refers to any oral habits not associated with eating or drinking.  Two very common nonnutritive sucking behaviors in infants are pacifier use and thumb-sucking.  These behaviors are typical and not worrisome in most children.  In fact, they are helpful in developing and strengthening the muscles that surround and involve the mouth.  These behaviors can become problematic; however, when a child engages in them for an extended period of time because of the forces that they exert on the teeth and jaw structures.

Prolonged nonnutritive sucking behaviors may unfavorably affect the way children’s upper and lower teeth fit together; the dental term for this is malocclusion.  Factors that ultimately determine the type and severity of malocclusion that may develop are the magnitude, duration and frequency of the behavior.  Generally speaking, the duration of the habit is the most predominant predictor of whether a malocclusion will develop; therefore, earlier cessation of these behaviors decrease the chance that it will affect the way your child’s teeth fit together.  In my practice, we recommend that parents help their kids eliminate these behaviors by the age of 3 years.  Continuing these behaviors beyond the age of 3 years will increase the odds that changes to their teeth or jaws may become permanent. 

If you are concerned any of these behaviors with your child, I recommend you have a consultation with a pediatric dentist to discuss the implications of their specific behavior and to discuss ways to prevent them from continuing.  We have found success with a variety of different ways to discourage these behaviors.  Most importantly, employing positive reinforcement by simply talking with your child and telling him or her that big boys/girls don’t do these sorts of things and that continuing to do it can hurt their teeth.  To discourage thumb sucking, some ideas are wrapping tape or a band aid around your child’s thumb.  Another idea is to paint a nail polish that doesn’t taste great on the nails that your child sucks (one such brand of this is Mavala).  To discourage pacifier sucking, we recommend gradually cutting the pacifier back such that one day it becomes a nub that your child can no longer suck on or keep in his/her mouth.  Alternatively, some parents have found success with cutting the pacifier in half and having their child find it “broken” (it’s important psychologically to use this word) and having him or her throw it away.  Finally, if your child seems to have any sort of physical dependence to the pacifier, parents have also reported success with building it into a stuffed animal.  This way your child will still be able to feel it but not place it in his or her mouth.  Ultimately, the method of quitting the behavior is child-dependent and the parents should decide which avenue will likely be the most successful for their child. 

Aside from the effect on your child’s jaw and teeth development, other implications of pacifier use has long been mired in controversy.  There have been studies performed that have concluded that early pacifier use leads to an infant having less ambition to breastfeed.  Other studies have claimed that pacifier use is associated with an increased development of a type of ear infection known as otitis media.  Another area of research has indicated that pacifier use decreases a child’s risk of developing SIDS.  As you can see, the implications of pacifier use extend beyond the development of your child’s teeth and jaws.  My personal opinion with regard to these studies is that although there may be an association between pacifier use and the above mentioned conditions, no direct cause cause-and-effect relationship can be established at this time.  I’m sure that we will all hear about more research being conducted on these topics with time. 

The following link provides more information with what was discussed above:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2791559/