Pacifier Teeth: Causes, Effects, Damage, And Treatment - Healthline

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Parenthood

What You Need to Know About Pacifiers and Dental Problems

Medically reviewed by Karen Gill, M.D. — Written by Dorian Smith-Garcia on April 30, 2021

Uses
Dental issues
Prevention
Age to wean
Treatment
Vs. thumb sucking
Takeaway

Toddler with pacifier in mouth — Westend61/Offset Images

Many parents feel that pacis, binkies, dummies — or whatever your preferred word for pacifiers happens to be — are something of a lifesaver. Along with helping babies self-soothe, they can also act as the perfect solution for little ones who simply love to suck on anything they can.

But some children experience dental problems as a result of constant pacifier use over a long period of time. Understanding how these comfort objects may cause oral problems can help parents avoid encouraging “pacifier teeth” in their children.

What makes pacifiers (and thumbs!) great

While pacifiers and thumb-sucking sometimes get a bad reputation because of the risk of dental issues, they’re not without benefit. Experts agree that pacifiers — and even thumbs — serve four major uses.

1. Encouraging self-soothing in babies

Pacifiers are ideal as a form of self-soothing for babies. This can be especially helpful when you’re exhausted and need a mini-break from holding your child.

Often, a pacifier can help relax a baby so you can attend to other things — like grabbing a quick meal or even just having a moment to sit and breathe.

2. Aiding in weaning

If you’re ready to wean your nursing little one, pacifiers can serve as a good segue that may make the process easier for babies to handle.

However, keep in mind that it’s best to wait until you’ve fully established a nursing routine before introducing a pacifier to a newborn baby. Note that this usually takes 3 to 4 weeks to set in.

3. Reducing the risk of SIDS

Probably one of the biggest health benefits of pacifiers is their link to a significant reduction in the risk of sudden infant death syndrome (SIDS).

Experts, including the American Academy of Pediatrics (AAP), encourage parents of infants to put babies to bed or a nap with a pacifier. (However, pacifiers shouldn’t be attached to your baby’s clothing or stuffed animals or straps, which could encourage suffocation or accidental strangling.)

4. Easing discomfort in nursing preemies

Along the same lines as self-soothing, pacifiers can help to reduce discomfort in nursing infants.

An intensive 2012 Turkish study conducted in neonatal intensive care units (NICUs) between 2007 and 2009 showed that premature babies who were given pacifiers were able to progress faster from tube feeding to nursing. They were ultimately released from the NICUs faster than preemies in the control group who weren’t given pacifiers.

However, preemies in NICUs aren’t the same as healthy babies who are home. Avoid giving pacifiers to babies who aren’t already nursing or feeding well, unless advised to do so by your lactation consultant or your baby’s pediatrician.

What types of dental issues pacifiers can cause

For all of their benefits, pacifiers do come with potential drawbacks by way of dental issues. But in most cases, when oral issues arise, it’s because a child has been using a pacifier for too long.

Misaligned bites

One of the most well-known risks from pacifier overuse is a misaligned bite. This can include a crossbite, an open bite, or other types of malocclusions.

In particular, these dental issues are more commonly seen when older children are still using pacifiers. Prolonged pacifier use may force a child’s teeth to move and can even change the shape of the roof of their mouth to accommodate the constant presence of a foreign object.

For example, an older 2001 study found that malocclusion was present in nearly 71 percent of the participating children who continued to use a pacifier or suck their thumbs past 4 years of age.

In contrast, only 36 percent of children that stopped thumb-sucking or pacifier use between ages 3 and 4 had signs of malocclusion. And just 14 percent of children who stopped thumb-sucking or using pacifiers by 24 months exhibited the condition.

Gingival recession and cavities

In some extreme cases, pacifier use has been linked to gingival recession, or gum loss, and pediatric cavities.

However, these oral conditions are also a consequence of parents dipping pacifiers in sweet substances. While children might love the tasty treat — who wouldn’t? — this exposes their teeth and gums to sugar, which can encourage plaque buildup and cause cavities to form.

Using pacifiers in a way that doesn’t cause pacifier teeth

There’s no reason to be afraid of using pacifiers, as long as you practice proper hygiene and are mindful of when it’s time to wean your little one off of them.

Sharing isn’t caring

Don’t share pacifiers between children. Besides being somewhat gross, sharing pacifiers can expose children to bacteria, which can also encourage cavities or general infections to occur.

Just the pacifier

Even if you’re extremely tempted to dip your baby’s pacifier in something sweet to encourage pacifier adoption, don’t. Leaving gums or that first set of pearly whites exposed to all that sugar can eventually cause cavities to develop.

Get the right size

If you’re new to the baby care world, you might be surprised to find that pacifiers have come a long way since you may have used one: They now come in sizes. Typically, they’re listed with recommended age ranges.

Finding the right size means you’re not using a pacifier too large for them. Likewise, if the pacifier shield is too small and your baby can get the entire pacifier into their mouth, this could be a choking risk.

Consider orthodontic pacifiers

If you’re concerned about a pacifier causing a misaligned bite, you can opt for orthodontic pacifiers. These pacifiers don’t have the classic round nipple shape. They’re flatter so that your baby’s jaws are in proper alignment when they’re sucking.

Still, despite claims, there aren’t any studies showing that orthodontic pacifiers decrease the risk of dental issues. If you’re interested in an orthodontic pacifier, speak with a pediatric dentist, as many do endorse them. But to avoid dental problems, be sure to wean your child off any pacifier at an appropriate age.

Age to take pacifier away

As early as about 24 months of age, continued use of a pacifier may encourage oral issues. However, there’s no one right answer for every family or child.

For example, some physicians may recommend reducing pacifier use between the ages of 6 and 12 months due to increased risk of contracting otitis media, or ear infections.

This was also supported by the AAP and the American Academy of Family Physicians, as of 2009.

The AAP has stated more recently that pacifier use beyond 2 years old may cause issues with baby teeth, but that these issues are often reversible if your kiddo stops the sucking behavior before their adult teeth come in.

The American Academy of Pediatric Dentistry, on the other hand, advises stopping pacifier use after the age of 3 years.

What everyone can agree on: By 4 years of age, children shouldn’t still be using a pacifier of any kind, as the risk of dental issues is even higher.

Treatment for pacifier teeth

Pacifier teeth — or rather, the dental issues they can cause — is a cause for concern for many parents. The most common question is, “Does it fix itself?”

The answer depends. There isn’t complete consensus within the pediatric dental community.

However, many experts say that when a child is weaned off of a pacifier will directly affect how permanent the dental issues may be. For example, issues detected before 24 months of age can often correct themselves within 6 months from when a child is weaned. In that case, no dental interventions may be necessary.

On the other hand, for children older than 24 months who exhibit pacifier teeth, there’s a risk that orthodontic appliances may be the only way to correct any dental problems that arise. This is especially true for children who are 4 years and older, as around this time is when adult teeth begin to form under their baby teeth.

Is thumb-sucking better or worse?

In terms of dental issues, vigorous thumb-sucking can be equally problematic for a child’s teeth or bite as using a pacifier.

And children that continue to suck their thumbs beyond 4 years old may have many of the same dental issues as those who use pacifiers.

The takeaway

While you shouldn’t let your child continue to use a pacifier well into toddlerhood, there’s no reason to toss all of their binkies just yet. In infancy, the benefits that pacifiers provide make them one of many effective parenting tools.

However, you’ll want to consider weaning pacifier use after 24 months of age — but definitely by 48 months — to lessen the risk of dental issues that may require orthodontics to correct.

Parenthood
Toddler

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Doğramacı EJ, et al. (2016). Establishing the association between nonnutritive sucking behavior and malocclusions: A systematic review and meta-analysis. https://pubmed.ncbi.nlm.nih.gov/27692622/
Frequently asked questions (FAQ). (n.d.). https://www.aapd.org/resources/parent/faq/
Harmes KM, et al. (2013). Otitis media: Diagnosis and treatment. https://www.aafp.org/afp/2013/1001/p435.html
Ling HTB, et al. (2018). The association between nutritive, non-nutritive sucking habits and primary dental occlusion. https://pubmed.ncbi.nlm.nih.gov/30134878/
Pacifiers and thumb sucking. (2020). https://www.healthychildren.org/English/ages-stages/baby/crying-colic/Pages/Pacifiers-and-Thumb-Sucking.aspx
Reduce the risk of SIDS & suffocation. (2017). https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/Preventing-SIDS.aspx
Sexton S, et al. (2009). Risks and benefits of pacifiers. https://www.aafp.org/afp/2009/0415/p681.html
Warren JJ, et al. (2001). Effects of oral habits' duration on dental characteristics in the primary dentition. https://pubmed.ncbi.nlm.nih.gov/11780987/
Yildiz A, et al. (2012). The effects of giving pacifiers to premature infants and making them listen to lullabies on their transition period for total oral feeding and sucking success.https://pubmed.ncbi.nlm.nih.gov/21668549/

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Medically reviewed by Karen Gill, M.D. — Written by Dorian Smith-Garcia on April 30, 2021

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