The use of a pacifier is a common and often effective way to comfort and soothe infants, leveraging the natural human sucking reflex. However, when this non-nutritive sucking habit extends beyond the early years, it can exert forces that alter the development of a child’s teeth and jaws. This phenomenon, colloquially known as “pacifier teeth,” is a legitimate concern for parents. This article explores the specific dental changes caused by prolonged pacifier use and details the range of options, including orthodontic treatment, available to correct these alignment issues.
Understanding Pacifier-Induced Dental Changes
The term “pacifier teeth” refers to specific types of dental misalignment, or malocclusion, that result from the constant presence and pressure of the object in the mouth. The most recognizable consequence is an anterior open bite, where the upper and lower front teeth fail to overlap or even touch when the back teeth are closed. This gap occurs because the pacifier physically obstructs the normal vertical eruption path of the incisors.
Beyond the front teeth, the continuous pressure on the roof of the mouth can interfere with the natural, lateral growth of the upper jaw, leading to a narrower dental arch. This narrowing often results in a posterior crossbite, where the upper back teeth bite inside the lower back teeth. A narrow upper arch can also contribute to a flaring or protrusion of the upper front teeth, a condition sometimes described as an overjet.
The mechanism is driven by the intensity and duration of the habit. The tongue, cheeks, and lips all apply forces that influence bone and tooth position. In a developing jaw, the constant foreign object disrupts the equilibrium of these muscular forces, pushing teeth out of alignment. These dental and skeletal changes become more pronounced the longer the habit persists, impacting not only aesthetics but also functions like speech and chewing.
The Importance of Timing in Habit Cessation
The critical factor in determining the permanence of pacifier-induced changes is the age at which the habit is completely stopped. For many children, dental changes are temporary and can self-correct, provided the habit is discontinued early enough. Scientific evidence suggests that ceasing pacifier use before the age of two to three years old significantly increases the likelihood of a natural realignment.
This self-correction is possible because the primary teeth and the surrounding alveolar bone structure still possess flexibility and adaptability. Once the disruptive force of the pacifier is removed, the natural forces from the tongue during swallowing and the lips during rest can guide the teeth back into a more favorable position. The growth of the jaw itself also contributes to this process.
If the habit continues past four or five years of age, particularly when the permanent front teeth begin to erupt, the risk of irreversible skeletal and dental damage increases. By this time, the constant pressure may have caused more rigid changes to the underlying bone structure, making complete self-correction unlikely. When the malocclusion persists into the mixed dentition phase, professional orthodontic intervention is necessary to prevent the issues from becoming fixed in the adult dentition.
Orthodontic Interventions for Correcting Alignment
The answer to whether braces can fix pacifier teeth is yes, but the treatment approach depends on the patient’s age and the severity of the damage. Orthodontics offers tools to correct the dental and skeletal issues resulting from prolonged non-nutritive sucking. For younger children, treatment often focuses on interceptive orthodontics, aiming to guide jaw growth and eliminate the habit’s effects before all permanent teeth are in place.
Specific appliances are often used in a first phase of treatment to address skeletal issues, such as the narrow upper jaw. A palatal expander, for instance, is a fixed appliance designed to gently widen the upper arch, correcting a posterior crossbite and creating space for proper tooth alignment. This appliance corrects the structural foundation of the bite.
If the habit has created an anterior open bite or flared front teeth, a simple fixed or removable habit-breaking appliance may be installed to block the pacifier or thumb from resting against the teeth. This intervention, combined with the cessation of the habit, allows the front teeth to naturally erupt and close the gap over time. This approach capitalizes on the child’s ongoing growth and development.
For older patients whose malocclusion is more fixed or involves the permanent teeth, traditional braces or clear aligners become the primary method of correction. Braces use brackets and wires to apply continuous, controlled force to retract the flared upper incisors and close any remaining open bite. Clear aligners can also effectively manage the necessary tooth movements for closing gaps and correcting the overall alignment. The success of any orthodontic treatment relies fundamentally on the complete and permanent cessation of the pacifier habit before or at the start of the intervention.