A pacifier is a common soothing tool that offers infants and young children comfort by satisfying their natural reflex to suck. While reliable for calming a child and aiding sleep, prolonged use introduces a constant force into the mouth. This raises the question of whether the habit negatively affects the alignment of developing teeth and the growth of the jaw structure.
Specific Dental Changes Caused by Pacifiers
The constant pressure a pacifier exerts on the teeth and developing jawbones can lead to specific types of misalignment known as malocclusions. This pressure acts on the upper and lower dental arches, influencing how the teeth erupt and how the jaw grows.
One of the most common issues is an anterior open bite, where the front upper and lower teeth do not meet when the mouth is closed, leaving a gap. The pacifier physically prevents the front teeth from erupting correctly or pushes them outward, causing protrusion. This misalignment can also affect the ability to close the lips comfortably and may lead to speech difficulties.
Another potential dental change is a posterior crossbite, which occurs when the upper back teeth tuck inside the lower back teeth. Prolonged sucking can alter the shape of the palate, making the roof of the mouth narrower. This narrowing of the upper jaw forces the upper teeth to align incorrectly with the lower arch.
The degree of these changes is directly related to the intensity and duration of the habit. Consistent, vigorous sucking places a significant, imbalanced force on the dental structures, and bone changes can sometimes be noticed as early as 18 months of age. These misalignments can impact chewing efficiency and may require orthodontic treatment later in life.
The Critical Timing of Pacifier Cessation
The risk of permanent dental issues is closely linked to the child’s age when the habit stops. In the earliest years, the jawbones and dental arches are highly malleable. If pacifier use is discontinued early, typically before age two, the developing jaw often possesses a remarkable ability to self-correct most alignment issues.
Pediatric dentists suggest beginning the weaning process around 18 to 24 months, aiming to stop fully before the third birthday. If the habit stops by age three, temporary changes, such as an open bite, often resolve naturally within about six months. This self-correction occurs because removing the constant pressure allows the forces from the tongue, cheeks, and lips to guide the teeth back into a more favorable position.
If pacifier use continues past age four, the likelihood of dental issues becoming permanent increases significantly. By this age, the permanent teeth are preparing to erupt, and prolonged pressure can affect their positioning. Continued use beyond this threshold often necessitates orthodontic intervention, such as braces or other appliances, to correct the resulting malocclusions.
Pacifier Use Versus Thumb Sucking
Parents often wonder if a pacifier is a better soothing mechanism than digit sucking (thumb or fingers). Both habits can lead to the same dental issues, including open bite and protruding front teeth, because they involve placing a foreign object and pressure against the developing oral structures.
Many dental professionals prefer pacifier use over thumb sucking for several reasons. A pacifier is removable, giving parents more control over the habit’s duration and frequency, making weaning easier. The force applied by a thumb can sometimes be more intense and irregular, potentially leading to more severe dental changes.
The thumb is always available to the child, making the habit more persistent and difficult to stop. Because of this, pacifier use is associated with a lower risk of long-term dental problems, provided the habit is ended by the critical age of three. The comparative ease of controlling and eliminating the pacifier makes it the less detrimental choice for oral development.