Can pacifiers harm my child's teeth?


Pacifiers and teeth

Paci, soothie, binky, boppy, nigh nigh – whatever you call them, pacifiers can be a GREAT way to soothe and comfort your child. They have also been shown to reduce the risk of sudden infant death syndrome (SIDS). While a pacifier is okay during infancy, eventually your child may need help breaking the habit.


What is the big deal?

Beyond a certain age, pacifiers can have poor effects on the way a child’s permanent teeth grow in and fit together, as well as how their jaws develop. Children who have a habit of sucking on ANY object (fingers, pacifier, blankets) past a certain age have a higher risk of developing problems such as protruding teeth, overjet, open bite, narrow palate, and crossbite. These malocclusions can affect speech, chewing, appearance, and typically require orthodontics to correct. In severe cases they may require appliances or even surgery.


When should we stop using a pacifier?

Some medical groups (such as AAFP, AAP) advocate discontinuing use of the pacifier before age 1, mostly related to reducing the risk of ear infections. From a dental perspective, it is recommended that pacifier use be reduced (if not stopped) by age 2, but the most important age to stop is before age 4. If the pacifier is stopped by age 2, we often see side effects from the habit reverse and self correct. The most significant dental problems occur in those who use pacifiers beyond age 4, which is why the American Dental Association (ADA) and American Academy of Pediatric Dentistry (AAPD) recommend totally discontinuing pacifier use by this age. In general, the earlier the pacifier is taken away, the better for the developing jaws and erupting teeth.


Tips for breaking the habit

Here are some principles to keep in mind as you go through the process:

  1. The earlier the better -- the longer a pacifier habit continues, the more reliant and emotionally attached a child can become, making it harder to stop.

  2. Help prepare your child -- plant the seed in your child's mind that the day is coming. Talk or read books about it. Check out:

  3. “Bea Gives Up Her Pacifier" or "Ben Gives Up His Pacifier"

  4. "Bye-Bye Binky: Big Kid Power"

  5. "Pacifiers are not forever"

  6. "No more pacifier, Duck"

  7. Praise -- be positive, provide words of encouragement and praise. Your child may have an easier time separating from their old friend if they get something in exchange, like a big kid toy that you shop for together.

  8. Distract -- some children use pacifiers out of boredom. Try giving your child something to do to distract them such as playing with a game or toy.

  9. Alternatives -- encourage your child to use other loveys like a blankie or stuffed animal for comfort.

  10. Don't go back -- once you've established a rule or taken it away, try not to give in when they ask for their pacifier.


How did Dr. Godley wean her babies off of the pacifier?

What works for one family or child may not work for another. For both of her children, Dr. Godley had luck using the same tactics. "When our girls were around 18 months, we began limiting use of the pacifier to sleep only (naps and nighttime) and established a rule that the paci does not leave the crib. After about a month, we opted for the "broken binky" method, and snipped the tips of all of the pacifiers. I remember the girls having a rough first nap, but after a few days they became uninterested in them and were back to a normal sleep routine. It helped to offer stuffed animals or blankets for comfort."


If you aren't ready to drop the pacifier cold turkey, Dr. Godley recommends simply trying to limit its use, whether it is through "pacifier-free" times during the day, or by using it just for sleep.


Here are some other strategies to consider when you're ready to drop the pacifier:

  • Repackage -- Consider placing it inside of a build-a-bear or other stuffed animal that the child can be involved in making.

  • Binky fairy -- If your child is old enough to understand the concept of a mythical creature coming to take their binkies in exchange for a toy or prize, this may be a great method to motivate them to give up their pacifiers. If the timing is right, Santa or the Easter Bunny could also help take pacifiers in exchange for a gift.

  • Pass the torch -- Consider arranging for your child to drop off their pacifiers at our office or a fire station to give to new babies in need. Or sending them to Santa’s workshop to make it into a new playground for little kids!

  • Cold turkey -- If you decide to drop it all together, we recommend putting aside a few days when you know your sleep may be compromised as your child adapts to sleeping without their pacifier. Most parents say that after about 3 days, their child no longer asks for their paci.

  • "Dr. Godley says so" -- Some children love to follow rules, and many of our patients give up their pacifiers after hearing Dr. Godley tell them it’s time to be a big kid... or maybe it’s because she also promises them a surprise at their next visit if they stop the habit!


If you have any questions or concerns regarding your child’s pacifier habit, never hesitate to ask your child's pediatrician, pediatric dentist, or Dr. Godley. We are here to help!