As many caregivers know, sucking can help calm a fussy baby. Pacifiers are often used to help babies fall asleep, sooth anxiety and go through medical procedures, such as vaccination and blood tests. Pacifiers can also lower the risk for sudden infant death syndrome (SIDS) and sudden unexpected infant death (SUID). But you may have also heard that pacifiers are bad for your baby’s teeth. Here’s what you need to know.

What types of dental issues can be caused by pacifiers?

• Misaligned teeth: Excessive use of a pacifier can result in misaligned and crooked teeth. The intensity of sucking determines the severity and quickness of developing pacifier teeth, including underbite, overbite, open bite and crossbite.
• Gum recession: Using pacifiers excessively can cause gum recession, or gum loss and cavities. When gum recession occurs, “pockets” form between the teeth and gum line because a portion of the gum tissue covering the teeth is worn away or pushed back, revealing more of the tooth at the base. The gaps make it easier for disease-causing bacteria to accumulate.
• Cavities: Dipping pacifiers in sweet substances — such as sugar, honey and corn syrup – can encourage plaque buildup and lead to cavities. For kids under the age of 12, their teeth and gums are more likely to get irritated due to the high sugary contact.

Are orthodontic pacifiers better than traditional pacifiers?

The short answer is NO. A typical orthodontic design mimics a natural nipple, which is flatter and square-shaped, as well as the motion that pulls milk from the nursing parent’s breast. Although orthodontic pacifiers are often marketed as dental-friendly for children, prolonged use can cause bite issues.

Will pacifier teeth eventually correct themselves?

Whether or not pacifier teeth correct themselves depends on when pacifier use is discontinued. If your child stops sucking on a pacifier before their permanent front teeth grow in, there is a good chance their bite will correct itself. Detecting tooth misalignment and addressing it before your child turns 2 years old increases the chances of self-correction. By the age of four, permanent teeth start to grow which makes orthodontic appliances the only available solution for pacifier teeth.

A pediatric orthodontist may suggest one of the following appliances:

• Braces
• Clear aligners followed by retainers
• Tongue cribs
• Bite blocks
• Vertical pull chin cups
• High-pull headgear

How do I get my child to stop using a pacifier?

The American Dental Association (ADA) and the American Academy of Pediatric Dentistry (AAPD) both recommend that children stop using pacifiers between 2 to 3 years old. To reduce the risk of otitis media, also known as middle ear infection, the American Academy of Family Physicians(AAFP) and American Academy of Pediatrics(AAP) joint guidelines recommend reducing or stopping pacifier use in the second six months of life.

Here are some suggestions for weaning your child off their pacifier:

• Make sure your child feels secure and comforted so they do not resort to old habits.
• Distract your child with a favorite toy or activity when they ask for the pacifier to redirect their attention and ease their desire for the pacifier.
• Offer your child positive reinforcement when they are not with the pacifier for a period of time, such as a small toy.
• Ask your pediatric dentist to speak with your child about stopping. A child is more likely to comply with the advice or instructions given by a health professional.

Using a pacifier is not inherently harmful if you practice proper hygiene and are aware of when to wean your little one off them! It is also important to regularly monitor your child’s dental development and discuss any concerns with their pediatrician or dentist.

And remember: the AAP and AAPD recommend that patients should establish a dental home by age one!