Thumb Sucking and Pacifiers: When is it Time to Break the Habit?  

A lot of parents ask us about thumb sucking and pacifier use in babies. Thumb sucking and finger sucking come naturally to all babies. Most parents will transition their little one to a pacifier at some point. If parents rely on pacifiers or let thumb sucking go on too long, it can increase the risk of orofacial problems. Here’s what some of the latest research says.

Benefits of Pacifier Use

Sucking behaviors in infants are a natural part of their development. Sucking on fingers, thumbs, or available objects like a pacifier mimics the act of feeding, so it’s very comforting to them. Many parents will tell you that the use of a pacifier is great because it often calms a baby down when they’re crying. Using a pacifier is an effective way to stop a baby from compulsive finger- or thumb-sucking. The American Academy of Pediatrics (AAP) recommends using a pacifier when putting babies down to sleep because it can reduce the risk of Sudden Infant Death Syndrome (SIDS). However, don’t try to force the pacifier on a baby if they are resistant to it.

Risks of Pacifier Use

There are some very specific risks associated with pacifier use. Some of those risks, especially as they pertain to dentistry, are increased if a child continues pacifier use past the age of 36 months.

One common problem with pacifier use is that it can lead to a middle ear infection. The AAP notes that reducing the use of a pacifier between the ages of 6 and 12 months can significantly reduce the risk of ear infections. A pacifier can be used again after a baby is past 12 months of age because the risk of ear infections goes down. However, many parents opt to simply stop using a pacifier altogether at that age.

It is strongly recommended that parents not use honey as an enticement to get a baby to use a pacifier. Honey contains spores from Clostridium botulinum, which can cause serious health complications in babies less than a year old. It’s also recommended that parents boil or disinfect a pacifier regularly. A pacifier is a breeding ground for germs that can lead to an oral yeast infection.

Finally, there are risks to your child’s orofacial development if a pacifier is used too long or too aggressively. Kids that use a pacifier beyond 12 months of age have been shown to have an increased risk of developing an anterior open bite. An anterior open bite will often resolve on its own, so long as pacifier use and thumb sucking have ended by age 3.

A more serious risk is the development of a crossbite from extensive pacifier use. This type of malocclusion will usually require orthodontic treatment such as a palatal expander and/or braces to correct it later in childhood. The best way to prevent the development of a crossbite is to greatly reduce or eliminate the use of a pacifier once a baby reaches 18 months of age, or around the time when their canine baby teeth start to erupt.

Most children will stop thumb-sucking and using a pacifier on their own between two and four years of age. However, ending the habit around 18 months of age is the best way to reduce most of the risk.

Ponte Vedra Pediatric Dentistry and Orthodontics

Have a question about teething, thumb sucking or pacifier use? Contact us today to schedule an appointment.