Pacifier Teeth: What It Is, Prevention & How To Deal With It

The pacifier has many nicknames and soothes millions of babies throughout the world. Tete, Bobo, Paci, Dummy, Binky … They’re all names for the same thing. Parents rank these little silicone bulbs as top priority in their day to day lives – right up there with diapers and wipes.

But, there comes a point in your little one’s life where the risks of pacifier use outweigh the benefits. (Here is an article from “Pediatric Child Health” that discusses a variety of pros/cons of pacifier use, including the effects on dentition).

You don’t want a dummy getting in the way of your little one grinning from ear to ear.

This article is a guide on when and how pacifiers can negatively affect baby’s oral health, as well as recommendations on what you can do to prevent your child from developing pacifier teeth.

What Are Pacifier Teeth?

In most cases, you’ll know if a child has Pacifier Teeth just by looking at them. Pacifier teeth usually have the following characteristics:

  • Crooked
  • The front teeth don’t come together – called an anterior open bite
  • Protruding 2 front teeth – or a severe overbite
  • Negative changes to the roof of the toddler’s mouth
  • Tilt in the bottom teeth and cause the top teeth to slant upward

Don’t make the mistake of thinking that “pacifier teeth” don’t matter just because they’re baby teeth.

Yes, these teeth do eventually fall out, but if pacifier use goes too far, baby stands the chance of incurring damage to the jaw, bite, palate, tongue placement and gums permanently.

Note from Dr. Leah Alexander, M.D., F.A.A.P.: “In clinical practice, I also see this same teeth issue from prolonged bottle use.

In some cultures (Latino, Indian), it is common for parents or extended relatives to encourage drinking milk from a bottle until the age of 6!

For the same reasons that pacifiers should be discontinued no later than the age of 2, so should infant bottles.

The Mayo Clinic recommends that pacifiers be discontinued between the ages of 2 to 4 years old, although this is a bit late in my opinion.”

How Can You Minimize Your Baby’s Risk of Developing Pacifier Teeth?

Moms around the world love to exhibit their rights to their unique parenting decisions, especially when it comes to the pacifier. It’s a culture.

So, if you’re the momma or papa bear that believes in letting your little one use their pacifier past the cultural norm, huddle around – It’s a good idea to switch to an orthodontic pacifier ASAP.

Switch To An Orthodontic Pacifier

Orthodontic pacifiers are specifically designed to minimize the negative impact their non-orthopedic counterparts usually have on a baby’s developing teeth and mouth. So, what sets orthodontic pacifiers apart from the rest?

  • The design doesn’t interfere with a baby’s growing jaw and palate.
  • Reduced pressure on baby’s gums during the sucking motion.
  • Mimic natural suckling by flattening when baby sucks on it.

So, before you jump the gun on weaning your little one off the binky, switch to a pacifier that prioritizes their dental health.

Note from Dr. Leah Alexander, M.D., F.A.A.P.: “Regarding whether or not dentists or orthodontists actually recommend Orthodontic Pacifiers: There is a conflict of opinion.

The main issue is how long an infant or toddler is allowed to use the pacifier, regardless of the type.

Here’s what Pediatric Dental Group of NY says about this.

A literature review from “Prognostic Orthodontics” did find some benefit of orthodontic pacifiers in preventing anterior bite problems, but not for posterior cross bite.

Since opinion on these types of pacifiers is conflicting and further research needs to be done, it would be best for parents to consult a pediatric dentist regarding the use of an orthodontic pacifier.”

Sleep Time Rule

Yes, I know that all rules are meant to be broken in a baby’s world and it’s totally fine if you want to give your little one the right to the pacifier.

But, at some point, you may want to consider the “sleep time rule.”

Pediatric dentists agree that the pacifier should only be used at bedtime – or naptime. The “sleep time rule” is really the best of both worlds.

Why exactly? Doing this allows your baby the freedom to their pacifier at the time they need to self-soothe most, but will simultaneously minimize the negative impact on their oral health.

It’s the best of both worlds, no matter when you choose to take the pacifier away.

Note from Dr. Leah Alexander, M.D., F.A.A.P.: “Reserving pacifier use for bed or nap time is that it prevents delayed speech.

I have seen quite a few toddlers whose parents complain “they aren’t talking,” but have a pacifier in their mouth most of the day.

Once the pacifier is reserved for sleep times, the toddler has more opportunity to talk.”

When Should Baby Ditch the Pacifier?

Pacifiers help prevent SIDS, among aiding in the development of the sucking reflex. But, when baby says ta-da to infancy (developmentally speaking), the binky offers no more benefits.

Ditching the dummy is an inevitable milestone in your little one’s life, and one that you’ll have to help them with.

Here are the top two expert opinions on when baby should ditch the dummy to prevent pacifier teeth (as well as other potential problems).

The Six Month Mark

By the time baby is six months old, they probably spend most of their time awake cooing.

When your baby starts cooing, it’s an indicator that they have control over their tongue and that their sucking reflex is developed. Technically, once this reflex is developed, the pacifier’s purpose is fulfilled.

From this point forward, your baby will become emotionally connected to their binky. The longer they build that connection, the harder it will be to wean them off.

Second Birthday

If the six-month mark has come and gone, then don’t panic just yet, it’s not too late if you manage to do it by baby’s second birthday.

They should say their final goodbyes to the binky by the time they blow out their 2nd birthday candles – no ifs, ands or buts.

Pacifier use after baby’s second birthday is considered excessive.

When Do Signs of Pacifier Teeth Usually Appear?

There are developmental risks of pacifier use past the age of three, such as speech and language problems. Excessive and chronic pacifier use can tardy baby’s teeth from falling out as well.

Also, toddlers who use pacifiers past the age of two sometimes convert to thumb suckers once they no longer have access to their binkies. And if you thought weaning your baby off pacifier use was difficult, you haven’t seen anything yet … Try getting them to stop thumb-sucking without losing your sanity!

Note from Dr. Leah Alexander, M.D., F.A.A.P.: “I have seen the developmental risks discussed here and malocclusion as young as 20 months old.

Recommended developmental speech milestones for 18 months is 6 words, but 50 words plus some phrases by 2 years old.

I have also examined 15-18 month olds whose top and bottom teeth no longer come together (the “slight open bite” mentioned here), even though there is minimal teeth protrusion.”

Excessive Pacifier Use – Past Age 2

If a toddler is still using a pacifier between two and four years old, it’s considered excessive.

During this period, toddlers may begin to show signs of pacifier teeth, but luckily these symptoms may be able to correct themselves once the pacifier is taken away. The longer it takes you to help them cut out this habit, the slimmer their chances, though.

Earlier signs of pacifier teeth include:

  1. Teeth are becoming excessively crooked
  2. Top teeth are pushing forward
  3. Slight open bite

Chronic Pacifier Use – Past Age 4

If a child is still using a pacifier between four and five years old, their use is considered chronic.

By this point, early and later signs of pacifier teeth will present themselves clearly, some of which will be permanent – even after the pacifier is taken away.

More severe cases of pacifier teeth usually require dental intervention.

If your little one already has surefire signs of pacifier teeth (especially a cross-bite), they’ll at least need an expander.

The Cost of Pacifier Teeth

Seek medical advice from a dentist, sooner rather than later, and take the binky away before that $5.00 pacifier costs you a pretty penny.

Corrective measures for pacifier teeth can cost a pretty penny, sometimes exceeding $10,000.00. And that’s not including the cost of a speech therapist if the situation is left untreated for long enough, mind you.

When it comes to pacifier teeth, prevention is by far the best option.

If you haven’t found success in breaking the dummy habit after trying countless methods and implementing all the tips you could read up on, ask your dentist for help.

Most dentists are more than willing to help in breaking such a costly habit, and pediatric dentists are especially good at this.

More Likely to Avoid the Dentist as Adults

If your little one develops pacifier teeth, they’ll more than likely make frequent visits to the dentist, and experience intervention that may hurt or feel uncomfortable.

It puts them at a higher risk of developing dental phobia – a.k.a fear of the dentist.

This phobia may cause them to avoid or skip dental visits as an adult, which obviously isn’t good. Adults who skip dental visits have poorer overall health and are less happy than adults who prioritize their oral health.

Remember, Your Little One’s Smile Is An Investment In Their Future

One of the greatest investments you can make in your little one is their smile.

A confident smile can positively affect every aspect of their life as an adult, from their future career to personal relationships. Some of the positive ways that a smile will make your little one’s life richer is by increasing:

  • Overall happiness
  • Attraction
  • Emotional health

A smile can have a serious impact on your self-confidence – be it in a good way or bad way. Adults who like their smiles and smile often are more likely to be successful, confident and approachable. People are also more likely to trust them and be attracted to them.

The Recap On Pacifier Teeth

6 to 9 months: Considered the best time to take binky away from baby, because they have no emotional connection with it yet.

9 months to 2 years old: Although baby has an emotional connection with their pacifier at this point, it’s not too late to prevent any damage to their dental health.

2 to 4 years old: At this point, baby’s continued pacifier use is considered excessive. Baby may begin showing early signs of pacifier teeth. Signs and symptoms at this point usually correct themselves if they discontinue pacifier use as soon as possible. The earlier they discontinue use, the better chances they have.

4 to 6 years old: Baby’s pacifier use is considered chronic and is almost definitely damaging their oral health at this point. It’s likely they show several symptoms of pacifier teeth, some of which will almost certainly require corrective measures.

There’s also a high risk of your child developing language or speech impediments if pacifier use continues – or signs of language/speech issues may already be present.

The bottom line is that the pacifiers have their perks but also have a dark side if abused. You know what they say about “too much of a good thing”.

Remember, it’s best to take the binky away by no later than baby’s second birthday.

What about you? How old is your little one and are they still using their pacifier? What’s your experience with pacifier teeth like, then? Share your story with us and help us raise awareness about this important issue!

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Medically Reviewed By: Leah Alexander, M.D., F.A.A.P.

Medically Reviewed By: Leah Alexander, M.D., F.A.A.P.

Leah Alexander, M.D. FAAP began practicing pediatrics at Elizabeth Pediatric Group of New Jersey in 2000. She has been an independently contracted pediatrician with Medical Doctors Associates at Pediatricare Associates of New Jersey since 2005. After graduating from Kalamazoo College and Michigan State University College of Human Medicine, she completed her pediatric residency at Overlook and Morristown Memorial Hospitals. She is board certified in General Pediatrics.

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