Friday, January 13, 2006


From a dental standpoint some pacifiers are better than others. However, it is really the way a child sucks the paci rather than the type that determines whether there are related orthodontic problems. Some kids can suck all day long and not move their teeth. Others will develop the dreaded open bite, overbite, or posterior crossbite*. Have you failed as a parent if your child won't let go of the paci? No. But I do have some recommendations:

1. I would rather have a paci in there than a thumb. You can't take the thumb away and a thumb habit is harder to break.

2. If you have to give your child a pacifier, I recommend the Nuk style seen here rather than the hard straight round kind.

3. Don't worry too much if the child's teeth get that overbite look. Most of the teeth movements that occur in the front of the mouth tend to revert to normal after the habit is discontinued. Usually there is no long-term effect so long as the habit does not persist into the permanent dentition. Basically, get the paci or thumb out of there before age 5 or 6 years of age. You've got a little time to work on it.

4. If the child develops a posterior crossbite, well that's not going to correct even if the paci is gone. Your dentist will likely need to place a crossbite "expander" for a few months to correct that.--very common orthodontic correction. Most of the time I wait till the child is at least five, but I have even corrected a posterior crossbite in a three year old (albeit a remarkable three year old)! Sometimes you need to wait till the child is older (after the six year molars have erupted). Oh one more thing, don't dip the pacifier in honey or anything like that!

*Update as of March 2006-The child in the photo above has two paci's in his mouth (and one in his hand). His mother just reported to me that he has kicked the habit. No more paci!

*If you are wondering about pediatric crossbites, expanders, or just want more info on crossbites, check here: Posterior Crossbites


jewelsc79 said...

Thanks for posting this! I'm really just tired I guess of people who think they know everything! I think they may need to go to college to be a dentist or something! My daughter is 3 going on 4 Jan 2009...She adores her binky and likes it very much! I've tried all sorts of things and they dont seem to work! I take her to pediatric dentist ( a very good dentist by the way) who knows that she uses her binky, basically it's not a good thing but not the worst I guess either! I guess having it gone by age 5 or 6 after all isn't so bad! My family needs to read this and stay off my case, half of them dont even take their children to a dentist! So what's worse the BINKY or not seeing a dentist @ all? Thanks!

Anonymous said...

thank you son is three and cant sleep with out his ba-ba as he calls it . i knew it was more common than people think ,i think people are selfish in way i mean i need my iced tea every day so whats wrong with my son having his charished ba-ba at night to sleep...thank you again

browneyedgirl said...

My daughter is 3 years old. She drinks milk out of a bottle 2-3 times a day. She doesn't want to drink it out of a cup. Is this going to cause issues with her baby front teeth? I'm worried she won't drink milk if I tell her she can't drink it out of a bottle. She has never had a paci. I never introduced one to her bc I didn't want it to mess up her teeth and jaw. She isn't sucking on a bottle ALL day just uses it to drink her milk.
Thanks in advance!

Dr. Dean Brandon said...

Sleeping with a bottle (or other container and ad lib drinking in bed is a real concern. During the day, bottle or sippy cup does not matter. What matters is duration. It's worse if it is at night. Milk, etc does not cause cavities, it may accelerate the progression.

Anonymous said...

The ortho Gibby pacifier was designed by a pediatric dentist which is FREE OF BPA and PVC NO FDC coloring made in USA. Clinical studies show that conventional pacifiers significantly increase the risk of jaw deformities and ear infections. Children using conventional pacifiers have a 50% greater chance of developing an ear infection (Source: Family Practice, Advance Access, published June 17 2008.

RMC said...

Hello, thank you so much for this information. My almost 3 year old daughter still uses a pacifier at naptime and bedtime. Her dentist told us last week that she has a posterior crossbite. He didn't really definitively say one way or another if the pacifer should be taken away. He did say it's probably not helping the situation, but that it probably wasn't the sole cause. He also agreed that it was better to use a pacifier than thumbsucking since it will be easier to break the habit. We have been talking with her about giving up the pacifier to get her ready, but honestly we were hoping let her keep her pacifier until she is done for good with naps. I am wondering what your suggestion would be on giving up the pacifier now or if we can wait?

Dr. Dean Brandon said...

As you can read, it is difficult to get a two year who loves the paci to let it go "cold turkey." Most kids give up the paci by age three and a half. You can gently distract over time when the use is predictable--like when watching TV or sleepy, hang it on the tree at Christmas for Santa to take, or clip off the end bit by bit. Those things only work when the child id=s ready and there is no way to tell. Good luck, get her pediatric dentist to follow this over time.

Anonymous said...

I have the same problem as u my family n other ppl say u need to take that away he is 3 and i say so he is my son last time i checked. I was even told i was a bad parent cause they said i treat my son like a baby cause he is still in diapers n on the binkie. Everyday someone is saying something to me about my son on ths binkie. And he goes to the dentist and they know he is on the binkie they said i need to get him off it when his perment teeth come in i mean he has a little overbite and he talks just fine like a 3 year is suppose to. One of my friends posted this to my status on fb so i hope everyone reads it and leaves me alone