Are Pacifiers Bad for Teeth?

Pacifiers are one of those things that are the subject of a lot of debate in the parenting world. From when to give a baby a pacifier to whether or not pacifiers are bad for teeth, there is a ton of conflicting information. As Bellaire and Houston orthodontists, we can’t give you a definitive answer on whether a pacifier is right for your infant, but we can address the subject from an orthodontic angle. In this post, we’ll be covering everything you need to know about pacifiers and teeth.

Is It Okay to Give a Baby a Pacifier?

Babies are born with a natural sucking reflex. Some babies start sucking their thumbs and fingers in the womb! It helps them soothe themselves. Plus, putting things in their mouths, thumbs and pacifiers included, is a way infants learn about the world around them. It’s perfectly normal for babies to suck their thumb or use a pacifier and it’s nothing for parents to worry about.

While sucking on a thumb, fingers, or a pacifier is okay during infancy, eventually, you will want to get your child to stop thumb-sucking or using their pacifier. Since the thumb is attached to their body, breaking a thumb-sucking habit can be much more challenging than stopping the pacifier. This is one reason why some parents prefer pacifiers and make an attempt to offer a pacifier during the first few months of a baby’s life. Additionally, there have been studies done on pacifier use and SIDS that have found giving a newborn a pacifier at sleep time can decrease the risk of SIDS. So, as you can see, pacifiers aren’t harmful to babies and may even have some benefits.

Are Pacifiers Bad for Teeth?

Now, back to the original question, can pacifiers cause dental problems? It depends. Pacifiers aren’t bad for an infant’s teeth, especially considering they don’t even have all of their teeth. However, prolonged pacifier use can lead to misaligned teeth and orthodontic issues, particularly if the habit is still going on when the permanent teeth are beginning to come in. In cases where a child vigorously sucks their pacifier, which is usually evidenced by a popping noise when they take it out of their mouth, issues can occur with the primary teeth as well.

As for a pacifier’s effect on teeth, prolonged and/or vigorous pacifier use can lead to a variety of different types of malocclusion (improper bite), including:

Protruding Front Teeth

When kids use pacifiers or suck on their thumb, it often places pressure against the top front teeth, which can cause the front teeth to stick out, sometimes referred to as “buck teeth.” When the front teeth protrude, they’re more likely to be damaged or injured.


Another common dental problem from pacifier use is an overbite. This is where the top teeth sit too far in front of the lower teeth when the mouth is closed. Orthodontics for an overbite is recommended when the space between the upper and lower teeth reaches a certain degree because it can cause uneven wear of the teeth, make the front teeth susceptible to injury and lead to jaw pain.

Anterior Open Bite

An open bite is sometimes the result of oral habits, including pacifier use. When a patient has an anterior open bite, the top and bottom front teeth don’t meet when the jaws are closed. It can make biting into food and chewing difficult and may lead to speech issues.


Spacing, also called gap teeth, is when there are gaps between two or more teeth. The constant pressure from a pacifier or thumb may create gaps between teeth. Gaps or spacing can occur on their own or in conjunction with other issues like an overbite.

Posterior Crossbite

A posterior crossbite can result from pacifier use. This is when some of the back lower teeth sit in front of the top teeth. Since patients often compensate by moving their jaw to one side so the molars can come together, it can lead to permanent changes in the facial structure if not addressed early.

Changes to the Roof of the Mouth

Prolonged pacifier use can cause changes in the roof of the mouth and interfere with proper development, leading to the roof of the mouth being narrower and affecting the distance from molar to molar.

What Are Pacifier Teeth?

So, what are pacifier teeth? What do pacifier teeth look like? All of the orthodontic concerns that can result from pacifier use listed above are sometimes lumped together and referred to as “pacifier teeth.” Essentially, pacifier teeth are teeth that are misaligned due to using a pacifier or thumb sucking. Often, the front teeth will stick out and, in certain instances, this is combined with other problems like the back molars not coming together properly (posterior crossbite) or the teeth being tipped forward so far they don’t come together correctly (overbite) or meet at all (anterior open bite). Pacifier teeth may also be crooked or have spaces between them.

How to Fix Pacifier Teeth

Unfortunately, any teeth damage from pacifier use won’t correct itself and the teeth will not shift into place on their own as a child gets older. Changes to the roof of the mouth, jaws and teeth will need to be addressed by an orthodontist. The good news is, for certain issues, by intercepting the problem early while a patient is still growing, we can guide jaw growth and the eruption of the permanent teeth. This will prevent more serious issues and make treatment down the road easier.

In these instances, during Phase 1 orthodontic treatment, your orthodontist will use certain appliances to encourage proper jaw development, ensuring the jaws will align correctly and the permanent teeth will all fit. Then, after a rest period, they’ll finish up with phase 2 orthodontic treatment and use braces or Invisalign® Teen to align the teeth.

This highlights the importance of following the recommendation of the American Association of Orthodontists and having kids visit an orthodontist for an evaluation by age seven. At this stage, we can much more effectively manipulate jaw growth to correct any of the negative effects of pacifier use. Once a patient has all of their permanent teeth and their jaws are done growing, fixing the issue will be more challenging.

When Should Babies Stop Using Pacifiers?

As for when to take away the pacifier, the American Academy of Pediatrics and the American Academy of Family Physicians recommend caregivers start weaning from the pacifier in the second six months of a baby’s life, because this can reduce the risk of otitis media (a type of ear infection). It is also a little easier to take away the pacifier at this point than it is when children are older.

When should babies stop using pacifiers to avoid dental problems? Well, some little ones exhibit effects from pacifier use as early as 24 months. This is usually the case when the baby sucks on the pacifier vigorously and uses it constantly. However, most kids don’t develop malocclusion from a pacifier until after the age of four. After the age of four, especially once kids start losing teeth, orthodontic issues can be much more severe. In general, if you can get your child to wean from the pacifier by age two, you likely won’t have to worry about pacifier teeth issues.

The majority of kids will stop pacifier use and thumb-sucking on their own between the ages of two and four if parents don’t intervene before then. If your child hasn’t stopped the pacifier by age four, you’ll want to make a concerted effort to break the pacifier habit and, if you’re not successful, reach out to a pediatric dentist for guidance.

How to Stop Pacifier Use

Though we can fix pacifier teeth, preventing misaligned teeth or malocclusion by weaning from the pacifier early is always preferable. Of course, taking away a baby’s pacifier by age one or two sounds great in theory but for many parents, we know it can be a challenge. Little ones may begin to rely on the pacifier to fall asleep and use it as their main method of self-soothing. Here are some ideas for how to stop pacifier use in little ones that may help:

  • Go cold turkey – You can simply take the pacifier away from your child when they reach the age of one, or whatever predetermined age you have in mind. Tell your child ahead of time that the pacifier will be going away on a certain date. This method does take patience, and you’ll have to stay strong and not give in even if your child cries or throws tantrums. While there can be some tears and sleepless nights, most kids handle it surprisingly well and adapt in less than a week.
  • Take a gradual approach – You know your child best and cold turkey may not work for every family. You can also stop pacifier use gradually. Start by taking away the pacifier when your child is happy and busy playing. They’ll usually be distracted enough that they won’t notice it’s not in their mouth. After a week or two, begin only using the pacifier at home and not bringing it with you when you leave the house. Again, in a new environment, babies and toddlers will often be stimulated and excited and won’t miss their pacifier.

Eventually, transition to only giving your baby their pacifier when they’re in their crib for naps and nighttime. Keep decreasing until your baby only has their pacifier at night before taking the pacifier away completely.

  • Teach alternative coping mechanisms – Sucking on a pacifier is a way babies soothe themselves. When the pacifier is gone, you may notice changes in their behavior and sleep patterns. Teach them new ways to cope with frustration or sadness like cuddling with mom or dad, talking about what’s bothering them (if they’re older), or taking deep breaths. If the habit is tied to anxiety, getting to the root of what’s making your child anxious and dealing with it will go a long way.
  • Create a bedtime routine – A bedtime routine is always recommended, however, it’s even more important when stopping pacifier use since using a pacifier helps many infants fall asleep. When taking away the pacifier, replace it with a soothing bedtime routine. When it gets close to bedtime, start turning the lights down low, turn off the television and other devices, and keep the house quiet. You may want to give your baby a bath and spend some time snuggling or reading a book to help them unwind.
  • Use distraction – The first few days after taking away the pacifier can be challenging. If your baby gets fussy, try to distract them to take their mind off of it. Go for a walk, read a book, or play a game. We promise fussiness won’t last forever and before you know it, your child will barely remember their pacifier.
  • Offer positive reinforcement – After stopping the pacifier, if your child is struggling to adjust, offer positive reinforcement by telling them how proud you are of them for being such a big boy or girl and giving it up. At times they would normally turn to their pacifier, if you notice they do something else to soothe themselves, praise them. However, while positive reinforcement is a powerful tool, if you take away your child’s pacifier and they don’t seem bothered, then it’s probably not a good idea to continually bring up the lack of pacifier even in the context of positive reinforcement since it will just remind them that their pacifier is gone.
  • Seek help – As we mentioned earlier, if you haven’t had any success in taking away your child’s pacifier and you notice teeth effects from pacifier use or your child is over the age of four, it’s a good idea to talk to their pediatric dentist. Your child’s dentist can offer you further guidance on how to stop pacifier use and other oral habits.

As you can see, while pacifiers are bad for teeth with prolonged use, if you do decide to offer a newborn a pacifier, you can rest assured that with early weaning, they aren’t likely to have any negative effects on their teeth or jaws. If your child did develop bite problems or misaligned teeth from pacifier use or other habits like thumb sucking, schedule a complimentary consultation for your kiddo at Houston Orthodontic Specialists in Bellaire or West Houston today! We’ll evaluate your child and let you know if early orthodontic treatment would be beneficial or if they can wait until they’re older. As a bonus, they’ll be able to join our awesome Kids’ Club. Schedule your child’s free consultation visit by requesting an appointment online.