Will Thumb Sucking or Using a Pacifier Ruin My Child’s Teeth?

From well-meaning friends and family to social media, parents are flooded with advice. Thumb sucking and pacifier use, in particular, tend to stir up a whole lot of opinions. If you’re feeling uncertain and worried that oral habits will ruin your child’s teeth, Straight Smiles has you covered. 

In this post, Dr. James Scramstad, general dentist practicing orthodontics only, is setting the record straight, from an orthodontic perspective at least. 

Finger and Thumb Sucking in Babies is Completely Normal

Babies are born with a natural sucking reflex. It’s how they explore their surroundings and a way to self soothe. According to John Hopkins Medicine, approximately 90% of newborns exhibit some form of hand sucking by two hours after birth. Babies sometimes even suck their thumbs in the womb.

So you can breathe a sigh of relief. It’s normal and natural for infants to suck their thumb or fingers.

What About Using a Pacifier?

Pacifier use is also normal during infancy! In fact, some experts consider it preferable to thumb sucking, because pacifiers are softer and able to be cleaned. They’re also an easier habit to stop since, unlike a thumb or finger, they can be taken away. 

Additionally, research shows that using a pacifier may reduce the risk of sudden infant death syndrome (SIDS). A meta-analysis published in Pediatrics found a strong correlation and felt the benefits outweighed the dental risks. 

The researchers stated, “In consideration of potential adverse effects, we recommend pacifier use for infants up to 1 year of age, which includes the peak ages for SIDS and the period in which the infant’s need for sucking is the highest.”

Will a Pacifier or Thumb Sucking Ruin Teeth?

Thumb sucking and using a pacifier in infancy will not ruin your child’s teeth. However, if the habits continue, particularly once the permanent teeth start to erupt, then the pressure exerted by the pacifier or thumb can have orthodontic consequences. 

It’s not just crooked teeth from sucking a thumb or pacifier that’s a concern though. When the habit is prolonged and aggressive (you might even hear a popping noise as your child removes the pacifier or thumb from their mouth), it can also cause skeletal changes, including a narrowing of the palate, or roof of the mouth, leading to different types of malocclusion (improper bite). 

The most common orthodontic problems caused by prolonged thumb sucking and pacifier use include:

• Protruding Front Teeth 

If kids are still engaging in the oral habits once the front teeth are ready to erupt, the pressure can cause these teeth to flare out over the bottom teeth. 

Protruding front teeth, sometimes referred to as “buck teeth ” and technically called overjet, are at risk for damage. The issue also impacts chewing and speech. 

• Open Bite  

Oral habits are tied to the development of an open bite. This is when the teeth don’t overlap when the jaw is closed. Sometimes, the top and bottom teeth don’t meet at all, leaving an opening in the front of the mouth. 

This significantly interferes with the ability to bite into and chew food. It can also cause speech problems and jaw pain. 

• Crossbite

A crossbite is when some of the bottom teeth sit in front of some of the top teeth. When a patient has a crossbite caused by sucking a thumb or pacifier, it’s usually a posterior crossbite (back crossbite) and develops due to a narrowing of the palate and upper arch. 

In an attempt to get the molars to come together, kids with a posterior crossbite often shift their jaw to one side. This can lead to further skeletal changes. A crossbite can also cause uneven wear of the enamel, jaw and TMJ pain and chewing problems. 

It’s important to keep in mind that there are a variety of causes of crooked teeth. While, yes, oral habits are one of them, genetics is also a major contributor. In some cases, kids may already be predisposed to malocclusion and the habits exacerbate the problem. 

Will Using an Orthodontic Pacifier Prevent Malocclusion?

An orthodontic pacifier, or functional pacifier, has a flat bottom and rounded top, while a conventional pacifier is rounded like a ball. Orthodontic pacifiers are supposed to support the shape of the jaw and palate as they develop. These types of pacifiers are marketed as a way to prevent or alleviate malocclusion. 

The jury is still out on whether orthodontic pacifiers are actually better. A 2018 systematic review published in Progress in Orthodontics revealed that there is evidence to support the claim that orthodontic pacifiers with a thin neck can reduce the incidence of an open bite. They did not, however, appear to reduce the occurrence of a posterior crossbite, but more research needs to be conducted. 

Another systematic study published the same year, found no difference at all between children who used a conventional pacifier vs. an orthodontic one. 

Truthfully, the type of pacifier used may not make much of a difference. But, there could be a small benefit to using an orthodontic pacifier. 

When to Stop the Pacifier or Discourage Thumb Sucking

Now for the million dollar question, when should you stop the pacifier or try to get your child to break their thumb sucking habit? The Canadian Dental Association recommends children stop sucking before their permanent teeth come in, around age 5.

While the most severe problems tend to occur if the habits persist past age 5, depending on the intensity of the habit and how many hours per day your child engages in it, research suggests issues can occur in some kids earlier than this. 

Participants in a study published in the Journal of the American Dental Association had significant changes in their craniofacial structure when thumb sucking or pacifier use continued to 4 years old and beyond. Changes included a narrow upper arch, greater overjet and an increased prevalence of open bite and posterior crossbite. However, the effects began to appear as early as 24 months. 

A meta-analysis in the International Journal of Orthodontics noted pacifier use beyond age 3 “has an increasingly harmful effect on the developing dentition.” The researchers suggested the ideal age to stop pacifier use was between 2 and 3 years old. 

The good news is most kids stop sucking habits on their own between the ages of 2 and 4. And many of the studies cited above suggest that when kids stop sucking while they still have all of their primary teeth, some of the dental changes correct themselves as children continue to grow and develop. 

The team at Straight Smiles recommends beginning to encourage your child to stop thumb sucking or using a pacifier around age 2 or 3. If your child is still sucking their thumb or using a pacifier by age 4, it’s a good idea to bring it up with their dentist. 

How to Stop Thumb Sucking and Pacifiers

Here are some tips for getting your child to stop thumb sucking or using a pacifier:

• Talk to your child and let them know that it’s time to let go of the habit, because you want their teeth to grow in nice and strong. Tell them you’ll be there whenever they’re ready to stop. Since most children stop on their own, sometimes, gentle encouragement is all you need.

• For a pacifier, if you want to go cold turkey, inform your child the pacifier will be going away on a specific day, and then on that day, get rid of the pacifiers. To soften the blow, you may want to have them gather up their pacifiers to “send” to another baby. Or start a new big-kid bedtime routine to mark the occasion.

• If you’d rather use a gradual approach, ask your child not to suck their thumb or take their pacifier away whenever you’re out of the house. Then, transition to only using a pacifier or thumb during naps and at bedtime. Then, only at bedtime, before eventually stopping altogether.
  

• Use positive reinforcement. Praise your child whenever they go for an extended time without sucking their thumb or pacifier.
  

• Create a system of rewards. If your child is able to make it through a predetermined length of time without engaging in the habit or they forgo it for a nap, give them a sticker to place on a chart. When they get a certain amount of stickers, they earn a prize.
  

• Sucking on a thumb or pacifier can become an unconscious habit. Help your child cultivate awareness by coming up with a sign or codeword that you can say or do when you see them sucking.
  For example, you could give them a thumbs-up or say a word like “dinosaur.” Or if your child doesn’t mind, be forthright and comment, “Hey, I see you’re sucking your thumb.” Try offering them something else like a favorite toy or stuffed animal.

• Distract them. If your kiddo is cranky and going back to the habit or asking for their pacifier, divert their attention to something else. Play a game or go for a walk together if possible.
  

• If none of these ideas work, ask your dentist to talk with your child. Sometimes, hearing the reason why they should stop doing something from an adult who isn’t a parent can be helpful. Your dentist can also provide personalized guidance.
  

• If your child is 4 or 5 and the habit is still going on, your dentist may recommend a habit-breaking appliance. The appliance prevents the thumb or pacifier from coming into contact with the palate and creating suction, which makes the action less enjoyable. 

Can Crooked Teeth From Thumb Sucking or Using a Pacifier Be Fixed?

Absolutely! If you’re concerned about your child’s teeth after thumb-sucking or using a pacifier, schedule an orthodontic evaluation. In fact, it’s recommended all kids have their first orthodontic visit at age 7, regardless of whether they have a persistent oral habit or not. 

At age 7, most kids have a mix of permanent teeth and primary teeth, so Dr. Scramstad can get a sense of how their bite is shaping up. If it appears that thumb sucking or pacifier use has caused a narrow palate, early orthodontic treatment, also called phase 1 orthodontic treatment, could be necessary. 

During phase 1 treatment, Dr. Scramstad uses an appliance, such as a palatal expander, to guide jaw growth while your child is still developing. This will help reduce any discrepancies in size between the upper and lower jaw and make room for the permanent teeth to erupt properly. 

As for how to fix pacifier teeth or problems from thumb sucking at a later age, it’s still possible! Even adults can benefit from orthodontic treatment. Depending on the specific orthodontic issue and the severity of your case, Dr. Scramstad may be able to use braces or Invisalign, along with auxiliaries like rubber bands and attachments, to straighten the teeth and improve the bite. 

Book a Visit for Your Child at Straight Smiles in Kelowna, BC

As a general dentist practicing orthodontics only, Dr. Scramstad is experienced in helping kids overcome oral habits, as well as in correcting misaligned teeth and bites after the fact. 

If you’re worried about persistent thumb sucking or pacifier use or the effects it’s had on your child’s teeth, schedule an orthodontic evaluation at Straight Smiles today!