Thousands of parents rely on pacifiers to calm and soothe a fussy baby.  For children under the age of one, the continuous sucking action is normal and healthy.  However, if parents allow children to continue using a pacifier after age one and into toddler years, this action becomes habit instead of a natural instinct and can be detrimental to a child’s oral health. 

Researchers have found no physiological reason why children should need a pacifier past the age of one, and report a trend that many prolonged pacifier users become prolonged thumb-suckers after the pacifier is taken away.

Prolonged use of the pacifier and thumb sucking can impede the natural development of teeth, the jaw and normal palate formation.  It is generally agreed that if the habit is discontinued before the age of five, no residual damage to the alignment of the teeth is likely to result, however, if the habit persists after the permanent teeth begin to erupt, some disfiguring consequences can occur.  Even with this information, it is best to stop by the age of one if at all possible. 

Pacifier use and thumb sucking can cause the upper teeth to protrude and the lower teeth to jut in.  For the first few years it is more of a social inconvenience, but as the upper front teeth protrude further, they become and easy target for trauma.  Unfortunately, I have seen too many fractured front teeth that “stopped a fall” because they stuck out too far. 

In addition to moving and shifting the teeth, studies show that pacifier users are more likely to suffer from acute middle ear infections.  Continuous sucking on a pacifier causes the auditory tubes to open abnormally, allowing secretions from the throat to seep into the middle ear.  This makes the ears more susceptible to the infection-causing bacteria and viruses.

Prolonged thumb sucking and pacifier use can also relate to tongue thrusting problems, breathing concerns and speech difficulties as well. 

What can be done to help a child stop?

First of all any habit breaking techniques are something to help the child, not a punishment!  Unless the child has an understanding of what needs to be done and wants to stop, it is an uphill climb to break the habit.  Parents must be willing to work with the child or the results may not be as good as expected.  With all of that said here are some things that can be tried:

• Often, simply talking with the child and explaining the concerns will be all that is needed.
• Place an over-the-counter bad tasting substance on whatever the child is putting in their mouth.  I’ve seen limited success with this method, but it can be successful.
• Place a “Band-Aid” on the child’s thumb as a reminder.
• “Sock method” – if the problem occurs at night while sleeping, place a sock over the child’s hand and lightly tape it to their wrist so the hand is covered and the thumb isn’t accessible.  Be sure not to tape it too tight where the circulation is impaired.
• “Ace bandage technique” – Wrap a 3-inch “Ace bandage” around the child’s elbow joint.  The joint can still bend and the thumb can still be placed in the mouth, but as the child falls asleep, the pressure on the joint will straighten out the elbow and remove the thumb.  Once again do not wrap it too tight!
• There are over-the-counter devices that can be utilized as well.  One is called the “T-guard”.  They are somewhat of a bother to put together, but can be effective.
  

 The bottom line is that if a child is utilizing the pacifier or sucking their thumb past the age of one parents should begin helping them stop.  It may save them a lot of concerns in the future.