Pacifiers & Thumb Sucking/Finger Sucking

Can they cause mouth problems?

Can Pacifiers and Thumb/Finger Sucking Affect the Mouth?

Babies are born with a strong sucking reflex. It is necessary to eat and drink and also has a soothing effect. However, prolonged thumb/finger sucking or pacifier use can cause problems. Some changes in bone structures can be noticed as early as a year and a half in age. Beyond 2-4 years of age, the pressure on the teeth and jaws can impact the shape of the mouth and how teeth are lining up.

How vigorously the child sucks on the pacifier or their thumb/finger should also be considered. Children who tend to suck more aggressively are likely to develop more severe problems. They may need to be weaned from the habit sooner than children who passively suck the pacifier/thumb.

If a child continues thumb/finger sucking or pacifier use past age 4, parents and caretakers should consider taking additional steps to help wean the child from the habit. The risk of abnormal development of the teeth and jaws that would require professional intervention is much higher after this age.

What Kinds of Dental Issues Can Occur?

Problems caused by prolonged pacifier usage or thumb/finger sucking affect the alignment of teeth and jaws. Orthodontics is the area of dentistry that focuses on these types of irregularities. Common orthodontic issues that may occur include:

• Crossbite – When the upper teeth fit inside the lower teeth, the condition is called a crossbite. If a crossbite is not corrected, the jaw can shift to one side causing lopsided jaw growth.
• Open bite – When a child develops an open bite, their upper and lower front teeth do not overlap. This can create problems with their speech or swallowing.
• Protruding front teeth – Protrusion of the front teeth ("buck" teeth) makes it difficult for the child to close their mouth and lips. This can cause problems with speech and make a child more prone to trauma.

Besides tooth-alignment issues, other consequences of prolonged use may include:

• Changes to the shape of the roof of the mouth
• Skin irritation of the mouth due to friction from a pacifier or of the thumb/finger
• Possible psychological or social issues in the future if the child's appearance is affected

How Parents and Caregivers Can Help

Weaning a child off of the pacifier or helping them break a thumb/finger sucking habit can greatly reduce the risk of potential jaw and tooth misalignment. To help reduce the stress that could be created when trying to wean them, make gradual changes. For example: you could try reducing the use of the pacifier during the day and limit it to only naps and bedtime.

Helping a child develop new strategies for coping with reduced pacifier use is important. Other potential strategies include:

• Talking to them about what is upsetting them or helping them identify their emotions
• Giving them a hug and reassurance or offering them a toy to hug
• Deep breathing with them
• Positive reinforcement/rewards, like a sticker or prize
• Trades, such as swapping a pacifier for a gift
• Rocking them or playing music

Knowing the communication skills that a child has at each age may be helpful. Keeping them calm will lead to greater success. You may wish to avoid weaning them off the pacifier or thumb/finger sucking habit during major changes, such as when they are being potty trained, changing childcare services or moving to a new house.

Your dentist or orthodontist can identify jaw and tooth problems caused by these types of oral habits. They can offer you advice and treatment options to help your child and correct existing problems.

Note: The information in this article is not meant to replace the advice of your dentist or another licensed healthcare professional. Talk to your dentist for any specific dental advice.