The Effect Of Pacifiers on Oral Health and Overall Health

My First Story

I have two children, so I have two stories. We never gave my eldest son a pacifier. As a dentist, I had learned all the negative effects of pacifier use on the oral cavity. It is the same negative effects that can be seen with prolonged thumb-sucking and prolonged bottle use. It can be explained by the following physics: the sucking motion creates a vaccuum suction that developmentally shapes the oral cavity. The palate (roof of the mouth) forms high and narrow, sometimes into the shape of a "V". The tongue learns to rest forward as it tries to push against the pacifier. It is also trying to rest in the narrow roof of the mouth but does not fit.  The narrow arch and tongue thrust, as its called, pushes the erupting teeth forward into an overjet position The tongue thrust can also lead to an open bite to make space for the tongue.

This is what that looks like:

Effects of Extended Pacifier Use

You can understand why this would be an issue since the baby teeth create the eruption pathway for adult teeth. But it isn't cosmetics that I am worried about.

The restricted airway caused by the narrow palate and the tongue pushed forward behind the upper anterior teeth blocks the airway causing the habit of mouth-breathing. I suggest you take a second to just try this exercise. Push your tongue forward and to the roof of your mouth with pressure as someone using a paci might do. Now take a deep breath through the nose. Difficult, right? Now rest the tongue on the floor of the mouth against the back of your lower teeth and take a deep breath. Now breathe with your mouth open. Which is easier? Humans need oxygen so we tend to breathe in the easiest way possible!

You can now see how pacifier use prevents the positive habit of breathing through the nose to expand the airway and properly filter the air through the nose cavity, which has evolved to have nose hairs and mucus. The bacteria in the air enters through the mouth which has no such filter, exposing the oral cavity to air pathogens. This is why chronically inflamed tonsils is a sign that your child is mouth-breathing. Mouth breathing also causes oral health issues such as dry mouth which promotes bacterial growth and cavity formation. And most importantly, the restricted airway causes a lifelong progression towards sleep apnea which affects many adults today and is known to shorten one's lifespan by 7 to 15 years.

In summary, prolonged pacifier use does affect oral and overall health in the following ways:

Effects of Prolonged Pacifier Use

• High and narrow palate

• Tongue Thrust Habit

• Overjet Eruption of Teeth

• Overbite Eruption of Teeth

• Mouth breathing habits

• Chronically Inflamed Tonsils

• Potential for developing sleep apnea which leads to a shortened lifespan

My second story

So what is my second story? When my daughter was 7.5 months old, we went on a trip to Europe. Our first stop was Copenhagen. Our itinerary consisted mostly of coffee shops and restaurants with a toddler and a baby. I had heard Copenhagen was extremely family friendly - which it was. Dads are given as much time off from work as moms are, so there was a slew of both moms and dads pushing prams or riding bicycles with bassinets and wagons attached to the back. School children were biked in groups in these big wagons. And prams were parked outside bakery windows while their parent enjoys a cup of coffee and a cardamom bun - by themselves in peace! But there was one distinction. All the children were well-behaved and the babies were quiet. Whereas our toddler was fidgety, and our baby cried.

It didn't take long to realize that even five year-olds were walking around with pacifiers in their mouths. Every child was soothed by a pacifier way past toddlerhood.

Our second child used a pacifier

The second story is that we bought our daughter this Wubbanub pacifier(affiliate link) on the second day of our month-long trip in Europe. We were breaking up the peace in those coffee shops, and we were not going to give up coffee. We, as her parents, ended up relying on that pacifier as much as she did - for much longer than we wanted. It made our Europe trip enjoyable. She started sleeping through the night on that trip, learning to self-sooth. But she kept using that pacifier until she was 11.5 months old, when one morning, I threw it away. Did 3 months pacifier use affect her airway?

Yes. I see the difference. She tends to breath through her mouth and like moms of ancient cultures, I have to press her lips together after she has fallen asleep to force her to breathe through her nose. She has congestion all the time. This is due to her mouth-breathing habit, as she is more exposed to airway pathogens. Even during the day she breathes through her mouth. Her upper teeth are a bit flared forward, leaving a gap between her four front teeth. This is unlike her brother's perfectly straight teeth.

There is also one more difference worth noting. She is a better self-soother. She has calmer energy. Whether this is pure temperament or a skill, we can't say for sure.

But I share the second story because even a good, well-intentioned mum sometimes lets her baby use a pacifier. Even a dentist mom who knows the consequences. Pacifiers soothes babies, it's a fact. If you let your child use a pacifier, do not be hard on yourself. It's normal and acceptable. The recommendation is to stop pacifier use before the baby turns 1 years old. If your baby is past 1 years old now, it is time to wean them off of it.

If you are using pacifiers, know that not all pacifiers are made equal. This post on the one pacifier you should avoid is worth a read for all parents! And if you want to know more about what to do if your child did use a pacifier in the past, check out this post My Child Shows the Effects of Prolonged Pacifier Use.

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