Smile Studio Orthodontics Blog

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Entries in thumbsucking (1)


Pacifiers and Thumbs Suck

Note:  This is a reprint of an article published in February 2017 Natural Awakenings.

Finally, science is confirming what orthodontists have long understood.  Pacifiers cause children to need braces later on.  And not just pacifiers, but thumbs, fingers, blankies, and any other comfort device an infant may habitually suck on to soothe himself.

A systematic review and meta analysis published in the December 2016 Journal of the American Dental Association concluded that non-nutritive sucking behaviors are strongly associated with malocclusion as late as the mixed dentition.  By pooling 15 different studies, Australian researchers Drs. Esma Dogramici and Giampiero Rosse-Fedele were able to provide the strongest evidence yet that sucking habits are definitively associated with anterior open bite (front teeth that don’t overlap or touch), posterior crossbite (top teeth that don’t overlap the bottom ones), and class II (top teeth that protrude and/or bottom teeth that retrude).

Local orthodontist, Dr. Marie Farrar, says she struggled when her children were infants with how to proceed regarding sucking habits.   Having seen the after-effects of sucking behaviors, she was anxious to prevent as much orthodontic treatment as possible for her own children.  But she totally gets why it’s such a hot-button issue for stressed out parents.

“It’s easy to say no ‘paci’, no thumb.  But when it’s your child suffering -- or your own self, suffering from lack of sleep and sanity – I know from experience that you’ll do whatever it takes to keep your child comfortable and happy,” Dr. Farrar relates. 

The thumb vs. pacifier debate has raged for years.  Dr. William Sears promoted the thumb over the pacifier because baby can always find it in the night and self-comfort herself for years. 

“But I’d read,” Dr. Farrar continues, “that babies’ suckling instinct starts to decline from about six months and that six to nine months is the magic age for weaning them from the paci, before they get too emotionally attached to it.  We were successful in getting our oldest off his pacifier that early, but our daughter was a different story.  She had started day care earlier and got in that cycle of recurrent ear infections, so for our sanity and hers, we weren’t able to get her off her pacifier until she was almost three.”

Dr. Farrar suggests offering a cozy “lovey” at the time of weaning off the pacifier to transfer the child’s emotional attachment to something more tactile.

“I’m actually less concerned with the dental after-effects of sucking habits—those can be fixed with orthodontic interventions and treatments, Dr. Farrar states.  “But I’m a lot more concerned about the successful transition from tongue thrusting.  Non-nutritive sucking just seems to delay that transition, and some adults never develop proper tongue function.  Normal tongue posture happens naturally at the right time if a baby doesn’t have a thumb or pacifier in the way.  But the longer it goes on, the harder it is to correct.  And improper tongue posture and function WILL create lifelong dental problems; that’s what I treat all day long every day.”

Dr. Farrar asserts that dental arch and even airway development would be improved if babies were swaddled, carried, and nursed on demand for at least the first nine months of life, and never offered a pacifier, bottle, or sippy cup.  But with a laugh, she says, “that’s highly unlikely and unreasonable in our 21st century society, so we orthodontists are here to help pick up the pieces.”