Pacifiers and Thumb-Sucking: When It's Okay and How to Stop

Pacifier and thumb-sucking are natural in infancy. How they affect teeth, the goal of stopping before age 3, hygiene tips, and gentle ways to cut back.

When your baby needs a pacifier to fall asleep or happily sucks a thumb, you may worry that the teeth will come in crooked. Here's why sucking matters, how long it's okay, and how to cut back without a struggle.

Sucking is how babies self-soothe

Babies are born with an urge to suck. Sucking is how they feed, and it's also how they calm themselves when they're sleepy, in a new place, or anxious. So a pacifier or thumb habit in infancy is nothing to worry about. Most kids give it up on their own between ages 2 and 4.

The time to pay attention is when sucking goes on for a long time. If a thumb or pacifier presses on the front teeth and palate for years, it can push the front teeth apart or forward and change the shape of the palate. That's why the goal is to stop before age 3.

The good news is that if the habit stops before the permanent front teeth come in, the bite of the front teeth often improves on its own. There's no need to rush to quit right away. You can cut back little by little, at a pace that fits your child's age.

Comparing the two, a pacifier habit is easier to break. You can put a pacifier away, but a thumb is always right there.

Keep it clean and cut back without scolding

If your baby uses a pacifier, start with these basics.

• Never dip it in honey, sugar, syrup, or anything sweet. Sweetness lingers on the teeth and makes cavities more likely.
• Don't clean a dropped pacifier in your own mouth. Cavity-causing bacteria in your mouth can pass to your baby. Rinse it with clean water or swap in a different one.
• Sanitize pacifiers often, and replace any that are cracked, stretched, or discolored.
• Choose a one-piece design, and don't use a bottle nipple as a pacifier. A piece that breaks off could get stuck in the throat.
• Don't use a pacifier to put off a feed when your baby is hungry. And don't push one on a baby who doesn't want it.

From around the first birthday, start cutting back so the pacifier is only for sleep. Try these steps.

1. During daytime play, keep the pacifier out of sight.
2. If your child seems to be sucking out of boredom, shift their attention with hands-on play or a picture book.
3. When your child does well without it, give a big hug and praise. For a slightly older child, something they can see, like a sticker chart, helps too.
4. Once sucking at bedtime has also gone down, take away the sleep pacifier last.

If your baby has started thumb-sucking, rather than pulling the thumb out or blocking it, offer another comfort object like a stuffed animal or blanket to hold. Busy hands are less likely to go to the mouth.

Scolding, teasing, or punishing makes kids anxious, and that often leads to more sucking. Whatever method you use, explain it in simple words, and take a break if your child gets scared or very tense.

Frequently asked questions

When to talk to a dentist

• Pacifier or thumb-sucking continues past age 3
• The front teeth are visibly spreading apart or sticking out
• The shape of the palate seems to have changed
• It's hard to cut back on the habit even after trying several approaches

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The information in this article is for general educational purposes and does not replace professional dental care. Talk to a dentist about your child's condition.

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