How Pacifiers & Thumb-Sucking Can Affect Your Child’s Teeth

Using a pacifier or thumb-sucking is an extremely common action that satisfies a young child’s natural reflexes and can help soothe them and encourage sleep. In fact, within two hours of birth, about 90% of infants start sucking their thumb or fingers.
In the short run, these habits are ok. But, both of these things can affect the development of your child’s teeth if it happens too much or goes on for too long. While many children naturally grow out of this habit on their own, others may have a tougher time stopping.
In this article, we’ll go over the effects that pacifiers and thumb sucking have on children’s teeth, when it should be stopped, how you can help your child stop doing these things when it’s time, and how the effects can be fixed if needed.
The Effects of Pacifiers and Thumb Sucking on Children’s Teeth
Over time, both of these things can negatively impact the development of your child’s teeth. Both the suction and the pressure from a foreign object— whether from a pacifier or thumb— can push teeth out of place and can even impact the development of the jaw and shape of the mouth.
Here are some of the things that can happen from prolonged pacifier use or thumb-sucking:
An Open Bite
It is referred to as an open bite when the top teeth don’t slightly overlap the bottom teeth when the jaw is closed. In more extreme cases, the upper and lower teeth don’t touch at all, leaving a space between the upper and lower arch. An open bite can impact speech (causing lisps and other impediments), chewing, and swallowing.
Protruding Front Teeth
Sucking on either a pacifier or thumb puts quite a bit of pressure behind the front teeth. This can cause them to tilt and stick out, which is referred to as protruding teeth, overjet, pacifier teeth, or buck teeth. When this happens, not only are the teeth more susceptible to injury, but it can also cause speech problems and may make it difficult to close the mouth and lips.

Crossbite
It is referred to as a crossbite when several of the top teeth sit inside of the bottom teeth. When caused by a pacifier or thumb-sucking, it will usually be a posterior crossbite (back crossbite) due to the narrowing of the upper arch. Crossbites can cause jaw pain and uneven wear of the tooth enamel. Plus, sometimes, children with a crossbite will compensate by shifting their jaw to the other side, which can cause further mismatched jaw development.
The level of impact on the teeth due to pacifier use or thumb-sucking will depend on both the frequency and level of suction. Oral development in toddlers and children is impacted more significantly when there is extended usage of pacifiers or instances of thumb-sucking. Rather than letting your child do it all day, it is important to limit the behavior. (More on this below.)
In regards to how hard your child is sucking, while you can’t control that, monitoring it is important. Some children vigorously suck on their thumb while others just gently rest their thumb in their mouth. For children who exhibit a stronger suction, their teeth/jaws will benefit from transitioning away from pacifier usage or thumb sucking at a younger age.
The Age Your Child Should Stop These Oral Habits
The most common question when it comes to pacifiers and thumb-sucking is exactly when you should try to stop these habits in a child.
Most children naturally stop on their own between the ages of 2 and 4. But, when children continue to do these things when their permanent teeth are ready to erupt is when the most severe orthodontic problems happen. However, problems can start to develop even earlier than that. This is especially true if the child uses a pacifier or sucks their thumb daily and/or aggressively.
So, to answer the question of when it should stop, the specific answer can vary. The American Academy of Pediatric Dentistry says that these oral habits should be discouraged if they continue after age 3, while the American Dental Association recommends intervention if they continue past age 4.
Based on the most recent research, it is ideal to start gently encouraging your child to give up their pacifier or stop thumb-sucking, or at least reduce the frequency, around age 2 or 3. If you can’t get your child to stop by age 4, you should speak with your child’s pediatric dentist about the issue.

How to Gently Stop the Habit
As a newborn and young child, thumb-sucking is a natural reflex. As children get a little older, it becomes more of a way to comfort themselves and relieve stress. So, when it’s time for your child to stop, they have to have other ways to self-soothe. Pacifier usage will be easier to stop than thumb-sucking.
But, there are some strategies you can use to help your child overcome these habits with as little stress or discomfort as possible:
- Communicate why it should stop: Your child can become confused or upset when you start encouraging them to quit using a pacifier or sucking their thumb. So communication is key. Explain why they should stop and what can happen to their teeth if they don’t. Some children may even respond better to their dentist explaining why they should stop.
- Keep it positive: Don’t punish your child for using a pacifier or sucking their thumb. Instead, praise them and offer rewards for not doing it.
- Stay patient: It can take time to break these habits. Weaning them off gradually can be extremely effective. Start by limiting the times when they can do it. First, explain to them that they can’t have their pacifier or suck their thumb in public but can do it in the house. Then, transition to only doing it at bedtime. Then eventually, take the pacifier away totally or start encouraging them to give up thumb-sucking completely.
- Offer them a substitute: As mentioned above, your child will need an alternative way to self-soothe. A blanket or stuffed animal can be effective in providing the same comfort. There will be an adjustment period, but they’ll eventually learn to comfort themselves in other ways that won’t harm their teeth.
- Distraction is effective during distress: If your young child is cranky and/or having a rough day and is reverting back to the habit of a pacifier or thumb-sucking, divert their attention somewhere else. Distract them by playing a game, getting out paper and crayons, or going outside to play.
- Use your dentist to help: Your child’s dentist or your orthodontist is a valuable resource to tap into if nothing seems to be working to break the habit. Don’t be afraid to ask them what they suggest. They’ll be able to offer you guidance and/or talk with your child. As we mentioned above, sometimes it can be very helpful for the child to hear something from someone who is not their parent.
If your child is past the age of 3 or 4, the habit is prolonged/vigorous, or it is starting to cause dental issues, an oral appliance may be necessary. These appliances stop the habit of thumb-sucking by preventing the thumb from coming into contact with the palate and stopping suction, which takes away the enjoyment of the action for your child.

How the Effects of a Pacifier or Thumb-Sucking Can Be Fixed
The good news is that if your child’s teeth and/or jaws have been negatively affected by these habits, it can be fixed! According to the American Association of Orthodontists, children should have their first orthodontic evaluation at age 7 (or earlier if there is indication of an orthodontic problem.)
At this age, your child will still have some baby teeth but if orthodontic treatment is necessary, it will be much easier and faster. For early intervention, the orthodontist may use certain appliances to help guide jaw growth. After this period, your child may start the next phase of treatment with braces or Invisalign® Teen (for older children).
Not every child will need two phases of orthodontic treatment to address problems caused by pacifiers or thumb-sucking. But for those who do, this approach can help prevent the need for tooth extractions or jaw surgery. It also makes treatment during their teen years faster, easier, and more affordable.
If your child has missed the window for early orthodontic treatment, it’s not too late to still correct the problem. Our orthodontists can create a customized treatment plan to address any issues with the bite and straighten teeth at any age.
Our Caring Team Can Help!
If you are concerned about the effects of a pacifier or thumb-sucking on your child’s teeth, we are here to help! The team here at Cook & Gutsche Orthodontics in Springfield can address any issues and work with you and your child to give them a healthy, beautiful smile that they will be proud to show off. Call (610) 622-4400 or contact us through our website to schedule a consultation today!