Dental caries, malocclusion and gingival recession are commonly cited problems associated with pacifiers. Most studies have found that these problems exist only with prolonged (after age five) or inappropriate use (sweetened pacifier).
A recent study showed significant differences in dental arch and occlusion characteristics in users at 24 months and 36 months of age compared with those that had stopped sucking by 12 months of age. Another study looked at children aged two to five years and also found significant increases in overjet (greater than 4 mm),
open bite and posterior crossbite in pacifier users. The longer the use was, in months, the stronger the association with open bite and
cross bite.
Both the Canadian Dental Association (CDA) and the American Dental Association (ADA) have similar publications on the appropriate use of pacifiers. The CDA recommends pacifiers over thumb sucking because it is easier for a parent to control the sucking habit. They advise against putting sugar, honey or corn syrup on a soother because of the risk of promoting caries. They state that a sucking habit should stop before the permanent teeth erupt. The ADA also advises parents who choose to use a pacifier to use a clean, unsweetened one. They state that although prolonged use can harm the teeth, it is easier to wean a child’s sucking habit from a pacifier than from a thumb.
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