24 November 2022

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Dental and Orthodontic problems: Can they be due to the use of the pacifier?

By Niccolò Cenzato, Cinzia Tripicchio, Massimiliano Vella and Luca Esposito

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One of the most common non-nutritive sucking habits in the first years of life is the use of the pacifier. Although scientific evidence has revealed the benefits that derive from its use, the concerns of parents about its use are increasingly growing. Such concerns generate confusion. In fact, parents often rely on the advice of professionals to receive clarifications on its use.  

The purpose of our review, published in Dental Cadmos in April 2022, is to evaluate the advantages and disadvantages of using the pacifier, guiding professionals in conversations with parents to clarify doubts and perplexities, providing recommendations relating to the type of pacifier to be used, timing of administration and other keys to managing this habit.  

Results  

Several cross-sectional studies have shown that breastfeeding has a protective effect against the development of dental skeletal abnormalities and that it is able to prevent the establishment of non-nutritional sucking habits.  

Evaluating the occurrence of dysgnathia in preschool children using pacifiers, the authors of the studies we reviewed said that prolonged use of the pacifier is correlated with a higher prevalence of anterior open-bite, increased overjet and rear cross-bite. From the myofunctional point of view, studies found pacifiers to be a contributing cause of the presence of a reduced transverse palatal diameter — ogival palate or narrow palate. Atypical swallowing and oral breathing and hypertonicity of the facial muscles occur with greater prevalence in these subjects.  

Based on these findings, some authors have evaluated the effect of differently designed pacifiers on oral structures. The use of orthodontic soothers is associated with a lower prevalence of malocclusion than conventional ones. Finally, the pacifier is defined as a cause of the onset of infections because it acts as a bacterial reservoir and therefore as a vector of infection. Consequently, several methods for disinfecting and sterilizing the device have been evaluated.  

Conclusions  

It is recommended for infants to use the pacifier at night in the first year of life. However, the authors suggest this be avoided after the child reaches two years of age. Three years is considered the age limit of use beyond which it is necessary to stop the habit. Choosing an anatomically designed pacifier is useful for preventing the onset of malocclusions.  

It is important to carry out correct decontamination and disinfection maneuvers to decrease the surface bacterial load and prevent the development of infections.

This article was originally published in Dental Cadmos. 

doi: 10.19256/d.cadmos.04.2022.04