Pacifier Use: Information for Parents
The American Academy of Pediatric Dentistry (AAPD) recognizes that pacifiers can provide benefits during infancy, but prolonged use may affect a child's developing teeth and jaws.
Benefits of Pacifier Use
During infancy, pacifiers may:
Provide comfort and help soothe an infant.
Help premature infants develop their sucking reflex.
Provide a pain-relieving effect during some minor medical procedures.
Reduce the risk of Sudden Infant Death Syndrome (SIDS) when used during sleep in infancy.
Help prevent development of a persistent finger- or thumb-sucking habit. A pacifier is generally easier for parents to discontinue than a finger- or thumb-sucking habit.
When Should Pacifier Use Be Discontinued?
The AAPD recommends that parents work toward discontinuing pacifier and other nonnutritive sucking habits by 36 months of age.
There are good reasons to begin reducing pacifier use well before age three:
Pacifier use after 12 months of age may increase the risk of acute ear infections.
Pacifier use beyond approximately 18 months can begin to affect development of the teeth and jaws.
Prolonged use can contribute to dental problems such as an anterior open bite, posterior crossbite, and other changes in the child's bite.
Some dental changes associated with pacifier use may improve after the habit is discontinued, particularly when the pacifier is stopped before age three.
For a child who continues to use a pacifier, parents may find it helpful to gradually limit its use—for example, initially restricting it to naps and bedtime—and work toward complete discontinuation.
Pacifiers and Speech
Research has not established a strong relationship between ordinary pacifier use and speech problems. However, prolonged and frequent daytime pacifier use may interfere with opportunities for a young child to talk, practice sounds, and interact verbally. Limiting pacifier use as a child gets older is therefore reasonable.
Pacifier Safety
Parents should:
Choose a pacifier with a firm shield that is at least 1.5 inches across and has ventilation holes.
Consider a one-piece pacifier, which is less likely to break apart and become a choking hazard.
Never attach a pacifier to a child's neck, clothing, crib, or other object with a cord, ribbon, or strap that could create a strangulation hazard.
Regularly inspect pacifiers and replace them if they become cracked, torn, damaged, or excessively worn.
Never dip a pacifier in honey, sugar, syrup, or another sweet substance.
Never give an infant or young child a pacifier containing or filled with honey.
"Orthodontic" Pacifiers
Pacifiers marketed as "orthodontic" may differ in shape from conventional pacifiers, but no pacifier should be considered harmless to the developing bite when used for a prolonged period. How long and how frequently a child uses a pacifier are important considerations.
Helping Your Child Give Up the Pacifier
When it is time to discontinue pacifier use, encouragement and positive reinforcement are preferable to criticism, teasing, punishment, or creating a struggle over the pacifier.
Parents can gradually reduce when and where the pacifier is used, offer other forms of comfort, and praise the child for periods of time without it.
Regular Dental Care
The AAPD recommends establishing a dental home by 12 months of age. A pediatric dentist can monitor your child's oral development and provide individualized advice about pacifier or thumb-sucking habits.
Parents who have concerns about pacifier use, thumb or finger sucking, their child's bite, or other aspects of oral development should discuss them with their child's pediatric dentist.
Source: American Academy of Pediatric Dentistry (AAPD), Policy on Pacifiers, revised 2024.