Pacifiers: The Dirty Truth, Bad Habits, and Bad Teeth

First pregnancies typically come with a lot of questions. Motherhood and pregnancy websites are filled with forum posts questioning one of the great debates of all new moms. “What are the pros and cons of using a pacifier?” The question is usually met with hundreds of responses from veteran moms who think they know it all on both sides of the issue. All moms want a bit of piece and quite now and then, but in this case the risks outweigh the reward. Pacifiers should not be given to babies because it elevates their risk for poor dental development, increases their risk for illness, and becomes an emotional comfort habit that can be traumatic to break.

According to Dr. De-Kun Li, a research scientist with Kaiser Permanente in Northern California, "A baby who sleeps on his stomach without a pacifier has a 2. 5 times greater risk of SIDS (sudden infant death syndrome). " Li interviewed 497 women, 185 of the women lost their babies to SIDS to reach his conclusion. Since Li, more studies have been done all resulting with the same conclusion, the only missing information from the studies is how pacifiers actually reduce the risk of SIDS. The risk of SIDS can be greatly reduced by following safe sleep practices such as placing baby to sleep on back on a firm flat surface. While pacifiers are listed on the Safe to Sleep campaign brochure, it is suggested not to attach the pacifier to a string, clothing, blanket, or stuffed toy. The pacifier can then become the risk factor for suffocation during sleep.

Besides reducing the risk of SIDS pediatricians often recommend pacifiers to premature babies in the NICU (neonatal intensive care unit). Babies born early often lack the ability to breath, suck, and swallow during feedings (Drewes). Pacifiers help these babies to develop the oral muscles necessary to feed. They are also more to likely gain weight faster than preemies not given pacifiers. While pacifiers are beneficial in helping premature infants thrive, most of the same pediatricians also recommend that healthy full-term babies are not introduced to a pacifier until after a month old and weaning between six months to a year old. Pacifiers given too early can cause nipple confusion and poor eating habits, while prolonged use leads to dental, health, and dependency issues.

Non-nutritive sucking (i. e. pacifier or thumb) changes the shape of the roof of the mouth, prevents proper growth of the mouth and causes problems with the alignment of the teeth. Long term pacifier use has been linked to causing malocclusion (imperfect positioning of the teeth) in toddlers ranging from 24-36 months. Posterior crossbites develop in young children between 18 months to five years old. A cross sectional study done in Brazil has shown children as young as 18 months with a posterior crossbite. The study analyzed 2, 750 children with posterior crossbites and concluded that 950 of the children or 34. 5% were pacifier users.

Anterior open bite is a more common malocclusion that can be caused by pacifier use. Researchers in Cava de' Tirreni, Italy conducted a study of 1, 000 preschool children ranging in ages three to five years old, they found that 89% of the children with anterior open bite were pacifier users or thumb suckers. Small children are twice as likely to have issues with the placement of their teeth.

The last dental issue that is a problem for pacifier users is cavities. It is always recommended to never dip pacifiers in sugar or honey to entice an infant, this adds to the risk of cavities. Pacifiers are porous harboring bacteria, fungus, and mold, if not cleaned properly they grow a slimy coating called biofilm. Besides causing cavities, bacteria on the pacifier can increase a baby's risk for illness. These bacteria can lead to oral yeast infections, also known as thrush, which can be hard to treat. Bacteria on the pacifier can also cause inflammation which can lead to cardiovascular disease, asthma, metabolic syndrome, and auto immune disease. Dr. Thomas Glass, a professor of forensic sciences, pathology, and dental medicine at Oklahoma State University conducted a study on 10 pacifiers with fellow researchers. Researchers found that of the 10 pacifiers tested five were lightly contaminated and five were heavily contaminated with 40 different cultures of bacteria. Four of the cultures found were different strains of staphylococcus which can cause illnesses ranging from mild to life threatening. These illnesses can be anything from acne to meningitis. Dr. Glass concludes “After doing the study, I say why take a risk? The key is to recognize that pacifiers can cause illness. In the long run, it may be that what you do now may have a lot to do with whether a child ends up developing atherosclerosis or type two diabetes”.

Babies as young as six months who use pacifiers are at an elevated risk for ear infections. Sucking on a pacifier causes the auditory tubes of the ear to become more open allowing secretion from the throat to drain down into the middle of the ear. Dr Marjo Niemela of Finland, where it is custom for children to have a pacifier until age 3, and a team of researchers concluded that by limiting pacifier use to just before bed parents can reduce their child's risk of ear infections by 29%. The study did not include how much the risk would decrease if pacifier use was stopped all together. When used properly pacifiers help babies soothe and build oral muscles to help feed correctly. For some parents the pacifier is no longer used to teach baby to eat or soothe baby to sleep. They begin to take advantage of the pacifier offering it at all signs of distress. This creates a dependency and teaches the baby that the pacifier is the only thing that can make them happy. Hunger cues, stomach aches, and bathroom issues might be missed and the pacifier becomes the go to for the crying baby. Once a baby or toddler is fully dependent on the pacifier it becomes a traumatic experience when it is time to start the weaning process.

The internet is full of different websites suggesting which ways work best when starting the weaning process. They all tend to suggest using the pacifier in moderation and then weaning slowly. This whole process can become a giant head ache for parents. By skipping pacifier use all together babies learn to recognize body and emotional cues and rely on their parents for comfort. Parenthood, especially new parenthood is complicated. New parents learn by scouring google and parenting sites, and a lot of trial and error.

The pacifier debate will always be a top question and concern for these parents. Besides reducing the risk for SIDS, which can be reduced by following sleep safe guidelines, and helping build oral development for premature babies', pacifiers are not worth the headache they cause. Prolonged pacifier use is linked to dental problems such as anterior open bite and posterior crossbite in infants as young as 18 months. The bacteria found on pacifiers can cause cavities as well as minor to severe infections. Pacifiers also become a bad habit. Babies and toddlers become dependent on the pacifier for emotional comfort, while parents rely on them to quiet a crying baby quickly. Weaning done at the recommended age of six months to avoid the risk of middle ear infections and the other dental and health complications associated with prolonged use can be a daunting process. It is easier to avoid pacifier use and the headache that comes with it all together.