Pacifiers: A spectrum of views

The issue gives local medical experts lots to chew on

A pacifier provides some benefits other than keeping a baby happy and quiet, but continued or incorrect use can cause oral health problems, family dentists in Durango say.

A rule of thumb is to take a baby off a pacifier by age 2.

Angela Pinkerton at Durango Kids, the only board-certified pediatric dentist in Durango, said the Academy of Pediatric Dentistry recommends a much shorter period of pacifier use.

“The academy recommends that non-nutritive sucking should stop at 14 to 16 months,” Pinkerton said. “If the habit goes beyond that age, it can affect bone development and tooth problems.”

Joseph Baumgart provides service for Southwest Smilemakers, a San Juan Basin Health Department-sponsored dental clinic for low-income, CHIP+ and Medicaid patients.

“The earlier the better to stop pacifier use or finger sucking,” said Baumgart who, between examinations and corrective work, sees 10 to 20 patients a day.

Prolonged use of a pacifier can cause crowding of teeth and what is called open bite, he said. This occurs when certain opposing teeth aren’t positioned correctly when the jaws are closed, he said.

The Academy of General Dentistry says a pacifier offers comfort to infants.

An academy newsletter cites an authority who says another positive effect of pacifier use is the reduction in sudden infant death syndrome, or SIDS, the unexpected, inexplicable death of a child, most likely between 2 and 4 months old.

The hypothesis is that babies who use a pacifier sleep less deeply than those who don’t, so they arouse more easily if the body detects a problem such as the buildup of carbon dioxide in the blood.

But potential problems loom from sucking on a pacifier, dentists say.

There is an association of pacifier use with acute middle-ear infection because sucking can open the auditory tubes, allowing secretions from the throat to migrate to the middle ear.

Pacifiers can be used up to 2 years of age because incipient bone or teeth misalignment can self-correct within six months of giving up the pacifier.

But longer use can lead to problems with the growth and shape of the mouth and alignment of teeth.

Prolonged use of pacifiers or thumb-sucking can result in tooth crowding, tongue thrusting – the protrusion of the tongue between the front teeth while swallowing or talking – and speech impediments.

Snipping the nipple on a pacifier decreases the sucking satisfaction, Pinkerton said. This is an effective way to end pacifier use, she said.