Misaligned Teeth and More Caused by Pacifiers?
An Interview on the Topic with Dr. Bettina Brem
The pacifier is an important source of comfort in everyday life, but prolonged use can leave its mark. From jaw misalignments to effects on speech development – the risks to dental health are varied. But at what point does sucking become critical, and how can you achieve a gentle farewell? In our interview, Dr. Brem answers the most important questions and explains what parents should look out for to promote a healthy child's smile.
Dr. Brem, many parents wonder if pacifiers are fundamentally harmful to oral development. What is your perspective from a dental point of view?
A pacifier is not harmful per se – on the contrary, it can even be helpful during the first few months of life. Sucking has a calming effect on babies and is a natural reflex that provides a sense of security. However, it becomes problematic if the pacifier is used too frequently, for too long, or beyond the second birthday. At that point, it can influence the development of the jaw, teeth, and musculature – and can lead to incorrect swallowing patterns in the long term.
What exactly is meant by an „incorrect swallowing pattern“?
An incorrect swallowing pattern means that when swallowing, the tongue pushes too far forward or against the teeth instead of against the roof of the mouth. This is often a result of prolonged or intense pacifier use, thumb sucking, or bottle feeding. Normally, the tongue should press against the palate while swallowing to move food toward the throat. If this pattern is not learned correctly, it can contribute to long-term dental misalignment, open bites, or speech problems.
How exactly does the connection between pacifiers and an incorrect swallowing pattern occur?
When a child regularly sucks on a pacifier over a long period, the tongue becomes accustomed to a specific position – usually low in the mouth and pointing forward. This position often persists even during eating, drinking, or speaking. As a result, the proper coordination of the lips, tongue, and chewing muscles is disrupted. The tongue 'learns,' so to speak, a faulty movement pattern. If this pattern remains, it is referred to as a myofunctional imbalance, which can affect the entire range of oral motor skills.
What consequences can an incorrect swallowing pattern have for dental health and development?
The most common consequence is what is known as an open bite – this means that the upper and lower front teeth do not touch when the mouth is closed. This can lead to chewing difficulties, and the child may have trouble biting into food or masticating properly. Additionally, an incorrect swallowing pattern can contribute to speech development issues because certain sounds like 's,' 'z,' or 'sh' cannot be formed correctly. Nasal breathing is also often compromised if children habitually breathe through their mouths.
That sounds like great reasons to wean a child off the pacifier in time. However, for many children, that isn't easy at all – what do you advise parents?
That’s true; saying goodbye to the pacifier is often emotional – for both children and parents. That is why positive rituals, which turn the moment into something special, are so helpful. A wonderful option is the 'Pacifier Fairy': the child 'gifts' their pacifier to the fairy, who picks it up at night and leaves a small surprise in return. This allows the farewell to be experienced in a playful and loving way, rather than as a loss.
Iou have the „Lachzahn Pacifier Fairy“ at your practice. What is that all about?
Yes, that is a special highlight for us! To make the farewell even easier for the children, we regularly invite our Lachzahn Pacifier Fairy to the practice. She arrives in a long dress with wings and accepts the pacifiers in person. The children can ceremoniously hand over their pacifiers and receive a small teddy bear as a keepsake in return. This encounter is a magical moment for many children – and often very moving for parents to watch. To help us organize the visit, we ask for prior registration. This ensures we can give each child enough time and attention.
Do you have tips on how parents can make pacifier weaning easier?
Yes, it is crucial that weaning takes place during a calm phase of life – not, for instance, when a new sibling is born or when starting daycare. Parents should lovingly prepare their child and explain why the pacifier is now 'ready to go.' Rituals are very helpful: a small farewell letter to the Pacifier Fairy, a fixed date, or choosing a farewell gift makes the process tangible. It is important to remain consistent, but without pressure or punishment. Usually, the parting happens surprisingly quickly – and the children are very proud of themselves afterward.
What can parents do if they suspect their child has already developed an incorrect swallowing pattern?
In this case, you should first visit a pediatric dentist or a speech therapist. A thorough examination will show whether a myofunctional disorder is actually present. If so, targeted myofunctional exercises help to train the tongue and lip muscles and regain the correct swallowing pattern. When detected early, it can usually be corrected very well – the earlier, the better!
Finally, do you have a tip on how parents can maintain a good balance between pacifier use and dental development?
A pacifier is allowed to provide comfort, soothe, and help with falling asleep – however, the important thing is to use it mindfully and in moderation. It should not be a constant companion, but rather used specifically in moments when your child truly needs comfort.
Make sure to choose an orthodontic, flat pacifier with a soft nipple and replace it regularly. Even more important, however, is giving your child plenty of opportunities for free speech, chewing, and drinking from a cup – this naturally trains the tongue and lip muscles. A pacifier can certainly be a faithful helper in the first years of life, provided parents pay attention to the duration and frequency of use. Through mindful usage, you support your child's healthy jaw development and prevent incorrect swallowing patterns early on.
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