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Let’s Talk Pacifiers and Thumb Sucking with Dr. Adena Borodkin of Golden Valley Kids Pediatric Dentistry in Golden Valley, MN

Thumb sucking and pacifier use is one of the most common concerns we hear at the office, so we thought we’d take some time to put the parents of Golden Valley’s minds at ease. Thumb sucking and using a pacifier is totally normal up to a certain age, and usually goes away by itself as your child begins to eat solid foods. Let’s discuss why children suck their thumbs and use pacifiers, and when it becomes a cause for concern.

When babies are breast or bottle feeding, their tongue moves forward between the space in their upper and lower jaw as they swallow so that a seal is created with their mouth, and milk comes out of the nipple. Thumb sucking and using a pacifier can be soothing to babies because it mimics that movement and (hopefully) allows your child to self soothe. Some babies even suck their thumbs or fingers in the womb!

What happens when thumb sucking and pacifier use goes on too long? If thumb sucking and pacifier use goes on too long, teeth and jaw development can be impacted. Kids can develop an ‘open bite’ which means that there will be a space between the upper and lower front teeth when the jaw is closed. The upper teeth can also be pushed outward when fingers and thumbs are in the mouth past age 3 or 4, making incisors more prone to injury. The roof of the mouth (palatal vault) can also be impacted. The upward pressure on the palate causes a narrowing of the upper arch. Rest assured, when children quit their habit completely, the positioning of the front teeth does improve slightly.

When to stop: As with most child related topics, there are a WHOLE lot of opinions on when you should stop using a pacifier and thumb/finger sucking. Generally, kids will stop on their own as they eat more and more solid foods. Sucking will no longer provide comfort when they’re breastfeeding or bottle feeding less. From a dental standpoint, quitting prior to losing the first baby tooth is imperative. Young permanent teeth are easily pushed outward by thumb pressure resulting in the need for orthodontic correction. If your kiddo does not stop on their own, Dr. Borodkin recommends that you start the process at around age two and a half or 3 if your child has not stopped on their own. We want to be sure to emphasize the word START in the previous sentence. This is something (unlike potty training; don’t even get us started) that you can take your time with.

How to stop: Keep in mind that if you start around age 2, you have plenty of time to stop by the age 4 ‘hard stop’ recommended by the American Academy of Pediatric Dentistry. Start slowly by trying to eliminate pacifier use or thumb sucking for certain times during the day; during waking hours only. Slowly increase the amount of time your kiddo is going without. Use gentle reminders if you notice them sucking their thumbs or fingers during the times you’ve designated. Be sure to give lots of praise when you notice your kids aren’t using a pacifier or sucking their fingers/thumb. When it comes time to eliminate the behavior at nap or bedtime, involve your child in choosing a new comfort. Pick out a special stuffed animal, or have a new blanket made for them that is only used at sleep time. If they’re old enough, you can also use a reward/star chart! We’ve also heard of parents using a ‘binkie fairy’ to make the final leap into no more pacifier use. Kids put their pacifiers in a bag and tie the bag to a tree outside before they go to bed. When they wake up, they’ll find that the binkie fairy left a toy for them in exchange for the pacifiers. For thumb sucking at night, reminders are often needed to effectively stop the habit completely. Products like bitter nail polish can be enough of a gentle reminder to find another way to self soothe, besides finger/thumb sucking. Sometimes, creating a goal to quit by an important milestone (such as the 3rd birthday), can empower a child to give up their habit as they become a ‘big kid’.

As always, call us or visit the office if you would like to discuss further!