Thumb, Finger and Pacifier Habits

Q: Why do children suck on fingers, pacifiers or other objects?
A: This type of sucking is completely normal for babies and young children. It provides security. For young babies, it's a way to make contact with and learn about the world. In fact, babies begin to suck on their fingers or thumbs even before they are born.

Q: Are these habits bad for the teeth and jaws?
A: Most children stop sucking on thumbs, pacifiers or other objects on their own between two and four years of age. No harm is done to their teeth or jaws. However, some children repeatedly suck on a finger, pacifier or other object over long periods of time. In these children, the upper front teeth may tip toward the lip or not come in properly.

Q: When should I worry about a sucking habit?
A: Your pediatric dentist will carefully watch the way your child's teeth come in and jaws develop, keeping the sucking habit in mind at all times. For most children the AAPD recommends encouraging these habits cease by age three.

Q: What can I do to stop my child's habit?
A: Most children stop sucking habits on their own, but some children need the help of their parents and their pediatric dentist. When your child is old enough to understand the possible results of a sucking habit, your pediatric dentist can encourage your child to stop, as well as talk about what happens to the teeth if your child doesn't stop. This advice, coupled with support from parents, helps most children quit. If this approach doesn't work, your pediatric dentist may recommend a mouth appliance that blocks sucking habits.

Q: Are pacifiers a safer habit for the teeth than thumbs or fingers?
A: Thumb, finger and pacifier sucking all affect the teeth essentially the same way. However, a pacifier habit is often easier to break.

Here are what some specialists say about pacifier use;

Dr. Michael Cabana,
chief of General Pediatrics at UCSF Children's Hospital
"There are potential benefits and potential pitfalls. On the plus side, pacifier use during sleep has been associated with a decreased risk of Sudden Infant Death Syndrome (SIDS). SIDS is most likely to occur in the first year of life. But the pacifier use does not guarantee that SIDS will not occur. The most important thing to prevent SIDS is to place babies to sleep on their back. On the negative side regarding pacifiers, their use may cause 'nipple confusion' and thus make breastfeeding less successful, but the evidence for this phenomenon is not strong. Some health care providers discourage the use of pacifiers for the first few weeks of life, until breastfeeding is firmly established. Prolonged use of pacifiers (for example, older children still using pacifiers) is associated with orthodontic issues (for example, crooked teeth that later require braces)."

Dr. Janet Stafford,
pediatrician at Kaiser Permanent San Francisco
"Every baby is unique. Every baby has a different neurological path of comfort. Some babies are extremely oral. They're born that way. They're satisfied when there's something in their mouth, a finger, a thumb, a nipple, a pacifier. If a pacifier is what satisfies that need, then I think it's OK to use one. But if a parent uses it rather than rocking or holding a baby, I would prefer the other. I advise most parents to edge their baby off the pacifier before the child turns 1-year-old. When you take the pacifier away, you can use your index finger to make little circles on the baby's cheek to help relax them. For older kids over 1 year old, I recommend a goodbye pacifier party where the child picks out wrapping paper and ribbon and wraps up the pacifier and throws it away saying it's going to another baby who needs it."

Dr. Janesta Noland,
a pediatrician at Burgess Pediatrics in Menlo Park
"I tell my patients they shouldn't use one. I'm a proponent for breastfeeding and I think there's a lot to be said for natural sucking and self-soothing. For my patients who do use them after breast-feeding is established, I say that at 6 months it really should only be used for sleep. At 12 months my recommendation is to give it up cold turkey."

Staci Sampo,
a lactation consultant at the John Muir Women's Health Center in Walnut Creek
"If the parents can avoid it, I tell them not to use it. Sometimes the pacifier satisfies the baby's need for sucking and so the baby isn't interested in breast-feeding and then loses weight. Often babies who are feeding well won't even take a pacifier. But if a mom can't stand to listen to her baby while she's driving then I say OK."

Dr. Thuan Le,
an assistant adjunct professor in UCSF's Division of Pediatric Dentistry
"I have no problem with the pacifier up until 2 years. After two years, the child is going to experience some skeletal and dental problems. If you quit before age 3, it will likely self-correct. But after 3 or 4 years the child will likely have permanent damage that might require orthodontic surgery."

Dr. Alan Greene,
a clinical professor in pediatrics at Standford's Lucile Packard Children's Hospital
"If a child is getting a lot of ear infections the first thing I would try--before antibiotics--is eliminating the pacifier. Studies have shown that pacifier use can increase the frequency of ear infections by as much as 50 percent, but only one-third of kids get ear infections and some of those kids use pacifiers and some don't."