Toddlers' Pacifier Type
Won't Halt Dental Problems
Excerpt By Stephanie Riesenman, Reuters Health

NEW YORK (Reuters Health) - Pacifiers sold as "orthodontic" are no better than traditional pacifiers when it comes to warding off dental problems in children who continue a sucking habit beyond the age of three, say researchers in Brazil.

"It's very common for a child to suck on a pacifier; it's almost a universal habit, but by 24 to 28 months the majority have stopped, and those who continue might develop dental problems," Dr. John Warren of the University of Iowa said in an interview with Reuters Health. Warren, who was not involved in the study, is an assistant professor in the dental school and has conducted similar studies.

In the study of 61 Brazilian preschool children, who were three to five years old, the habitual pacifier suckers had a higher prevalence of altered dental arches and abnormal lip and cheek mobility compared to toddlers who never sucked on a pacifier. There was no benefit for kids who used an orthodontically designed pacifier, which has a concave nipple designed to simulate the shape of a mother's nipple, rather than a traditional round pacifier.

Some studies have shown that children who suck on orthodontic pacifiers have a smaller chance of developing an overbite than those who use conventional round pacifiers. A spokesperson for Gerber, one of the companies that sells orthodontic pacifiers, said that the pacifier was "designed to simulate the form and function of a mother's breast nipples while feeding," but made no claims about the pacifier's ability to prevent an overbite.

The Brazilian study, conducted by Dr. Cristina Giovannetti del Conte Zardetto and colleagues at the University of Sao Paulo, was the first to compare children who had exclusively used either an orthodontic pacifier or a traditional pacifier. Any child who had ever sucked their fingers or thumbs was excluded from the study.

Mothers were provided with questionnaires to assess their child's pacifier use. The survey did not address pacifier size or the number of hours a day that it was in a child's mouth. A single examiner was brought in to measure and describe the children's dental arches and bite. A speech therapist examined the physical structure of the mouth and had the children perform different exercises to verify lip, cheek and tongue mobility, according to the report in the journal Pediatric Dentistry.

Warren said the action of sucking on a pacifier, whether it's an orthodontic design or traditional model, draws a child's cheek muscles tighter, which inhibits the growth and width of the upper jaw. A pacifier also tends to push a child's tongue down into the lower jaw, so they end up with a cross-bite, or a wider than normal arch between the bottom teeth.

Oversized dental arches are usually reversible if the child stops sucking on a pacifier, said Warren, but the longer they put something in their mouth the less likely the problems will resolve. If a child stops using a pacifier at the age of two, Warren said their dental arches will usually go back to normal.

"Probably about a year of age is when parents should start to wean them off," said Warren. "Somewhere between their first and second birthdays would be ideal."

Many dentists recommend that parents pick a target date for their child to get rid of a pacifier. Warren says it shouldn't be a birthday or major holiday, but make it an important day for the child, and stick to the deadline. He said the older a child becomes, the harder it is to break the pacifier habit.

SOURCE: Pediatric Dentistry 2002;24:552-559.

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