If your toddler still can’t fall asleep without a pacifier, you have probably been given several deadlines already. Your mother says six months. A friend says two years.

I know you are probably confused. And the confusion is fair, because each age you hear is tied to a different risk. This guide explains those risks, when your child should stop, and how to wean them without a fight. 

From a medical standpoint, aim to stop between 6 months and 18 months. Cut back daytime use from about six months and keep the pacifier for sleep only after the first birthday.

The American Academy of Pediatric Dentistry (AAPD) recommends ending pacifier and other sucking habits by 36 months.

Why You Keep Hearing Different Ages

Each age comes from a different risk. Ear infections come first. Changes to your child’s bite begin around 18 months and become harder to reverse after age 3. To help you understand what happens at every age, see the table below:

Age	What changes	What to do
0 – 6 months	Offered at sleep time. Can reduce the risk of sudden infant death syndrome (SIDS).	Fine to use, especially at sleep. Never force it when refused.
6 – 12 months	Pacifier use raises the risk of ear infections.	Start reducing daytime use.
12 – 18 months	The ear infection risk continues, and the canine teeth arrive around 18 months.	Keep it for sleep only and plan the full stop.
18 months–3 years	The longer the habit lasts, the more likely an open bite or crossbite becomes.	Wean fully. Most open bites improve if the habit ends before age 3.
Over 3 years	Bite changes are more likely to stay.	Book a dental check.

You must know that pacifiers are not your baby’s enemy. In the early months, a pacifier soothes a crying baby, and the American Academy of Pediatrics recommends it. Offering it at sleep time is ideal because it is linked to a lower risk of SIDS.

It can also stop a baby from taking up thumb-sucking. This is harder to break because you can’t take a thumb away. The goal is to wind it down on a sensible timeline, not to snatch it on the first birthday.

What long-term pacifier use does to your child’s teeth

When babies are given birth to, their bodies are generally very soft, and this is also the case with their mouth. Your child’s jaw is soft and growing fast.

The teeth and the roof of the mouth shape themselves around anything that sits between them for hours a day. The two main changes are:

• Open bite. The upper and lower front teeth don’t meet when your child bites down. It is significantly more common in children who use a pacifier for 36 months or longer.
• Crossbite. The upper back teeth close inside the lower ones, often because the roof of the mouth has become narrow.

How long the habit lasts matters more than how often it is used each day.

The good news is that an open bite caused by a pacifier usually improves once the pacifier stops before age 3. Bite problems left to settle can lead to crooked teeth and orthodontic treatment later.

Other Risks That Come with Using a Pacifier

As mentioned earlier, a pacifier doesn’t just affect the dentition. It has been medically proven that the prolonged use of a pacifier can lead to ear infections, germs, and stomach upsets.

1. Ear infections

Pacifier use is a known risk factor for middle-ear infections. Cutting back or stopping in the second half of the first year reduces them.

2. Germs and stomach upsets

Pacifiers collect germs and are linked to oral thrush. In an Ibadan study, almost half of children under two had a sucking habit, and their mothers reported diarrhoea more often.

Signs That Pacifier is Affecting Your Child’s Teeth

There is a simple test you can conduct with your child to know if the pacifier is already affecting him/her. Just ask your child to bite together on their back teeth and smile. Look for:

• a gap between the upper and lower front teeth
• upper front teeth that stick out further than you would expect
• a lower jaw that slides to one side as the mouth closes
• upper teeth that look narrow compared with the lower teeth

If you notice any of these, then you know the pacifier is already affecting your baby. You must stop immediately. If you are not sure, or still have concerns, then you should visit a dentist.

How Do You Wean Your Child Off a Pacifier Without a Fight

I’ve been there. And I understand the fight babies can pull up when they don’t get their pacifier. Surprisingly, many parents reach for punishment. But it tends to backfire.

The AAPD advises praise and rewards instead, because power struggles can make the habit last longer.

1. Pick a calm time. Avoid starting around a new baby, a house move, travel, or a new crèche.
2. Cut daytime use first. Keep the pacifier for naps and bedtime only, and leave it in the cot.
3. Offer a new comfort. For children over one, a soft toy or small blanket can take over at bedtime. Babies under one should sleep with nothing soft in the cot.
4. Make a goodbye moment. Let older toddlers trade the pacifier for a toy they choose.
5. Stay consistent. Expect a few difficult days and nights. Then get rid of every pacifier in the house.

When to take your child to the dentist

The AAPD recommends that every child has a regular dentist by their first birthday, the best time to get advice on pacifiers. Book a check sooner if your child is past 3 and still uses a pacifier or sucks their thumb, or if you have spotted any of the signs above.

If it’s your child’s first visit, here is what to expect at a first dental appointment. At Dr. Reach Dental Clinic, a children’s dental check-up includes a full tooth-by-tooth examination, a bite assessment, cleaning and fluoride where suitable, and practical habit-breaking advice

If your child already has an open bite or crossbite, we can tell you whether it is likely to correct itself or needs an orthodontic assessment.

We see children at our Ikeja clinic on Opebi Road and our Yaba clinic on Hughes Avenue. You can book your children’s check-uptoday!

Frequently asked questions