Pacifiers have long been a source of comfort for infants, helping soothe fussiness and support self-regulation during early development. However, while pacifiers can offer short-term benefits, their prolonged use—especially beyond infancy—can have implications for craniofacial growth and oral development.
The Relationship Between Pacifiers and Craniofacial Growth
Craniofacial growth refers to the development of the bones and soft tissues of the head, face, and jaws. This process is especially sensitive in infants and young children, as their facial bones are still growing and highly adaptable. When non-nutritive sucking habits such as pacifier use persist for extended periods, they can influence the shape and function of developing oral structures.
Common dental and skeletal changes associated with prolonged pacifier use include:
- Narrowing of the upper jaw (maxillary constriction)
- Open bite (when the front teeth do not touch when the mouth is closed)
- Posterior crossbite
- Protrusion of upper front teeth
- Altered tongue posture and function
These effects are more likely to occur if pacifier use continues beyond 12–24 months, especially with consistent daytime use or forceful sucking habits.
Insights from the Study: “Forces Generated During Plush Animal Pacifier Use”
A 2020 pilot study titled “Forces Generated During Plush Animal Pacifier Use: A Pilot Study” (Kramer et al., 2020, The Cleft Palate-Craniofacial Journal) explored a newer trend in pacifiers—those attached to plush toys. These products are designed to help keep the pacifier in place by resting on the infant’s chest, offering comfort and easier self-replacement during sleep.
However, the study raised important concerns. Researchers measured the forces generated when these plush animal pacifiers were used and found that:
- The added weight of the plush toy increases the force exerted on the oral cavity. In fact, the forces recorded in some positions exceeded 0.4 Newtons (N)—a threshold considered sufficient to induce orthodontic tooth movement. This means that even passive use of the pacifier could potentially influence tooth positioning or alter the shape of the developing palate.
- These forces can be transmitted through the pacifier nipple to the developing palate and alveolar ridges.
- Depending on the infant’s head position and the size of the plush toy, extra downward and anterior pressure was observed, potentially impacting midfacial growth and jaw development.
The study highlights the importance of considering not just how long a pacifier is used, but also what kind of pacifier is used—and how its design might influence oral forces and craniofacial development.
Best Practices for Pacifier Use
Given what we know from clinical experience and emerging research like this study, here are a few evidence-informed recommendations for parents and caregivers:
- Limit pacifier use to the first year of life when possible. (Earlier the better)
- Avoid pacifiers with added weight or attachments, such as plush animals, particularly during sleep or extended daytime use.
- Monitor sucking patterns—children who use pacifiers aggressively or often may be at greater risk for developing bite issues.
- Wean gently between 6–12 months, ideally before permanent habits form and while craniofacial growth is still highly adaptable.
- Seek guidance from a pediatric dentist or orthodontist, especially if you notice bite changes, speech issues, or altered tongue movement.
Final Thoughts
Pacifiers can be useful tools during infancy, but like all tools, they come with trade-offs. With thoughtful use and timely weaning, the risk of long-term impact on facial development can be minimized. Plush pacifiers, though marketed for convenience and comfort, may unintentionally apply extra forces that interfere with natural growth patterns—something parents and pediatric providers should be aware of.
If you have questions about your child’s oral development or are concerned about their pacifier use, our office is here to help guide you with a personalized plan focused on healthy growth and development.
Pacifiers have long been a source of comfort for infants, helping soothe fussiness and support self-regulation during early development. However, while pacifiers can offer short-term benefits, their prolonged use—especially beyond infancy—can have implications for craniofacial growth and oral development.