Thumb sucking and Long Term Pacifier Usage in Children
Thumb sucking and extended pacifier use in children can lead to what is known as an open bite. This is when the top and bottom front teeth each flare out, resulting in the patient to be unable to properly bite down. This leaves the child with difficulties eating, as it is challenging to bite into food, and will require orthodontic intervention and possibly myofunctional therapy to correct.
Thumb Sucking: A Comforting Habit with Long-Term Consequences
By Misty Pettit, RDH & Mom of Two
As a dental hygienist and mom, I know firsthand how comforting thumb sucking, pacifiers, and bottles can be for our little ones. These habits often start as natural reflexes, helping babies feel secure, calm, and ready for sleep. But what many parents don’t realize is that when these habits linger beyond the early years, they can quietly interfere with proper oral and facial development—and even impact how our kids breathe, sleep, and eat.
Thumb sucking isn’t “bad” in itself—it’s totally normal in infants and toddlers. But problems begin when it continues past age 2–3, especially if the sucking is frequent or intense. The pressure from the thumb (or pacifier or bottle nipple) on the developing palate can narrow the upper jaw, push teeth out of alignment, and contribute to an open bite—a condition where the front teeth don’t come together properly (see image above).
These changes don’t just affect the appearance of a child’s smile. They can also create bigger challenges as they grow. A narrow palate can restrict the airway, making it harder for kids to breathe through their nose—especially during sleep. This often leads to mouth breathing, snoring, restless sleep, and even signs of fatigue or attention struggles during the day.
As a mom, I completely understand wanting to soothe a fussy toddler or make bedtime smoother. I’ve used pacifiers myself in those early months! But from a clinical perspective, it’s important to be mindful of when to begin weaning. Prolonged bottle use beyond 12–18 months, especially overnight, can also affect oral development and increase the risk of cavities due to prolonged exposure to milk or juice sugars.
Thumb sucking and pacifier habits can also interfere with proper tongue posture and swallowing patterns. Instead of resting against the roof of the mouth, the tongue may stay low in the mouth, contributing to speech delays, open mouth posture, and even difficulty chewing food efficiently.
If you’re worried your child is still sucking their thumb or using a pacifier after age 3, don’t panic—but do take it as a sign to start helping them transition. Gentle encouragement, positive reinforcement, and distraction techniques can be powerful tools. Some kids also benefit from working with a myofunctional therapist who can help correct oral habits and restore healthy muscle function. If you are interested in a recommendation, search @MyobyMP on instagram. (Fun fact- she’s my sister in law and also a Dental Hygienist).
It’s never too early to pay attention to your child’s oral habits and breathing patterns. Early awareness leads to early intervention, which can prevent years of orthodontic treatment or complications down the line. Trust your instincts as a parent—if something feels “off,” it’s worth getting it checked.
Whether you're at the bottle-weaning stage or trying to curb a thumb habit, you’re not alone. I’ve walked this journey with both my children—and countless patients—and I’m always here to support families who want the best for their little ones’ health and development.