Breathing properly when a child is asleep is essential to their well-being, healthy brain function and behavior. When a child sleeps the healthiest natural positioning to create the most competent airway is nasal breathing, with the lips together and the tongue in the roof of the mouth.
Conventional pacifiers, clinically termed, “non-nutritive sucking devices”, are in reality silicone or latex nipple substitutes. Sucking seems to give an awake baby a sense of warmth, well-being and comfort. Children who are bottle fed and those not given unrestricted breast feeding use the pacifier to satisfy these instinctive needs. Kids retain the pacifier in the mouth by creating suction. Pacifier users are nose breathers. Mouth breathing children need an open mouth to breathe. They repeatedly spit out the pacifier. Pacifiers are held in a baby’s mouth in a nursing posture. The artificial nipple is positioned against the roof of the mouth and the tongue placed under the nipple in the floor of the mouth. Infants are often put to bed with a conventional pacifier in their mouth. While the nursing posture may work fine for daytime sucking and swallowing, it is a compromised position for sleep breathing because the presence of the tongue in the floor of the mouth reduces airway patency.
When a conventional pacifier is in the child’s mouth, the tongue is pushed back into a more posterior position. Normally the tongue rests on the palate. With an ever present pacifier, the developing teeth in the anterior and canine area have the pressure of the lips and cheeks sucking in and lack the counter balance of the tongue pressing up and out. This imbalance can result in reduced anterior arch width if the pacifier use continues beyond two or possibly three years of age. Children having prolonged non nutritive sucking have twice the risk of malocclusion as those who stop early. Pacifier use beyond the age of 2 can cause changes in the permanent teeth.
These children are probably too old to still use a pacifier.