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This question has troubled both parents and pediatricians and pediatric dentists.

Finger and pacifier sucking are the most common oral habits of infancy and early childhood.

In some cases, finger sucking has been detected in utero by ultrasound. Pacifier use or finger sucking is considered completely normal for infants and toddlers as it provides them with a sense of security and calm. Continuing beyond the age of 4 can lead to orthodontic abnormalities.

The most common effects come from the combination of pressure exerted on the upper and lower jaw teeth by both the finger and the pacifier.

The most common effects are cleft lip and cleft palate of the upper teeth and lingual cleft of the lower teeth depending on the position of the thumb during finger sucking or a symmetrical or asymmetrical gap in the teeth if the child sucks a pacifier for a long time.

Pacifier use – The pros and cons

The percentage of infants who use a pacifier is 65-80% in developed countries. The main negative consequences are as follows:

• Increased frequency of chasmodontia.
• Increased frequency of posterior crossbite.
• Increased frequency of acute otitis media episodes.
• Increased frequency of respiratory and gastrointestinal infections.
• Colonization of the oral cavity by Candida albicans.
• Undermining and reduction of breastfeeding time.
• Speech delay due to reduced interest in environmental stimuli.

However, it has been found that the use of a pacifier protects against sudden infant death syndrome.

Instructions for the correct purchase and use of a pacifier

• The pacifier should be a single piece with a soft nipple and a disc diameter of >3 cm.
• The pacifier should have a ring at the end so that it can be removed from the infant-toddler in one motion.
• The size of the pacifier should be such that it does not fit entirely in the child’s mouth.
• The pacifier should only be given to the infant when a meal has been given and we are sure that he is not hungry.
• Pure rubber pacifiers should be preferred over silicone pacifiers, because the previous generation of silicone pacifiers had a chance of breaking in the mouth. For the same reason, the bottle nipple should not be offered to the infant instead of a pacifier.
• The protective shield must have an appropriate curvature to fit satisfactorily in the lip area and have many large ventilation holes, so that the skin around the lips is not irritated by saliva.
• The pacifier must be manufactured in such a way that it is completely impossible for a child to disassemble it.
• Supporting the pacifier with a ribbon around the baby’s neck is strictly prohibited, because there is a serious risk of choking.
• The use of both the pacifier and the habit of sucking with a finger should stop before the age of 4. This way, any deformations of the teeth or jaws will have time to correct themselves with time and the child’s development. On the contrary, if this habit continues after the 4th year, as often happens with thumb sucking, the deformities risk becoming permanent and difficult to repair.