Pacifier-Related Open Bite: Signs and What to Do at Home
A pacifier-related open bite often improves when the habit is stopped in time, but it needs a pediatric dental assessment if the gap between the teeth persists or the child places their tongue between them. An open bite in children is a malocclusion in which the upper and lower teeth do not meet when the mouth closes. A pacifier alone does not determine the outcome, as duration, intensity and age also play a role.
In summary
- First reduce pacifier use during the day while keeping a calm bedtime routine.
- Do not shame your child or take the pacifier away during an illness or family change.
- Look for a gap when the mouth closes, a forward-positioned tongue or difficulty biting.
- Consult a pediatric dentist if the change persists or you have concerns.
What is an open bite in children and why does it happen?
An open bite in children occurs when some teeth do not touch when the mouth closes. Frequent pacifier use may contribute, especially when it takes up many hours of the day and continues for several years. However, tongue position, swallowing patterns, breathing and other oral habits also play a role.
Non-nutritive sucking habits and the teeth
Non-nutritive sucking includes sucking a pacifier, finger or another object without receiving food. When a child keeps doing this for long periods, repeated pressure can change the way the tongue and teeth rest.
Therefore, it is not enough to count how many months a child has used a pacifier. A pacifier-related malocclusion also depends on frequency, intensity and time of day. A pacifier-related malocclusion may improve when the habit is reduced, although progress varies from one child to another.
Signs of a bite problem
A bite problem may appear as a gap between the upper and lower front teeth when the child closes their mouth. You may also notice that they place their tongue in the gap, bite with their side teeth or avoid certain foods.
Other bite problems are not always easy to see in a photograph. If your child habitually breathes through their mouth, snores or has difficulty closing their lips, it is worth discussing this with their pediatrician and an oral health professional.
Pacifier-related open bite: when to take action
It is worth taking action when the pacifier is used for many calming, play and travel situations, not just sleep. A pacifier-related open bite calls for calm observation, because taking the object away without preparing the child may increase tantrums and shift the habit to thumb-sucking.
An example at 22 months
Imagine a 22-month-old girl who uses her pacifier while sleeping, in the car and while playing at home. For ten days, her family reserves it for naps and nighttime, offers water and a cuddle when she wakes up, and keeps the pacifiers in one fixed place. This helps her anticipate the change without being told that her teeth are wrong.
How things change with age
At 18 months, many children still need physical and verbal support to regulate themselves. At 30 months, they can often take part more successfully in a simple, repeated decision. In both cases, the family should look at the child’s overall development, not just their teeth. Withdrawal also works better when all adults respond in the same way.
How to stop pacifier use without turning it into a battle
Stopping pacifier use works best as a predictable, brief and respectful process. The goal is not to win a battle, but to help the child find other ways to rest and feel comforted.
- Observe for three days. Note when your child asks for it, what happened beforehand and what they really need. This helps you distinguish sleepiness, boredom, pain or a need for connection.
- Reduce one specific situation. Start with car rides or play at home while keeping the sleep routine for a few days.
- Offer one consistent alternative. You could sit nearby, sing a short song, read a story or cuddle your child. Do not offer five different options.
- Prepare your child for the next change. Use a simple phrase such as, “The pacifier sleeps in its box during the day.” Repeat the same phrase calmly.
A practical scene at 30 months
A 30-month-old child asks for the pacifier every afternoon after returning from school. The family decides to remove it during that hour for one week. When the child arrives, they offer a snack, ten minutes of play with an adult and then a quiet activity. If the child protests, they acknowledge the upset and maintain the limit without negotiating every minute.
The common mistake and the solution
When to seek a professional assessment
A professional assessment is helpful when the gap remains when the mouth closes, the tongue pushes forward or the child has difficulty biting. If the pacifier-related open bite continues after the habit has stopped, arrange a review with a pediatric dentist. The professional can monitor development and decide whether follow-up is needed.
Also seek advice if your child breathes through their mouth, snores frequently, has discomfort or struggles to eat. For general pediatric guidance on pacifiers and children’s health, you can consult the resources from the American Academy of Pediatrics. Oral health benefits from coordinated attention from the family, pediatrician and dental team.
Independence and support from a Montessori perspective
From a Montessori perspective, the adult prepares the environment and supports the move towards greater independence without shaming the child. The Association Montessori Internationale provides general information about the Montessori principles that inspire this approach. At home, one fixed box, a repeated phrase and a short routine are more helpful than lengthy explanations.
Frequently asked questions
Can a pacifier-related open bite correct itself?
It may improve when the habit stops early, especially if the change is mild and the teeth are still developing. Even so, it is worth observing how the mouth closes, where the tongue rests and how the teeth develop. If the gap remains after stopping pacifier use, a pediatric dental assessment can help determine the right follow-up.
At what age should a child stop using a pacifier?
It is sensible to begin reducing pacifier use gradually, especially during the day, when the family can maintain a consistent routine. It is better to avoid periods of illness, travel or major changes. There is no single age that works for every child: sleep, emotional regulation, habit intensity and bite development should all be considered.
How can I tell whether the pacifier is affecting my child’s teeth?
Look for a gap between the teeth when the mouth closes, difficulty biting with the front teeth or a tongue that moves forward. These signs cannot confirm the cause or severity at home. A professional review can distinguish a temporary change from one that needs monitoring.
Is it better to stop suddenly or gradually?
Many families begin by removing the pacifier during the day while temporarily keeping the bedtime routine. They then choose a clear date to stop completely. The strategy should be adapted to the child’s age, temperament and habit intensity. If significant difficulties appear or the child starts sucking their thumb, consult a professional.
