How and when do you stop pacifiers and thumb sucking?

Sucking on a pacifier, thumb, or finger is considered normal in infants and young children. In fact, pacifier use has shown to decrease the incidence of SIDS (sudden infant death syndrome) in infants. However, prolonged habits may result in the unfavorable movement of teeth. So when should thumb sucking or pacifier use stop?

The American Academy of Pediatric Dentistry recommends that children stop such habits by the age of three. This allows some time for potential self-correction of misplaced teeth before the growth of permanent teeth.

    Stopping a habit can be tricky. There is no "one way" to stop a habit. There are several different methods that may work with your child. It's important to consider your child's age, development, comprehension, and ability to cooperate when deciding upon a method to try at home. Here are a few techniques we've recommended to our patients.

1. Cold Turkey Approach - Taking a pacifier away "cold turkey" may be the quickest way to stop a habit, but it's likely the most dramatic. Parents should be prepared for several days of irritability, fussiness, and sleepless nights. As a general rule, it takes 21 days to break a habit. The first week will be the most difficult as your child learns to self-soothe in other ways. The cold turkey approach is not advised when other big life changes are taking place (new sibling, move, potty training). Some parents use the cold turkey approach with a twist; they incorporate something fun into the actual removal process. For instance, the Pacifier Fairy may visit one night and leave a toy in place of the pacifier. The family may also take a trip to Build-a-Bear and place the pacifier inside a new stuffed animal.
2. The Disappearing Pacifier - This technique is sneaky. The satisfaction of a pacifier comes from the ability to suck on the pacifier and create a seal or vacuum. When the seal is broken, part of the satisfaction is lost. Parents can start by poking a tiny hole in the end of the pacifier. Each night, the hole is slightly widened and eventually the tip of the pacifier is removed with scissors. As more of the pacifier is removed, it gets shorter and less appealing. Word of warning, if you aren't ready to potentially move into a cold turkey approach, a back-up pacifier should be on hand. Some kids immediately refuse a "broken" pacifier!
3. Bad Taste Approach - There are products on the market designed to stop nail biting. These bad-tasting nail polishes can be easily painted on the thumb or fingers to discourage sucking. A more natural, at-home polish can also be made by blending together onions and garlic cloves, then applying the mixture to thumbs, fingers, or pacifier. Be prepared, it will be smelly!
4. BandAid Technique - Placing a BandAid on the thumb or finger of choice may help older children stop a habit. It serves as a visual reminder to keep the thumb out of the mouth. Obviously this technique will only work for a highly motivated child, or one who "subconsciously" places fingers in the mouth.
5. Reward Calendar - Older kids may benefit from a sticker chart or reward calendar. Each day or night the habit is avoided, a sticker is placed on the chart. This allows kids to visualize their progress and work towards a reward (maybe a new toy or a trip to the movies)!
6. Thumb Guards and Habit Appliances - These products are secured to the thumb or teeth to physically prevent a child from placing a thumb, finger, or pacifier into the mouth. Such appliances should only be used when the child wants to stop the habit but is having some difficulty. Habit appliances can be made by a pediatric dentist or orthodontist.

Whatever approach you use at home, be prepared to be flexible! You may need to try several techniques before finding the one that works best for your child. If you have questions, please talk to your pediatric dentist or orthodontist.