Dummy and Pacifier Habits: Orthodontic Effects and Treatment

How does dummy use affect the developing bite?

A dummy placed between the teeth acts as a physical barrier that prevents the front teeth from erupting fully and applies lateral pressure to the upper arch. The most characteristic effect is an anterior open bite — the upper and lower front teeth no longer touch vertically because the dummy has occupied the space between them. Alongside this, the sustained cheek muscle pressure without adequate tongue counter-pressure narrows the upper arch, producing a posterior crossbite in which the upper back teeth occlude inside the lower. Overjet also tends to increase as the upper labial segment is pushed forward. These effects are dose-dependent: the longer each day the dummy is used and the older the child when the habit stops, the more pronounced the dental changes become.

Do NUK and orthodontic dummies cause fewer dental problems?

Orthodontic dummies — most commonly associated with the NUK brand — have a flattened teat with a bulbous tip designed to mimic the shape of a compressed nipple during feeding. The rationale is that this shape distributes pressure more evenly and allows the front teeth to approach each other more naturally than a round or cherry teat. There is some evidence that orthodontic dummies produce less severe anterior open bite than round teats and a marginally lower incidence of posterior crossbite. However, the difference is modest and prolonged use of any dummy design beyond age two to three still carries orthodontic risk.

How do dummies compare to thumb sucking for dental effects?

From an orthodontic perspective, dummies and thumb sucking produce broadly similar patterns of malocclusion — anterior open bite, posterior crossbite, and increased overjet. The key advantage of the dummy over the thumb is that it is an external object that can be removed or restricted by the parent. Thumb sucking, by contrast, is a behaviour generated by the child and is harder for parents to control, particularly when it occurs during sleep. Weaning a child from a dummy is generally more achievable than breaking a thumb-sucking habit. NHS guidance consistently advises stopping dummy use by age one for general health reasons and no later than age two to three to protect dental development.

When does self-correction occur after stopping dummy use?

The teeth and jaws of young children are highly adaptive. If the dummy habit stops before the permanent teeth begin to erupt — typically before age six to seven — the bite changes are often largely or completely reversible without treatment. The tongue returns to normal palatal position, the front teeth erupt downward to close the open bite, and the crossbite may narrow or fully resolve. Self-correction is most reliable when the habit stops before age seven. After this age, once permanent teeth are erupted, spontaneous correction becomes less predictable and residual malocclusion is more likely to require orthodontic intervention.

What strategies help with dummy weaning?

Health Visitors and the NHS recommend a gradual approach to dummy weaning. Starting by restricting dummy use to sleep times only — removing it from daytime use first — reduces exposure without abrupt removal. From there, limiting it to nighttime only and then removing it entirely is a staged approach that many children tolerate well. The dummy fairy — a narrative in which the child gives their dummy away to babies who need it — is a widely used behavioural strategy that works well for children aged two to three. Reward charts combined with positive reinforcement can also be effective for older children. Where a child is using a dummy primarily to manage anxiety, addressing the underlying cause alongside the weaning plan improves success rates.

What orthodontic treatment is available when self-correction has not occurred?

Children whose bite does not fully self-correct after stopping dummy use, or who used a dummy beyond age seven, will be assessed by an orthodontist. Common findings requiring treatment include a persistent anterior open bite, posterior crossbite — particularly when associated with a functional shift of the lower jaw — and upper arch constriction. In growing children, palatal expansion using a removable or fixed expander can widen the upper arch and correct the crossbite. Functional appliances or conventional fixed braces address the open bite and overjet. NHS orthodontic treatment is available to under-18s meeting the IOTN threshold.

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This guide is for general information only. It is not a diagnosis, treatment plan, or substitute for advice from a registered dentist or orthodontist.