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In children between 4 and 6 years old, nonnutritive oral habits are no longer considered normal and may be viewed in some cultures as socially unacceptable. Intervention may be required with success depending on the child's readiness to discontinue the habit. Habit discouragement will usually require 6 months of treatment.

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The American Academy of Pediatric Dentistry recommends pacifiers ONLY for children who engage in/exhibit nonnutritive sucking behavior. Parents of a child using a pacifier should be counseled on the necessary safety precautions. Pacifiers should be made of sturdy, one-piece, nontoxic, flexible materials. The Academy cautions against the use of a nursing bottle as a pacifier.

Pacifiers should never be attached around the child's neck. Use of a sweetener on the nipple should be discouraged. Pacifiers must also be kept clean and replaced when worn. Children should not be allowed to run or play with their pacifiers in their mouths.

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The ability to gradually discontinue the use of the pacifier by limiting the time it is available to the child is one method for gradual elimination of a pacifier habit. Nonnutritive sucking of a pacifier is an easier habit to break than nonnutritive digit sucking.

Dental changes created with prolonged pacifier use are similar to those of finger or thumb sucking habits, though protrusion of the anterior incisors may not be as pronounced.

(Photo: pacifiers and child with pacifier)

Download the Smiles for Tomorrow Dental Caries and Prevention PowerPoint Presentation.
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