The pacifier was one of the best tricks my wife and I had to soothe our three girls when they were babies. Because it's such a valuable comforting tool, many parents that come into my pediatric dental practice ask if they really need to "ban the binky," and if so, when.
While the sucking reflex is a normal, healthy part of childhood development, there comes a point in time—usually around 2 years old—when the binky can start doing more harm than good.
Frequent pacifier use over a longer period of time can affect the way a child's teeth bite together and how the jaw grows. The upper teeth might begin to tip outward or become crooked, and other changes in tooth position or jaw alignment could occur. The earlier a child can stop a sucking habit, the less chance there is that it will lead to orthodontic problems down the road.
Let's face it: taking away your child's primary source of calm can be intimidating and stressful. I typically recommend parents try one of the following approaches:
Identify trigger situations and offer an alternative
What causes your child to cry out for their beloved binky? Once you've identified which situations trigger your child's desire for a pacifier, be ready to replace it with comfort and reassurance. It can be helpful to swap out the pacifier with a transitional object, such as a cuddly doll or stuffed animal. Additionally, distracting your child with a fun activity can help take their mind off the pacifier. Be sure to offer positive reinforcement and praise when your child sleeps through the night or self-soothes without the binky.
Get creative, and have fun with it
Make the loss of the pacifier a party or coming of age celebration. Throw a "Goodbye Binky" party and have your child leave out his pacifier one night for the Binky Fairy to have, explaining that new babies are now in need of his binky. Or, celebrate your child's new "big girl" status and take her and the pacifier to the store to pick out a new toy to replace the binky. Many experienced store clerks are used to this trick and are willing to play along when your child "trades in" the pacifier for a new toy of her choosing.
Use a countdown and cut the pacifier
Create a countdown game and tell your child that over the next three to four weeks their binky will be shrinking. The first week, cut a very small hole in the top of the pacifier. Be careful to make clean cuts that do not leave any part of the pacifier hanging, which could break off in your child's mouth. Continue to cut a portion of the pacifier every week until nothing is left for your child to suck on. This is a great way to separate your child's association from someone taking the pacifier away to the binky just breaking on its own. At the end, you can tell your child it's time to bid binky bye-bye.
Go cold turkey
Of course, you could also just make the binky "disappear" one day. Tell your child the pacifier is lost, broken or gone for good. This could be an opportunity employ the Binky Fairy approach by explaining the fairy takes old binkies and leaves a new toy in its place. If you use the cold turkey approach, make sure you collect all the pacifiers around the house (look under the bed and couch cushions!) to ensure your kiddo won't find one days or weeks after she has forgotten it ever existed.
And don't forget...
Whether you decide to gradually wean or go cold turkey, make sure the time is right. Steer clear of taking away the pacifier during life changes, major transitions or traveling so you won't add further stress to the process. When you've made the plan to ditch the pacifier, make sure all caregivers are on board and stick with your new routine.
If you choose to gradually remove the pacifier, I'd suggest limiting its use to nap or bed time. Or, if you feel he particularly needs it during waking hours, gradually shorten the frequency and length of time the pacifier is used.
Your pediatric dentist may have other tips or tricks, so don't be afraid to ask for suggestions. He or she will also be able to recommend behavior modification techniques if your child needs further encouragement. If you don't yet have a dentist for your child, you can visit mychildrensteeth.org to find a pediatric dentist near you.
Dr. Edward H. Moody, Jr. is president of the American Academy of Pediatric Dentistry (AAPD). He has a private practice in Morristown, Tenn. He is a graduate of Auburn University and the University of Tennessee College of Dentistry, and he received his certificate in pediatric dentistry from the Medical College of Virginia. He has been a member of the AAPD for 25 years.