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Toddlers: 24 Months+
Experience with Paci causing overbite (longish)?
DD had 18 month checkup today. At the beginning I asked the Dr. if DD should be weaned from Paci at this age, which she mainly uses at night only to got to sleep ( mostly stays in the crib). He said no, it was fine for her to continue - until he checked her mouth/teeth and said that he felt her paci use was affecting the shape of her gumline (in an overbite sense) and as a result was affecting the spacing of her teeth (which are still coming in - she has a lot already, but not all). B/c of this, he told me stop paci use cold turkey and take her to a pediatric dentist! Let me state for the record that my daughter's teeth are totally normal new toddler teeth BTW -not horrible teeth at all - they are all coming in at different times and the front two have a minor space between, but older DD"s did at first too - and as the rest of her teeth came in, they moved the front two together - so that's what I figured would happen with younger DD. But Dr. thinks the spacing issues are due to affect of Paci on gum line. This upset me first b/c I had heard from so many sources ( including this doc!) that paci does not cause orthodontic problems. But also, she doesn't use it nearly as much as other kids - mainly only to fall asleep - not even all night. Even her identical twin sister - who uses the paci the same times/amount she does, does not have this supposed problem. Anyway - I have an appointment with a pediatric dentist on Tues. and quit paci cold turkey tonight with both twins!! (can you believe they both went to sleep no problem - one fussed for like 5 min. the other not at all - cross fingers). Anyone have experience with this? If so, how was your LO's overbite or other orthodontic problem caused by paci addressed? For instance, once paci is gone will the teeth/gumline adjust back to where they should be? Or does something need to be done? TIA
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Re: Experience with Paci causing overbite (longish)?
Whatever the "so many sources" are that told you pacifiers do not cause changes in dentition were incorrect. That doesn't mean ever pacifier user has teeth issues, but pacis very well can cause changes in their teeth.
With that said, it is typically an anterior open bite that develops. When biting down, the back teeth come together, but the front teeth do not. https://doctorohea.com/photos/openbite2.jpg
Quitting using a pacifier will possibly prevent the problem from getting worse, but if the teeth have moved and created a nice place for the tongue to go, you often see kids who develop tongue thrusts. And when they have forward movement of their tongue each time they swallow, the tongue maintains the anterior open bite.
If the problem is mild, the thrusting pattern probably hasn't been established (BTW, tongue thrusting is normal in babies and young toddlers, it just typically reverses on its own), and although the teeth may not return, once they are lost, the permanent teeth will grow in correctly. Problem solved.
There is not an orthodontic procedure that anyone is going to do with primary teeth. When it becomes an issue is when the permanent teeth come in. If the forward tongue pattern has developed, the perm teeth will come in with an open bite as well. Then, you have a few issues - speech therapy to retrain the tongue physiology during a swallow and resting placement or orthodontic gear aimed to prevent the thrust or over compensate for the tongue thrust. Tongue thrusts are tricky and can be stubborn to overcome.
If you can drop the paci - as you have done - with relative ease, no reason not to. GL
Susanmosley:
Do you work in this profession?
Is there any chance that the overbite could get even slightly better on its own after paci is gone?
How do I know if DD has a tongue thrust (I fear she might) and what do I do at this age to address it?
Last, is there any chance that her issues are not caused by Paci but something esle, and if not, why didn't anyone warn me about these problems? I would never have let her use one....
Im a speech therapist. But, I have only treated a handful of tongue thrusters so I am no expert.
Sure, the overbite could get better after the paci is gone because there is decreased time that an object is pushing the teeth forward. When our mouths are closed and lips are together, that is actually doing the opposite - putting slight pressure to 'push' the teeth back. Does that make sense?
You child probably does have the thrusting pattern - honestly is it typical until 3, 4, maybe 5. This is debatable between professionals - what age it is pretty certain the immature swallow pattern isn't going to reverse itself.
If your 18 month old has a lisp (or if not saying /s/ yet - which is normal, BTW), that is not an indicator of a problem - it is typical development. She probably does have a tongue thrust right now, and that is fine and typical. Where it looses the chance to mature is when there is a nice space that the tongue easily slips into.
Also, the spaces you describe are normal and even good for when perm teeth come in.
Honestly, there is not much you can do at this age to change it. Perhaps change to straws and open mouth cups as soon as she is ready instead of prolonging the sippy longer than needed.
If it isn't something that is visible to an untrained eye, and you are able to drop the pacifiers and move to better cup options, you are doing all you can and it isn't the end of the world - at all. If the pacis are gone at 18 months, I feel relatively confident that this will be a non issue when permanent teeth come in - although obviously I haven't seen your child, so really I don't know.
Don't stress. What a great sign that the pacifiers were dropped so easily! right? I can try to answer other questions if you have any. Maybe another SLP or orthodontist will jump in here...
at rest, is her mouth open and does she breath through her mouth? or when playing, etc are her lips together and she is breathing through her nose?
Susanmosley:
Thank you for this wonderful info!
DS's paci definitely affected his mouth development. Sounds very similar to your DD.
DS used the paci from day one on and I was in no rush to get rid of it since he seemed like he loved it so much...which he did. And from about 15 months on he only ever used it at night and naptimes at home, not at daycare.
I took him to the dentist when he was about 2 for his first visit, although I had noticed that he had an overbite and that his top teeth where "shorter" in the front than on the sides. I had a feeling it was from the paci, but wasn't sure.
The dentist confirmed that the paci was indeed affecting the development of his upper jaw and teeth and suggested we get rid of it in the near future. It wasn't a huge "OMG!" but he thought it would be best and said most of the time it will correct itself. He did say, however, to give him the paci back if he started to suck his thumb, since that's worse for their development.
We ended up taking it away shortly thereafter...very easily, I might add! I was so worried about how he was going to take it and it was literally no big deal. I think he asked for it once. Shocked me!
Anyway, the problem totally corrected itself very shortly afterwards. That was almost 6 months ago and his teeth in the front are all level, developing normally and he has no discernable lisp, just normal toddler pronunciation.
Good luck! Hope it is as smooth a transition for you as it was for us.