Can Bottle or Pacifier Use Make Teeth Crooked? Lets talk timing.

Jan 04 2014

Can Bottle or Pacifier Use Make Teeth Crooked? Lets talk timing.

When is the right time to stop giving a bottle or a pacifier to prevent unfavorable development of the teeth and jaw?

The American Academy of Pediatrics (AAP) strongly advocates for exclusive breastfeeding for the first year.  However, if you have chosen to bottle feed your infant the AAP recommends weaning before 18 months of age.  Otherwise, prolonged bottle use can cause tooth decay and may encourage your child to drink much more milk than he/she needs.

So, how do you start this big change to your infant’s routine?  The AAP recommends substituting a cup for the midday bottle when they approach their first birthday.  You can try a training cup with a spout or put small amounts of liquid in a regular cup.  This change can be challenging, but be patient, it may take a few weeks before your infant adjusts to the change and for them to figure out how to use the cup properly.  After the midday cup is a routine, then start to eliminate the evening and morning bottles.  Save the bedtime bottle for last since this can be the toughest.  Remember that by age 1, your child no longer requires anything to eat or drink during the night.  Your pediatrician can answer any questions you may have about weaning your child from his bottle.

Any oral habit has the potential to apply forces to the teeth and jaw.  If the child’s habit has a sufficient frequency, duration and intensity, then it may be associated with an increased overjet (the top teeth sticking out far), reduced overbite (the top teeth not overlaping the bottom teeth), posterior crossbite (the top jaw is more narrow than the bottom jaw so the teeth align the opposite way), or long facial height (long face).

There are behaviors termed non-nutritive sucking behaviors that are considered normal in infants and young children up to 3 years of age.  After this point, it is no longer part of the normal development of their reflexes and is now just a habit.

The goal is to stop sucking habits (i.e. pacifier) by age 36 months or younger.

How do you get rid of the pacifier?

Well, sometimes just throwing it away and dealing with a week of unhappiness works for some families.  A lot of parents in my practice have been having their child give it to Santa or to the Easter Bunny.  There is also a book called David Decides About Thumb sucking available on Amazon that is helpful too.

Dr Reid Pediatric DentistDr Reid is a Pugh Award distinguished board eligible pediatric dentist. She earned her pediatric specialty training through UCLA’s program at San Diego Rady Children’s Hospital. She has also served our servicemen as a Dental Officer at the Marine Corp Air Station, Miramar in San Diego. She’s also mommy to 5 year old Ezra. To follow her monthly blog posts, follow her at

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