Originally published August 1, 2018. Updated September 3, 2026.
Sucking is a natural, soothing reflex, and most babies and toddlers rely on a thumb, finger, or pacifier at some point. In the early years it is normal and usually harmless. The concern is when the habit continues as permanent teeth begin to arrive, because prolonged sucking can affect how the teeth line up and how the mouth develops. This guide explains what is normal, when to be concerned, what the different professional organizations recommend, and how to help a child stop.
Is it normal for children to suck their thumb or use a pacifier?
Yes. The American Dental Association (ADA) notes that children usually stop sucking between the ages of two and four, or by the time the permanent front teeth are ready to erupt. The American Academy of Pediatrics (AAP) likewise says most children give up the pacifier on their own between 2 and 4 years of age, and that many children stop thumb sucking before they get far in school, partly because of peer pressure.
When do sucking habits affect the teeth?
The American Academy of Pediatric Dentistry (AAPD) states that long-term sucking habits such as pacifier use and thumb or finger sucking have been associated with an anterior open bite, where the front teeth do not meet, and a posterior crossbite, where the upper and lower back teeth do not line up correctly. It also says that all of these habits affect the teeth in essentially the same way. The ADA adds that once permanent teeth emerge, sucking may interfere with proper growth of the mouth and alignment of the teeth and can change the roof of the mouth, and that vigorous sucking is more concerning than a thumb simply resting in the mouth.
What age is too old?
The organizations give slightly different guideposts, which is useful to know when you compare advice. The ADA and AAP point to ages 2 to 4 for most children to stop on their own. The AAPD says sucking habits up to about age 5 are unlikely to cause long-term problems, while recommending that a habit that continues be discouraged after age 3 and evaluated by a professional. The AAP says thumb or finger sucking before age 6 to 8 is unlikely to cause permanent damage, and that sucking strongly beyond ages 2 to 4 may change the shape of the mouth or how the teeth line up. The takeaway is consistent: watch the habit from age 3 on, and ask your dentist to check your child’s bite.
How can you help your child stop?
- Praise and reward. Both the ADA and AAP recommend encouraging your child when they do not suck, with star charts or small daily rewards.
- Find the reason. The ADA notes that children often suck when they are anxious or seeking comfort, and the AAP suggests keeping hands busy if boredom is the trigger.
- Involve your child. The ADA suggests letting older children help choose a method and having the dentist explain the consequences.
- Try practical aids. For persistent thumb sucking, the ADA mentions bandaging the thumb, using mittens at night, or asking the dentist about bitter-tasting coatings or a mouth appliance.
- Avoid scolding. Pressure can make a comfort habit stronger.
Are there pacifier habits to avoid?
Yes. The ADA warns that pacifiers dipped in sugar, honey, juice, or sweetened drinks can lead to tooth decay, and that cleaning a pacifier by putting it in your own mouth can pass cavity-causing bacteria to your baby. Rinse it with water instead. See our guide to teething and baby teeth for more on protecting young teeth.
When should you see a dentist?
The AAPD encourages families to establish a dental home by 12 months so they can get guidance on stopping sucking habits at the right time. Book a visit if your child is past age 3 and still sucking, if you notice the front teeth tipping outward or a gap where the top and bottom front teeth do not meet, or if the habit is hard to break. Our pediatric dentistry team can check your child’s bite and talk with them in a friendly way, and if orthodontic care is needed later we can discuss orthodontic treatment.
Frequently asked questions about pacifiers and thumb sucking
When should a child stop sucking their thumb or using a pacifier?
Most children stop on their own between ages 2 and 4. The American Academy of Pediatric Dentistry recommends discouraging the habit after age 3 if a child has not stopped, and a dental evaluation is a good idea for children who continue past that age.
Can thumb sucking or a pacifier ruin a child's teeth?
Prolonged, vigorous sucking can. The American Academy of Pediatric Dentistry links long-term sucking habits to an anterior open bite and a posterior crossbite. Sucking in the early years, however, is unlikely to cause lasting problems, and habits that stop early usually resolve without treatment.
Is a pacifier better than a thumb?
For teeth, they affect the mouth in essentially the same way. A pacifier can be taken away more easily than a thumb, but neither is harmless if the habit continues into the preschool and school years.
How can I help my child stop?
Use praise and rewards when they do not suck, address the reason they suck (boredom, anxiety, tiredness), and avoid scolding. Your dentist can talk to your child and recommend reminders or an appliance if the habit persists.
Should I dip a pacifier in honey or juice to calm my baby?
No. The American Dental Association warns that pacifiers dipped in sugar, honey, juice, or sweetened drinks can lead to tooth decay.
Concerned about your child’s sucking habit?
Our pediatric team can check your child’s bite and suggest gentle, effective ways to help them stop.
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Quick takeaways
- Thumb and pacifier sucking are normal in babies and toddlers. Most children stop between ages 2 and 4.
- Prolonged sucking can contribute to an open bite and crossbite, and thumb, finger, and pacifier habits affect teeth in essentially the same way.
- Sources differ slightly on the age limit, but all agree to watch the habit from about age 3.
- Use praise, rewards, and comfort, not scolding. Your dentist can help.
- Never dip a pacifier in sugar, honey, or juice.
Sources
- American Dental Association. Thumbsucking. MouthHealthy.org.
- American Academy of Pediatrics. Baby Pacifiers & Thumb Sucking: What Parents Need to Know. HealthyChildren.org.
- American Academy of Pediatric Dentistry. Policy on Pacifiers. Revised 2024.
- American Academy of Pediatric Dentistry. Policy on Oral Habits.
- American Dental Association. Healthy Habits: Babies and Kids. MouthHealthy.org.
