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Can Bottles and Pacifiers Harm Your Baby’s Teeth?

Medically Reviewed by Dr. Pierrette Mimi Poinsett, MD
Are your baby's bottles causing tooth decay?

Does your baby love their pacifier, but you’re worried it may cause dental issues later on?

Sucking on a pacifier or bottle can be soothing for a young child, but it can, unfortunately, lead to dental problems as they get older.

Even though baby teeth are temporary, they are still important and susceptible to cavities and other dental problems. They also influence how adult teeth will form.

We researched the effects pacifiers and bottles can have on teeth and wrote this article to help you avoid related dental problems. We also discuss when and how to wean your child from the pacifier and bottle and offer tips to make it easier on everyone.

Key Takeaways

  • Prolonged use of pacifiers can lead to dental issues such as crooked teeth, jaw misalignment, and narrowing of the roof of the mouth.
  • To avoid these issues, pacifiers should be weaned by the age of two or ideally, between 9-12 months.
  • To break the habit of pacifier use, parents can try distractions, transitional objects, rewards, and positive reinforcement.
  • Bottle use can also lead to dental issues and baby bottle tooth decay if the bottle contains anything other than water.
  • To avoid these issues, parents should limit the use of bottles and transition to a cup by the time the child is 12-14 months old.

Effects of Pacifiers on Teeth

Pacifiers can be beneficial for babies and parents as they satisfy a baby’s natural sucking instinct and provide a form of comfort. They have also been shown to reduce the risk of sudden infant death syndrome (SIDS) between one and six months (1).

However, the long-term or overuse of a pacifier can lead to dental issues because, as your baby matures, their jaw grows around anything consistently held inside it. According to the American Academy of Pediatrics (AAP) and the American Dental Association (ADA), overuse of a pacifier affects mouth and teeth development and can potentially lead to the following (2)(3):

  • Crooked teeth.
  • Front teeth not meeting: Front top teeth to slant out and front bottom teeth to tilt in.
  • Jaw misalignment (such as an overbite).
  • Narrowing of the roof of the mouth.

Avoiding Pacifier Teeth

With the proper use of a pacifier, your baby can self-soothe without developing dental problems. Wean your child from their pacifier by the age of two to reduce the risk of pacifier teeth.

Even better, stop using the pacifier between 9 and 12 months. The habit can be tough to break once the child is walking or crawling because they can go searching for it on their own.

Using pacifiers labeled as “orthodontically friendly” may lower the risk of dental issues. You could also limit pacifier use to sleeping times. This reduces the usage time, while still lowering the risk of SIDS.

Breaking the Habit

Think it’s time for your child to ditch the paci? Here are some helpful tips on how to break the habit:

  • Distractions: When your child asks for their paci, distract them with other activities, such as reading, coloring, playing with their favorite toy, etc.
  • Offer a transitional object: Because pacifiers are often a form of comfort, offer your child a transitional security object, such as a blanket or doll.
  • Encouragement/praise: Tell your child, “What a big girl/boy you are!” when they aren’t using their pacifier.
  • Rewards: Use positive reinforcement and give your child a sticker when they decide not to use their pacifier.
  • Offer other forms of comfort: Comfort your child in different ways when they need to be soothed. Sing to them, rock them, etc.
  • Avoid stressful situations as much as possible when starting to wean: It’s probably not the best idea to wean your child off their pacifier when you’re about to move, going on a big vacation, or about to have another child.
  • Don’t scold/punish/use negative reinforcement when your child does use the pacifier.
  • Cold turkey with an epic farewell event: Going cold turkey may be the best option for some children. Tie a ribbon to your child’s pacifier and let it “fly” away.

Effects of Bottles on Teeth

Bottles provide a form of nourishment and are a necessity if you’re formula feeding or pumping. However, many children use a bottle much longer than necessary, which can lead to dental concerns.

Bottles carry the same risks associated with prolonged sucking as the pacifier. Plus, they pose a risk of promoting cavities and baby bottle tooth decay if they contain anything other than water.

What Is Baby Bottle Tooth Decay?

Tooth decay in infants and toddlers is often referred to as baby bottle tooth decay. It can occur from frequent sucking or sipping on milk or juice over an extended period. This condition mostly happens when parents put their baby to bed with a bottle, use a bottle as a form of comfort, or prolong its use.

When sugars and carbohydrates come in consistent contact with teeth, decay-causing bacteria flourish, rotting the child’s teeth. Tooth decay is nothing to take lightly, as it can lead to painful infections. In extreme cases, tooth extractions or extensive dental treatments may result.


If you notice any white spots on your child’s teeth, particularly near the gum line, contact your dentist, as this is an early symptom of baby bottle tooth decay. The earlier you get your child to the dentist, the less extensive and invasive the treatment.

If tooth decay is spotted in later stages, you may notice the following symptoms:

  • Brown or black spots on the teeth.
  • Bad breath.
  • Bleeding and swollen gums.
  • Fever (which could indicate an infection).

If your child has any of these late symptoms, get them to the dentist as soon as possible to prevent the decay from spreading further and leading to extensive restoration treatments or even tooth loss.

Avoiding Baby Bottle Tooth Decay

The best approach to baby bottle tooth decay is to prevent it. Here are some ways you can do so.

  • Wean your child from the bottle by 18 months of age, preferably by 12 months.
  • Leave milk for mealtimes only, after your child has weaned from the bottle. Only offer them water to sip on throughout the day.
  • Do not give your baby a bottle when putting them to sleep or down for a nap.
  • Place only formula, milk, or breast milk in bottles. Do not give your baby or toddler juice or any other sugary drinks in their bottles.
  • Do not use the bottle as a pacifier or form of comfort.
  • Limit acidic foods and juices.
  • Practice good oral hygiene: Brush your child’s teeth twice a day with a pea-sized amount of toothpaste. Always brush their teeth before putting them to bed.
  • Start your child’s dental visits early (4).

Bottle Weaning Tips

Transitioning from the bottle to a sippy cup can be daunting, but it is essential to do it by 18 months to avoid baby bottle tooth decay. Here are some tips and tricks to smooth the transition:

  • Start early and introduce the sippy cup around six months of age.
  • Once your baby has the sippy cup figured out, start replacing one regular bottle feeding a day with a sippy. Do that for three days in a row before adding another feeding.
  • Do not coincide initial bottle weaning with stressful events such as a move, vacation, starting daycare, or the birth of a new sibling.
  • Offer lots of praise and positive reinforcement when your child uses a sippy or cup instead of a bottle.
  • Offer other forms of comfort: Caregivers often turn to a bottle when a baby is upset when they might not even be hungry at all. Provide other forms of comfort, like singing, rocking, or a security blanket first.
  • Go cold turkey and have a farewell ceremony: For some toddlers, you may need to ditch the bottle cold turkey. Involve your toddler and “send” their bottles away. Explain to them they are a “big girl” or “big boy” now and don’t need bottles anymore.


At What Age Does Pacifier Affect Teeth?

There has been some debate about this topic. We like to stick with the American Academy of Pediatric Dentistry’s advice and say it’s best to wean your little one off of pacifiers by the time they’re 12 months old.

Some experts say that it’s okay for kids to use pacifiers up to 3 years old, but from what we’ve seen, we don’t recommend this.

What Can I Use Instead of a Pacifier?

There are tons of pacifier-esque products that you can buy almost anywhere. Chewables, teething rings, binkies, etc., all work just like a pacifier.

If your little one isn’t a huge fan of the pacifier, let them try out some different options that they might like more. The good news is that pacifier substitutes are usually inexpensive.

What Do Dentists Say About Pacifiers?

Dentists say that pacifiers aren’t good for children older than 12 months. Professionals have seen how prolonged pacifier use has caused kids to have crooked teeth, bite problems, and sometimes even speech impediments.

While pacifiers are good for teething, the experts say you shouldn’t let your child have a pacifier for long.

What Is a Bottle Mouth Syndrome?

Your baby can’t get bottle mouth syndrome from a pacifier because it comes about as a result of your baby’s teeth being exposed to sugary liquids for too long.

Allowing your child unlimited access to milk whenever they want it can cause tooth decay because their teeth are constantly exposed to the sugars in milk. Limit when your baby can feed to prevent this.

Can Baby Bottle Tooth Decay Reversed?

Yes, baby bottle tooth decay is reversible, but you’ll have to be proactive about it. Fluoride can repair your child’s damaged enamel.

Still, it’s up to you to make sure your child’s teeth are brushed, and they can’t drink milk nonstop from now on. If your baby has tooth decay, take them to the dentist right away.

What Pacifier Doesn’t Mess Up Teeth?

All pacifiers can mess up teeth if your baby has access to them for too long. It’s not necessarily just that shape of the pacifier that can mess up teeth-it’s the repetitive sucking and biting that your child does with it.

It can be hard to wean your little one off a pacifier when the time comes, but stay vigilant because it’s very important you do this.

Don’t Let Comfort Become Discomfort

Bottles and pacifiers are beneficial for babies and parents as they provide nourishment, satisfy baby’s natural sucking instinct, and provide comfort and security.

However, the long-term use of bottles and pacifiers can lead to dental issues. These include crooked teeth, misalignment of the jaw, and baby bottle tooth decay.

You can prevent related dental issues by weaning your child from a pacifier by age two and the bottle by 18 months. By weaning early on, you and your baby can reap the benefits of bottles and pacis without harming your child’s smile.

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Headshot of Dr. Pierrette Mimi Poinsett, MD

Medically Reviewed by

Dr. Pierrette Mimi Poinsett, MD

Dr. Pierrette Mimi Poinsett is a veteran licensed pediatrician with three decades of experience, including 19 years of direct patient clinical care. She currently serves as a medical consultant, where she works with multiple projects and clients in the area of pediatrics, with an emphasis on children and adolescents with special needs.