Bye, bye pacifier: Dentists say children should give them up at age 2 1/2 or 3

Pediatric dentists Michael Glinka, left, and Stephen Pero.

Some night during the next week or so, the Pacifier Fairy is going to pay a little visit on 2 -year-old Nicholas Bowers of Maumee.

It will be the fairy's third fly-in to the Bowers family. The first time was about four years ago to take away big sister Ava's pacifier. The second was about a year ago to pick up one of Nicholas- two "nigh-nights." On this coming visit, the toddler's second pacifier will disappear, and the fairy will leave a gift in its place, most likely a stuffed dinosaur.

"The Pacifier Fairy is scheduled to come sometime around Halloween," said Nicholas' father, Robert Bowers, a stay-at-home dad who writes and illustrates books for children and young teens. He said he and his wife, Nicole, have been preparing Nicholas for the event. "I believe he's going to cooperate because we've really laid the groundwork."

They also have an ally in Ava, who will talk up the excitement about Nicholas' passage from baby to big boy.

At 2 , Nicholas is at just about the right age to give up his pacifier, according to Maumee pediatric dentists Stephen Pero and Michael Glinka, who have been in practice together for more than 36 years. The timing varies, but it's generally 2 to 3 years old, they say - or as Dr. Glinka added, "when the child is old enough to like money more than they like their pacifier."

Some of the 600 pacifiers from young patients hang on a wall in their Maumee office.

That measure of readiness is based on some 600 pacifiers that hang on the walls of their colorful treatment room. All have come from patients who have agreed to sell them to the dentists for 50 cents apiece. Some kids bring in more than one.

The dentists' approach to separating patients from their pacifiers inspired Mr. Bowers' latest book, You Must Take That Pacifier Out!, a slim, $6.95 paperback written in rhyme and available from the company he recently founded, A Gift of Words Publishing (agiftofwordspublishing.com), and Amazon.com.

Drs. Pero and Glinka also reward thumb and finger-suckers for breaking the habit. The kids get $1 when they bring a calendar to the office showing they've been clean for 30 days.

They recommend that parents step in to break the pacifier or thumb habit if it's still going on when the child is 3 to 4. By then, it's not serving any useful purpose and may be causing dental problems.

"The sucking reflex is normal," Dr. Pero stressed. "You want your baby to nurse or suck on a bottle."

Sucking also is a way for children to comfort and relax themselves, Dr. Glinka said. Parents shouldn't feel guilty about using a pacifier to silence a wailing infant, he said, pointing out that "child-rearing is not an easy task."

Babies begin sucking even before they're born, and most stop what's called "non-nutritive sucking" on their own between the ages of 2 and 4, according to the American Dental Association. "The behavior lessens gradually during this period, as children spend more of their waking hours exploring their surroundings. Peer pressure also causes many school-aged children to stop placing their fingers in their mouths," states a patient handout.

Pacifier use is often an easier habit to break than thumb-sucking, the ADA says.

Even more important than providing comfort, pacifiers have been shown to decrease the incidence of Sudden Infant Death Syndrome.

Parents should consider offering their infant a pacifier at nap time and bed time during the first year of life, the American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome recommended in 2005 (its most recent policy on the subject).

"Although the mechanism is not known, the reduced risk of SIDS associated with pacifier use during sleep is compelling," the task force wrote. It recommended:

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The pacifier should be used when placing the infant down for sleep and not be reinserted once the infant falls asleep. If the infant refuses the pacifier, he or she should not be forced to take it.

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Pacifiers should not be coated in any sweet solution

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Pacifiers should be cleaned often and replaced regularly

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For breast-fed infants, delay pacifier introduction until one month of age to ensure that breast-feeding is firmly established.

Prolonged sucking can alter the child's bite and upper jaw, although the damage can be reversible. In some extreme cases, Drs. Ginka and Pero explain, the bite opens as the teeth form around the pacifier or thumb, and the upper jaw collapses slightly. Hard-rubber pacifiers can cause more damage than soft ones, they say, particularly if a child sucks aggressively. Passive suckers may not do much damage at all.

There are lots of ways for parents to help break the habit, starting with simply talking to the child about why it's time to stop. Then ignore the behavior when it happens and praise the child when it doesn't. Focus on the positive.

"When we draw attention to a behavior we don't want to see, we end up reinforcing it," Dr. Glinka explained, because it becomes a way for the child to get attention from the parent, even though it's negative attention.

"That's basic psychology, and it's hard to do," he acknowledged.

Dr. Pero simply asks young patients: "Do you like money? I'll buy your pacifier and I'll put it up on the wall. Would you like to sell it?" Some say no, some agree, he said.

Parents can use the same rewards approach: Offer to buy the pacifier, or entice the child to swap the habit for a new toy.

Some parents snip the end off the pacifier to make it less satisfying and harder to hold in the mouth, but Drs. Pero and Glinka caution them to make sure they're not creating a choking hazard by loosening the nipple end.

Mr. and Mrs. Bowers may have had one of the easier pacifier habits to break when the time came for Ava, now 5, to give her's up.

That's because it worked its magic without ever going into her mouth, her father said.

"She used to set it by her pillow," Mr. Bowers explained. She was comforted "as long as she could see it and know it was there."

The Pacifier Fairy slipped away with it one night, but left behind a stuffed dog to stand watch in its place.

Contact Ann Weber at: aweber@theblade.com

or 419-724-6126.