Although benefits exist from pacifier usage, (please see earlier posts) equally, there may be potential issues in a child who sucks a pacifier beyond an acceptable time. The time frame researchers frequently cite is after 24-36 mos.
Researchers suggest weaning begins at 6 mos. Beyond that, increased incidence of otitis media could become a concern. Pacifier usage into early childhood may decrease opportunities for a child to learn positive strategies to self soothe, or decrease socialization in an older child who continues to suck. May I add potential issues that may relate directly to orofacial myofunctional development/oral muscular behavior patterns of activity?
We know from significant research that increasing the usage of a pacifier decreases time at the breast. Breastfeeding helps develop the proper peristaltic action of the tongue. Proper tongue activity encourages optimum growth and development of the hard palate and facial structures. Thus, extended pacifier usage may have the potential to impact orofacial growth and development in some children. For example, less breastfeeding=decreased potential of proper "tongue action", i.e. the potential to impact tongue behavior patterns.
A pacifier lowers the tongue in the oral cavity as well. A tongue prior to age 4-6 usually does not rest within the hard palate as for example, as the tongue of an adult with normal tongue posture does. The tongue should begin to rest in the roof approx. 4-6 years of age. Extended pacifier usage can interfere with the natural vertical transition of these more vertically based tongue activity patterns, and the tongue maintains this "lowered rest posture" instead of smoothly transitioning to a vertically-based rest posture.
There is much new research in this area being done. For example, newer studies have suggesteded that non-nutritive sucking beyond 24-36 mos. may result in a vertically-based growth pattern tendency of the roof and may impact facial growth patterns in some children, or may sustain a "tongue thrust" pattern of swallowing (thrusting the tongue against the teeth or beyond the dental arch rather than vertically towards the roof away from the teeth), as well. A narrow roof does not "house" the tongue efficiently at rest. Many dental professionals cite that a narrow roof does not allow optimum space for newly erupting teeth.
Fortunately, this is an opportune time to discuss your child's oral habit with their pediatrician dentist!