Episode 122: There’s No Such Thing As An Orthodontic Pacifier

Hi and welcome to episode 122 of the Untethered Podcast. Today it is me, your host, Hallie Falcon, all by myself and I'm really excited to chat today because we're going to be talking about one of the hot topics out there that never seems to get old, pacifiers. And I wanted to talk to you about this today because even though it's something that I've discussed on social media, we've discussed it within various podcast episodes. We've never really just done a podcast episode dedicated to pacifiers and it's one of those common topics that we discuss all the time. So let's hop to it. Quick Disclaimer all information, content and material of this podcast are the opinions of the speakers and is for the informational purpose only and not intended to serve as a substitute for the consultation, diagnosis and or medical treatment of a qualified health care provider. Welcome to welcome to the Untethered Podcast. I am your host, Hallie Balkan. I'm a certified orofacial myologist, feeding specialist and mentor. This podcast is all about getting your questions answered and collaborating with colleagues to bring you the most up to date information in the orofacial myofunctional therapy, tethered oral tissue and airway space. I challenge you to keep an open mind and join my mission to get this information out to the masses. Let's get started. The first thing that I want to point out is that if you want any information about this, if you want to see this in video format, you can always watch on YouTube. But I've also talked about this on Instagram and for professionals, we talk about orofacial development and oral motor skills and all that fun stuff within the course feed the PEDs, which will reopen at the end of this month. So for all intents and purposes, this episode is geared towards parents as well as professionals because we really all need this information on pacifiers and what it's doing to the orofacial complex. So let's dive in. The first thing I want to talk about is yes, I absolutely 100% recommend the Philips Avent Soothing Pacifier that, you know, I'm just going to like. Spoiler alert. That's my favorite. But I want to tell you why. And I want to tell you why orthodontic pacifiers are not a thing. I know they're marketed, but they are not actually a thing. And let's talk about why. It's really funny because I was about to hop on here and record this and I want to send this episode out like, within the week, right? Within the week of me recording this because it's such a hot topic right now. And I just hopped on it is. I'm recording this on July 26th, Monday, July 26th. And my dear friend and colleague Autumn Reed Henning just posted the most perfect Instagram post saying that. What did she say? She said that orthodontic pacifiers are an oxymoron. And I was like, yes, that is the perfect way to state it. So thank you, Autumn, for that. Here's the thing, guys. Orthodontics is a practice that treats malocclusion. It treats teeth that are misaligned. It treats something that has gone awry in the mouth. So why are we marketing pacifiers as orthodontic? They're not there to treat malocclusion. They're not there to shift teeth and bone. That's not their purpose. In fact, the purpose of the pacifier that we're using should avoid that. However, we know that pacifiers serve multiple purposes. One example is that, you know, the American Academy of Pediatrics talks about how pacifiers can be very beneficial for preventing sids, Sudden infant death syndrome. And we've talked about that on my Instagram account. Right. Especially through the first six months of life. We've also talked about how pacifiers can be really great for promoting oral development if they shape the tongue correctly. So we're going to jump into this because I want to explain to you why the Susie is the best pacifier. No, I'm not getting paid to say this. No, I have no relationship with Philips Avent, you know, or whatever that parent company is. This is not sponsored by anybody in any way. This is just my opinion, based on my experience, based on what I know as a certified orofacial myologist and speech language pathologist, specializing in pediatric feeding disorders and really working with the infant toddler population. That's been my favorite population to tackle. I've always worked with toddlers. I started working with infants about six years ago when I had an infant who went through all the struggles with feeding. And ever since then, I've really fallen down this rabbit hole of working with infants. And that's why I'm very passionate about what we put in an infant's mouth and how it affects impacts them later. So again, let's just remember that an orthodontic pacifier is a marketing tactic and it doesn't really mean anything. We're going to jump a little further into that in a second. But keep in mind, pacifiers are good for two Purposes to pacify or as a. And maybe prevent sids. Right. Like we talked about. Or as a therapeutic tool when directed by a pediatric feeding therapist or lactation consultant who is trained in tethered oral tissues, who's trained in developing that suck, swallow, breathe pattern, you know, who's trained in helping that infant shape their tongue the way they need to to effectively feed. Okay? So if you're hearing information about pacifiers and infants from another professional, that is not either a lactation consultant who's highly trained and really fully understands, because not all lactation consultants are created equal. So ideally an IV CLC. But I know there's also CLCs out there or there's people who have a CLC in addition to being an SLP or an ot, or they, you know, they have additional credentials. Right. Or a feeding therapist who's an SLP or OT. Now, again, not SLPs and all OTs are created equal either. So you really need the one who does infant feeding and who is trained in tethered oral tissues and ideally orofacial myology. Now, we're not doing orofacial myology or orofacial myofunctional therapy on an infant or a toddler. We all know from my prior episodes that that that is not a therapeutic approach that is appropriate for anybody under the age of four. From a cognitive standpoint, they cannot actively follow what you're asking them to do. Now, if you are a feeding therapist like an SLP and OT or a lactation consultant who is highly trained in oral motor, which, honestly, it's mostly going to be your SLPs and OTs, infant feeding beyond breastfeeding, that really, that is approached in a different way. Right. We're using a passive approach to treating their orofacial complex. And maybe if we have further credentials, maybe other areas of the face, the neck and so on. For example, you might get an OT who's trained in cranial sacral therapy and they can work on other parts of the body. Right? So that's why we really need to know who, who are working with what their credentials are and what their belief system is. Because if you go to somebody who doesn't believe in tethered oral tissues, even though they're a feeding specialist, and they dismiss that those tethered tissues and they dismiss, dismiss all the tension that your child is carrying, I can, I mean, most of the time, I can't guarantee, but most of the time a lot of these babies end up on reflux medicine or they end up in therapy much longer than they need to be, because nobody's looking under the tongue or. Or they're just dismissing it as not being something important that we need to address when it's absolutely medically necessary that we be addressing these things. Okay, so that's a whole different soapbox for a different day. Let's get back to pacifiers. So the other thing I want to point out is I had a post way back when from Shonda Colleen, who is an OT and who is a graduate of Feed the Peds my course, and she said using the MAM is like trying to dance with your foot super glued to the floor. Why would anybody do that like that? I mean, they wouldn't. That's the whole point. So let's stop falling prey to the marketing that is not regulated by any governing body. We'll talk more about that in a second. I mean, I've been preaching this as false marketing, and you may be, maybe you've heard me or seen me say this, but maybe you haven't. So let's dive in. Now, here's what I want you to think about before we go into that. Imagine that you're prepping an infant for a frenectomy, right? A tongue tie release or a lip tie release. But let's just focus on the tongue for a moment. And let's say your goal is to release that tongue so that we can improve function. I mean, why else are we releasing the tongue, right? We don't release it based on what it looks like. We release it based on function. Function is a driving factor. And then obviously, yes, we want to see what it looks like, but if it just looks tied but function is 100% intact, we're not going to release that, okay? At least not right now. We might monitor, but we're not releasing something that's working well that has no impaired function. All right? Now, there may be a lot of symptoms for baby or mom, but all symptoms lead back to two main functions, right? One, we want to help that baby breathe optimally. And two, we want to help baby feed optimally. I mean, after all, we need air and calories to live, do we not? So with our infants who are struggling to feed, we work to improve tongue cupping, and we engage baby in suck training, as I mentioned before. And of course, therapy is way more complex than this. But for the purposes of this post, let's just focus on, you know, or this podcast. Let's just focus on the big picture here. From a MYO standpoint, keep in mind, we're not doing active myotherapy Right. But from a MYO standpoint, if we think about the goals of myo, we want baby to elevate the tongue, the entire tongue to the palate, Close their jaw. Right. Close their lips and nasal breathe, breathe, breathe through their nose. The MAM pacifier works against these goals. It flattens the tongue to the floor of the mouth and it actually mimics a tongue tie. It forces the lips and the cheeks to compensate to then hold that pacifier in place. We don't want this. These compression babies, quote, unquote, who can hold on to a ma', am, may also bite the neck of a pacifier to keep it in. And if they can hold onto a MAM pacifier but not a soothie, which is a question, I get so, so much like, oh, my baby will hold on to a man, but they won't hold on to a suv. Major red flag for oral dysfunction. Okay, this, this should tell you, let's have an eval done. If there are some feeding issues or sleep issues, the mouth is open at rest when the passes, not in. All right, so I want to be clear on this because there are dentists and RDHs and IBCLC and I'm sure there's SLPs and OTs out there too. I haven't seen them, but I'm sure they're out there that promote the MAM and these orthodontic pacifiers. And I'm sorry, but like, this is false information. The MAM does not promote lingual elevation when in the mouth. There's no way it holds the tongue down all the way across. Oftentimes it creates tongue retraction. Where that means for the parents out there who may not be familiar with these terms, that means the tongue has to pull back where the mid blade, the middle of the tongue may rest on, on the velum, which is our soft palate, or fall back into your baby's airway. This is not ideal. We want that tongue to sit forward, but stop right behind where the future teeth will be and rest fully up in the top palate. Right? We want that, that tongue that kind of makes a U shape to fill a U shaped palate. Now, let's also remember that there's a class action lawsuit against the orthodontic pacifier because false claims. News flash, it's not orthodontic and no such pacifier exists on the market. Go Google it. All right. The only thing orthodontic about the man pacifier is that it will land these kiddos in the ORTHODONTIST chair between the age of six and nine. If they aren't helped sooner, please, and this is my, my call to please help them sooner. Six to nine years of age, if that's where your child is. I don't mean to worry you, but if your child is younger, do not wait that long. Do not wait. Traditional orthodontics will say wait until they're six or not six to nine, they need their six year molars to do orthodontics or oh, they're not ready yet. They haven't lost all their baby teeth. Let's wait till 9 or 10 or 11. No, no, no, no. We can help them as early as infancy, toddlerhood. So, and that can be another episode on this podcast, but we need to get in there asap, if not now, definitely by two to three years of age at the latest. And this really, again, is not to worry you if you have a child who's older. But I had this typical traditional rapid palate expander and orthodontia as a young teen and then had relapse and then, you know, as an adult, I had expansion and Invisalign. So we can always fix it, but let's get in there sooner so that we don't have to do this later on. It's much faster, it's much more effective. It improves their airway, their ability to breathe, their ability to chew foods. There's a lot of benefits to doing this sooner and it absolutely impacts quality of life. Okay, so, so what is the ideal pac? Well, I already told you guys that. I mean, I get a lot of questions in my, my inbox about this one, so it is my favorite personally is the Philips Avent soothing. I get a lot of parents asking me, well, is this passive or pacifier similar? Is this one? Is this pacifier similar? If it is not shaped exactly like the Soothie, I'm not recommending it. There are some out there that are similarly shaped now, but I really like the ones that have that cylindrical continuous size to the paci. From the tip of the paci to the base of the paci that looks like that SUV that Phillips Avent Soothy. So go Google that. And if the paci looks like that, then I will say, okay, that's fine. If it's bulbous at the end where it gets like bigger at the end of the passy, absolutely not. If it is flat, absolutely not. And when I say flat, look at the different ma' am pacifiers. For example, okay, those orthodontic pacifiers are the example of what you don't want. Now, I also want to point out to everybody that pacifiers are not a milestone. If your child won't take one, be thankful and move on. I was guilty of this as a new mom, so I know how you feel. Truly. Like, I was like, oh, my child will just take a pacifier. Like, that'd be so helpful. And I was woke to this concept about five, well now six years ago, when with my first daughter, right, she was a horrible feeder. I was determined to breastfeed. It wasn't going well. I talk about her tongue tie and lip tie journey and her feeding journey in the first episode of this podcast. If you want to go all the way back to episode one if you haven't heard it. So I'm not going to re repeat it here, but we've talked about my little one, Lily, quite a bit on this podcast. She's my oldest and it's definitely worth listening, especially if you have an infant who's struggling to feed. But I also want to talk about how some of these Philips Advent soothing pacifiers have like, the wubba nubs on the end. I'm not for that. Like the cute plush animals attached to the end. I've even seen parents like Super Glue Beanie Babies or other soft animals to the end of their child's pacifiers. Don't do it. Don't do it. I will give you this. They are cute. They're absolutely adorable. I loved them. With Lily, it's all hype, it's all marketing. And it's just to get, to get you to buy, like the most adorable pacifier ever. Now you can cut those lovies, as I like to call them, off of the end of the pacifier and give that to your child to keep and separate it so it's no longer associated with the pacifier. If they're like a toddler who's still using one, for example, and then eventually ditch that pac, right? Or wean them as they're ready. And look, as a parent, I, I'm just here giving you information. I pass. Pass no judgment. I am not here to shame anybody. You do. You. You decide what is best for you, your child and your family. I am just here imparting information from a professional standpoint and a mom who's been through this with my, with my child. So anyways, I just want to point out that pacifiers are not a milestone, okay? It's hype. It's marketing. The FDA does not monitor either what is on their packaging or Their OR website. Okay, insane. I know, but they don't. As long as guarantees are not made, then a company is good. Right? But they can say whatever they want and be as creative as they want in their marketing. And that is why these orthodontic pacifiers get pushed through. Because it's approved by one orthodontist or one dentist. And now it's like an orthodontic pacifier. What does that even mean? It literally means nothing because it's not an orthodontic appliance. It's not shifting your teeth, it's not changing your skeletal structure. In fact, it's messing up the orofacial complex, if nothing else. So anyways. Now, as I mentioned, the American Academy of Pediatrics does tell you to use a pacifier for the first six months to reduce. Reduce the risks of sids, as we talked about before. They also Recommend Weaning between 6 to 12 months of age. But it's interesting because when you talk to your pediatrician, they will tell you, you know, stop the PAC at two years. They'll be fine. Don't worry about that big gap in their teeth. It'll just close. In some kids it does, but in kids who have developed a lisp in addition to that open bite, it won't, because the tongue is going to constantly rest between the teeth and just plug where the PAC used to be. Right. So. And. And honestly, there's a lot of dentists out there who say it's fine to use a pacifier until like, age two or age four. I mean, yikes. Like, I've heard a lot of this. Where did they arbitrarily come up with age to, like, show me the evidence? It doesn't exist. Okay? So I'm seriously sorry for this shit advice out there. Sorry for cursing if you have a child with you. I try not to do that on here. Let's, like, review what we do know. Okay. We do know that habits form around age 6 months. We do know it's easy to break a pacifier habit around six months, and it becomes harder after that. We know that six months is a perfect time to get rid of the pacifier, per the ap, the American Academy of Pediatrics and specialists in the feeding and orofacial myofunctional therapy spaces. And we know that pacifiers are not milestones. Right. Just like sippy cups, by the way. But that's a whole nother conversation. Sippy cups are not a thing. Don't use them. They're bad for all facial development. We can do Another podcast episode on that if you guys are interested. So what's the takeaway here? Okay, one, if your baby won't take one, don't force it. Think of it as a gift. It's like one less thing that you have to wean or change during that first year with your little one. Number two, wean around six months. If you do use a paci and use the suv, right, the Avan suv. And there are systems out there. Gosh, there used to be the Lilly system, which I think may have been bought by Frida Baby. So you can look at like the Frida Baby pacifier weaning system for a gentler weaning approach. If you're someone who doesn't want to do like cold turkey, for example, and just like, you know, rip it away one night and have them cry for a couple nights. I get it. You as a mom, it's really challenging to listen to your baby cry. So if you don't want to do that and you want to like wean them off so they no longer want it because it's no longer fulfilling the void, then a free to baby pacifier weaning system. Again, not sponsored. This is just me sharing information with you. That might be a great option. And then number three, there are other ways to soothe your baby. And we can talk more about that in another episode as well as like thumb sucking because we get a lot of questions on that. But what I want everybody to realize is that when the tongue, when we're breastfeeding or bottle feeding, okay, the tongue needs to be able to cup. That means that the sides of the tongue are the lateral borders. They need to come up and the tongue needs to create a sucking shape that it's like we call it cupping. That allows the tongue to do its job and pull the liquid out. These flat pacifiers don't allow that. They train the tongue to lay flat in the mouth and compress the pacifier against the palate. However, it doesn't compress the pacifier. That's what they tell you, is that it will compress the tongue into the palate. Just the same of a pacifier, wasn't there? Absolutely not. It glues the tongue to the floor of the mouth. So orofacial complex is absolutely impacted. And I just want you guys to realize that. Now if you have questions, you can always find me at Hallie Balkan on Instagram. H A L L I E B U L K I N and ask me a question. I'm happy to chat about pacifiers. Answer any questions that you have, but just know that there is no such thing as an orthodontic pacifier and the number one pacifier that I recommend is the Philips Avent Soothy for oroficial development with weaning around six months. I hope this is helpful and I look forward to hearing from you all if you have questions. Thanks for listening to this podcast. If you want to hear more of these Myo Tots, Airway and Feeding related episodes, be sure to leave a review on Apple Podcasts or pledge a small amount on patreon.com the untethered podcast if you found value, others you know in this space will too. So be sure to share this episode on your social media platforms and join us over on Facebook on my Facebook page at Halibulcan Biz, on Instagram at Hallebulcan. And you can head over to theuntetheredpodcast.com to grab a copy of the Show Notes, where you can also subscribe to be kept up to date on the latest podcast episodes.