Pacifier Sizing as a Prescription for Better Oral Health Outcomes for Infants: A Call to Action.

Sucking is essential for feeding and impacts the development of the cranio-facial-respiratory complex (CFRC). Non-nutritive sucking on a pacifier causes palatal narrowing and modifies the natural balanced relationship between intraoral pressure, peristaltic action of the tongue and the palate. Advanced engineering models have shown that malocclusions caused by pacifier use, are often a result of improper sizing. The sizing of pacifiers has historically been based on chronological age. Chronological age is not a size metric. Undersized pacifiers in a baby's mouth can cause growth complications, palatal collapse airway incompetence and other orthodontic problems that can last a lifetime. Technical advances in facial anthropometrics and predictability of the rapid growth of the infant palate, can guide recommendations for pacifier size and design. This encourages change to a model of biometric sizing. Smartphone applications are being developed that use Ai and machine learning can predict conformity between palatal width and pacifier width.