Q: My nearly 3-year-old daughter still uses a pacifier to fall asleep for her naps and at night. Otherwise she doesn’t use it. I’ve gotten conflicting advice about whether this will cause orthodontic problems in the future. I’m loath to take the pacifier away from her since it’s such a limited use and it really does soothe her and help her fall asleep.  — Via email

A: Many orthodontic problems are genetic, and the development of a child’s teeth, bite and facial bone structure changes over time. It may be impossible to know whether a misaligned bite would have emerged even if a child hadn’t used a pacifier.

Sometimes, stopping pacifier use appears to correct bite problems. You can have your child’s pediatric dentist take a look, but it may be tough to predict the future of problems identified now unless they’re severe.

Researchers compare groups of children who use pacifiers to those who don’t. Studies rely on parents’ reports and must track the children over years. Results may be complicated by habits that aren’t always reported — for example, children’s finger- and thumb-sucking.

Many studies report that bite misalignments are more common in children who use pacifiers, and that some problems (particularly posterior cross bites) are likelier with longer duration of pacifier use, markedly so after age 4.

Along with research limitations, deep-seated prejudices also come into play. Sometimes pacifiers seem to be misused as “plugs” to keep a child quiet.

When the pacifier becomes a kind of panacea for a child’s distress, there is cause for concern. The pacifier may keep parents from learning to offer a broader range of responses. It may interfere with the child’s learning other ways to soothe herself and even to understand and express her own discomfort.

Some adults may be troubled to see young children soothe themselves. Sucking a pacifier may seem “babyish” and lead to fears that the child will never stop. It is reassuring to see a child move ahead on her developmental pathway and discouraging to watch her hold onto or even revert to an old behavior.

Adults may worry that pacifiers, thumbs, bedraggled blankets and beloved stuffed animals are “crutches.” Children are often pushed to give up such habits before they’re ready — before they’ve mastered other ways of handling feelings of distress.

One simple guideline: If you try to take away a pacifier, or stop a child from sucking her thumb or fingers, you are likelier to reinforce the behavior. Instead, you can make the pacifier available as little as possible.

Once your 3-year-old is sound asleep, you may be able to ease the pacifier out of her mouth.

Try this: Introduce a “lovey,” a soft bit of cloth or favorite doll that she can hold as she goes to sleep — while she sucks on her pacifier. This will help her rely less on the pacifier.

Questions or comments should be addressed to Dr. T. Berry Brazelton and Dr. Joshua Sparrow, care of The New York Times Syndicate, 620 Eighth Ave., 5th Floor, New York, N.Y. 10018. Questions may also be sent by email to:

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— New York Times Syndicate