It's one of the hardest habits to break and can require a great deal of persuasion: Parents often struggle with weaning their child off of a pacifier.

There is much debate regarding the use of pacifiers, but there is evidence to show that there are both pros and cons, according to a study in the January/February 2007 issue of General Dentistry, the Academy of General Dentistry's (AGD) clinical, peer-reviewed journal.

"Contrary to popular belief, there are some positive effects that result from sucking on pacifiers," says Jane Soxman, DDS, author of the study and Diplomate of the American Board of Pediatric Dentistry. "One is that they assist in reducing the incidence of sudden infant death syndrome (SIDS). Babies who are offered a pacifier do not sleep as deeply as those who sleep without a pacifier. Pacifier sucking makes it possible for the infant to be aroused from a deep sleep that could result in the stopping of breathing. Pacifiers also increase sucking satisfaction and provide a source of comfort to infants."

However, parents should be aware of the negative effects of pacifier sucking on an infant's oral health. "Children should stop using pacifiers by age 2," says AGD spokesperson Luke Matranga, DDS, MAGD, ABGD. "Up until the age of 2, any alignment problem with the teeth or the developing bone is usually corrected within a 6-month period after pacifier use is stopped. Prolonged pacifier use and thumb sucking can cause problems with the proper growth of the mouth, alignment of the teeth and changes in the shape of the roof of the mouth."

There is also an association between pacifier use and acute middle ear infections (otitis media).

"Continuous sucking on a pacifier can cause the auditory tubes to become abnormally open, which allows secretions from the throat to seep into the middle ear," explains AGD spokesperson Maria Smith, DDS. "Transmission of bacteria in secretions would lead to middle ear infections."

The bottom line is that if your child is continuously battling middle ear infections, you may have an alternative to surgery or antibiotics to stop this problem, says Dr. Smith, which would be to remove the pacifier.

Breaking the pacifier habit is not always easy, and there are several methods parents can use to stop it. Parents can dip the pacifier in white vinegar, making it distasteful; pierce the nipple of the pacifier with an ice pick or cut it shorter to reduce sucking satisfaction; leave it behind on a trip; or implement the "cold turkey" method.

Tips and recommendations:

•  Pacifier use should be restricted to the time when the infant is falling asleep.
•  Pacifiers can cause severe lacerations if the shield is held inside the lips.
•  Look for a pacifier with ventilation holes in the shield, as they permit air passage. This is important if the pacifier accidentally    becomes lodged in your child's throat.
•  In order to prevent strangulation, do not place a cord around your child's neck to hold a pacifier. Look for pacifiers that have a ring.
•  A symmetrical nipple permits the pacifier to remain in the correct sucking position.
•  Dispose of the pacifier after use; it is not sanitary to keep it or give it away.