Influence of pacifier design on pacifier-palate contact: a finite element analysis

Abstract

Objective: The study compares the contact pressure and pressure distribution of various pacifier shapes on the palatal surfaces of newborns and six-month-old infants using nonlinear finite element analysis (FEA). Additionally, it seeks to assess the extent and pattern of interaction between pacifier designs and the lateral and medial zones of the palates.

Materials and methods: 3D finite element models of four pacifiers (A = NUK^®, B = MAM^®, C = BIBS^®, D = CURAPROX^®) of newborn and six-month-old palate and tongue were developed. The palate geometries were based on dental stone impressions of a neonate and six-month-old infant. The pacifier designs were digitized using computed tomography and analyzed in ANSYS Mechanical 2024 R1 (Ansys, Inc., Canonsburg, USA). Hyperelastic silicone rubber properties were used, while the palate and tongue were modeled as rigid and the mucosa as flexible. The interaction between different pacifier designs and the palate of a newborn was assessed through deformation, contact area, and contact pressure relative to the vertical tongue displacement in the anterior, medial, and lateral zones of the palates.

Results: Pacifier D exhibited the highest lateral and medial pressures on both the newborn and six-month-old palates with its broad-winged design. Pacifiers A and B showed moderate but steady increases in lateral pressure. In contrast, pacifier C showed concentrated pressure in the anterior zone with its distinct, rounded shape, particularly on the newborn palate. Pressure distribution patterns differed significantly between pacifier designs, with pacifier D showing the most extensive and uniform pressure distribution across the palate.

Conclusions: Pacifier design significantly influences palatal interaction, with broader shapes resulting in higher pressure concentrations on the lateral sides that may affect the transversal palate dimension. Understanding the biomechanical impacts of pacifier use is the first step in giving valuable insights to both clinicians and parents in making informed decisions regarding pacifier selection to support optimal oral development. Further clinical studies are needed to validate these findings.

Keywords: Finite element analysis; Infant; Non-Nutritive sucking; Oral development; Pacifier morphology; Palatal pressure.

Fig. 1

Digitized top and side views of the palate models for newborn (left) and six-month-old (right) infants, with frontal (green), medial (blue), and lateral (violet) zones highlighted. Scale bar = 10 mm

Fig. 2

Newborn pacifiers: (a–d) Isometric views of pacifiers A, B, C, and D; (e–h) inferior-to-superior views; (i–l) cross-sectional views showing the palate (mucosa in red, bone in ivory) and tongue (pink). Scale bar = 10 mm

Fig. 3

Six-month-old pacifiers: (a–d) Isometric views; (e–h) inferior-to-superior views; (i–l) cross-sectional views showing the palate and tongue. Scale bar = 10 mm

Fig. 4

(a) Cross-sectional and (b) isometric finite element mesh for newborn palate, mucosa, tongue, and D pacifier

Fig. 5

Newborn Palate: (a) Deformation (mm), (b) contact area (mm²), and (c) contact pressure (kPa) results for the pacifier interaction relative to the vertical tongue displacement for NUK^® (A), MAM^® (B), BIBS^® (C), and CURAPROX^® (D) pacifier bulbs. The frontal, medial, and lateral, zones of the palate are highlighted in green, blue and purple, respectively. In (d), each pacifier bulb’s contact pressure (kPa) is shown for specific palate zones: frontal, medial, and lateral, with a vertical tongue displacement of up to 7 mm toward the six-month infant palate. Additionally, the plot shows the total reaction force (red) required to achieve a maximum tongue displacement of up to 7 mm for each pacifier bulb

Fig. 6

Six-month-old palate: (a) Deformation (mm), (b) contact area (mm²), and (c) contact pressure (kPa) results for the pacifier interaction relative to the vertical tongue displacement for NUK^® (A), MAM^® (B), BIBS^® (C), and CURAPROX^® (D) pacifier bulbs. The palate’s frontal, medial, and lateral zones are highlighted in green, blue, and purple, respectively. In (d), each pacifier bulb’s contact pressure (kPa) is shown for specific palate zones: frontal, medial, and lateral, with a vertical tongue displacement of up to 7 mm toward the six-month infant palate. Additionally, the plot shows the total reaction force (red) required to achieve a maximum tongue displacement of up to 7 mm for each pacifier bulb