Hi, I personally don't sleep with a pacifier, I could never keep it in my mouth all night, and loose it somewhere in the bed. However I do have a tendency to clench my teeth at night, and know exactly what pain you are talking about. While sleeping with the pacifier every now and then will not cause damage, doing it every night for a long time can possibly push your teeth out of line. Just use it in moderation and you should be fine.