Improved pacifiers are provided. Certain embodiments better accommodate the anatomy of the human oral cavity and throat, and can provide for improved airway patency, healthy jaw development, correct swallowing, and/or satisfy a user's inclination to suck and nibble. Certain embodiments include an upper ridge groove configured to receive a user's upper anterior ridge, and a lower ridge groove configured to receive the user's lower anterior ridge. The ridge grooves can be substantially vertically aligned, can span a user's anterior ridges, and can maintain vertical spacing between the user's anterior ridges. Certain embodiments include an anterior flange and a posterior flange, the upper ridge groove configured to receive the upper anterior ridge between the posterior flange and anterior flange, and the lower ridge groove configured to receive the lower anterior ridge between the posterior flange and anterior flange. Certain embodiments include a nipple projecting substantially vertically from the posterior flange.