Abstract
BackgroundPacifier sucking habit has been associated in the literature with alterations of dental occlusion, and it could be a predisposing factor for other poor oral habits among children. Orthodontic pacifiers have been introduced in the market aiming to reduce these disadvantages caused by the conventional type of pacifiers. The aim of this study was to evaluate the prevalence of poor oral habits and malocclusions, after usage of orthodontic pacifiers in children with primary dentition.MethodsA sample of 198 pre-school children, aged 3–5 years, (96 males and 102 females) who had exclusively used an orthodontic pacifier were included in order to assess the level of poor oral habits and the absence/presence of dental malocclusion. Firstly, children’s parents/legal guardians were given a validated questionnaire, then the children were clinically examined at a dental clinic.ResultsMost of the children (79.79%) had started using the orthodontic pacifier within the first 3 months of life, and the 43.49% of them continued using it over a period of 2 years. The recorded percentage for those who had used it throughout sleep was 89.39%. Mouth breathing during the night was reported for 36.04% of the children. Tongue thrust swallow affected 16.16% of the sample. The 5.56% of the data indicated the presence of fingersucking/thumbsucking habit. The noted percentages for children with lip biting, lingual interposition between teeth at rest and those with nail biting, were 5.56, 12.63 and 15.15%, respectively. The regression revealed a significant contribution between early start of using an orthodontic pacifier with the prevalence of fingersucking/thumbsucking (OR 0.13, 95% CI 0.04–0.47, p = 0.0004).This also reported a noticeable increase of the malocclusion prevalence among the female gender (OR 2.74, 95% CI 1.42–5.31), as well as those who were not exclusively breastfed (OR 2.26, 95% CI 1.17–4.37).ConclusionsOrthodontic pacifiers does not favor the development of poor oral habits, even if it has been used for a period of 2 years in children with primary dentition. Children who begin to use orthodontic pacifier between 0 and 3 months, are less likely to acquire fingersucking/thumbsucking habit. The use of an orthodontic pacifier appears not to be correlated with the prevalence of malocclusion in primary dentition, differently from what stated in literature about the conventional type of pacifier.
Highlights
Pacifier sucking habit has been associated in the literature with alterations of dental occlusion, and it could be a predisposing factor for other poor oral habits among children
When the sample was divided into two groups, based on the presence/absence of a malocclusion, compared to each other, statistically significant differences for gender distribution, with a significantly higher percentage of females with malocclusions compared to the males (63.38% vs 44.88%, p = 0.012), and for breastfeeding, which interested a lower proportion of children in the malocclusion group (71.65% vs. 57.75%, p = 0.046), were detected
The estimates of the Odds Ratios (OR) - adjusted for the effects of the other factors - are presented in the model (Table 2), through a logistic regression, that revealed a significant contribution of female gender, and the not exclusive breastfeeding in increasing the probability of developing a malocclusion
Summary
Pacifier sucking habit has been associated in the literature with alterations of dental occlusion, and it could be a predisposing factor for other poor oral habits among children. From the craniofacial development point of view, the use of a conventional pacifier for a long time (over 2 years) [2] and with high frequency (a “daily use”, as recently stated by Ling et al [1]) has been associated with some alterations of the occlusion, such as anterior open bite and posterior crossbite [3,4,5] For this reason, the so-called orthodontic pacifiers have been introduced into the market, designed with a flattened nipple to simulate mothers’ nipple anatomy, to maintain the necessary pressure of tongue on the palatal vault and to obtain a more acceptable lip seal, allowing its physiological development and reducing the side effects related to utilising conventional pacifiers [6,7,8,9]. The main conclusion stated the insufficiency of currently available evidence to support this hypothesis that the usage of orthodontic pacifiers is able to prevent malocclusion traits when compared to conventional ones, and that new data on orthodontic pacifiers effects are necessary in literature to substantiate the argument [8]
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