Abstract
Culturally different population groups have distinct infant feeding practices, which presumably may be related to diverse occlusal features in the primary dentition. Aim: To investigate the associations between nutritive and non-nutritive sucking habits and the prevalence of anterior open bite, in children from Aragua-Venezuela and Sao Paulo-Brazil. Methods: Seven calibrated examiners (κ = 0.89-1.0) performed clinical assessments in Venezuelans (N = 809) and Brazilians (N = 1,377) aged 3-6 years. Sucking habits were investigated using questionnaires answered by the mothers. Data were analyzed using logistic regression models (α = 0.05). Results: Among 380 children with anterior open bite, 309 were Brazilians. Approximately 65% of Brazilians with pacifier-sucking habit lasting beyond 3 years of age had this malocclusion. Brazilians who prolonged pacifier and digit-sucking habits beyond 3 years of age have, respectively, 68.5 and 14.5 times more chances of presenting anterior open bite than children without sucking habits (p < 0.001). In Venezuelans with open bite, 37.7% had digit-sucking habits beyond 3 years of age, resulting in a high odds ratio (9.3; p < 0.001) when compared to children without this habit. No significant effect was found for bottle feeding. However, non-breastfed Venezuelan children or those breastfed for periods shorter than 6 months have a two-fold higher chance of presenting anterior open bite than children who were breastfed for longer periods, p = 0.008. Conclusions: Infant feeding had some effect on Venezuelan children, since insufficient breastfeeding was related to a higher prevalence of anterior open bite. Pacifier-sucking was more prevalent in Brazilians, corresponding to pronounced chances (8-68 times greater) of diagnosing anterior open bite in pacifier users compared to non-users. Among Venezuelans, on the other hand, digit-sucking effect surpassed that of pacifier use and was associated with far higher chances (6-9 times) for this malocclusion.
Highlights
Breastfeeding should be extensively promoted as opposed to bottle feeding and non-nutritive sucking habits, as far as it concerns the morphological, immunological and psychological aspects of child development[1,2,3,4,5]
Despite the high number of Brazilian children with anterior open bite, the logistic regression model adjusted for combined analysis of all explanatory variables did not indicate a significant effect of geographic location
Because each type of sucking habit may have a different effect according to the sociocultural characteristics of the two population groups, individual logistic regression models were adjusted for Venezuelan and Brazilian children
Summary
Breastfeeding should be extensively promoted as opposed to bottle feeding and non-nutritive sucking habits, as far as it concerns the morphological, immunological and psychological aspects of child development[1,2,3,4,5]. Even though the relationship between prolonged non-nutritive sucking habits, especially pacifier use, and malocclusions in the primary dentition is well established[3,4,5,6,7,8,9,10], the effect of bottle feeding is still controversial. The occurrence of anterior open bite is markedly associated to extended non-nutritive sucking habits[4,5,7,8,9,10,11,12,14,17,18,19,20,21,22] and possibly related to bottle feeding . 8,11 the present study aimed at evaluating the effects of nutritive and non-nutritive sucking habits on the prevalence of anterior open bite in preschool children from AraguaVenezuela and São Paulo-Brazil The occurrence of anterior open bite is markedly associated to extended non-nutritive sucking habits[4,5,7,8,9,10,11,12,14,17,18,19,20,21,22] and possibly related to bottle feeding . 8,11 the present study aimed at evaluating the effects of nutritive and non-nutritive sucking habits on the prevalence of anterior open bite in preschool children from AraguaVenezuela and São Paulo-Brazil
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