Pacifier use modifies the association between breastfeeding and malocclusion: a cross-sectional study

Abstract

This study aimed to evaluate the influence of breastfeeding and pacifier use on the occlusal status of preschool children. A crosssectional study was conducted with children (n = 489) aged 2-5 years in private and public schools in Pelotas, South Brazil. Mothers answered a questionnaire on demographic, socioeconomic and behavioral variables, including breastfeeding and non-nutritive sucking habits. Malocclusion was classified as normal/mild and moderate/severe, according to WHO criteria. The association between breastfeeding and pacifier use with malocclusion was tested using multivariate logistic regression. The prevalence of malocclusion was 37.83% (95%CI 33.52-42.14), and 57.87% of the children used a pacifier. A total of 46.01% of the sample was exclusively breastfed for 6 months, and 24.74% were never breastfed. Malocclusion was associated with pacifier use, and with both non-exclusively breastfed and never breastfed. After adjustments for demographic and socioeconomic variables, the children who used a pacifier and were never breastfed (OR = 19.08; 95%CI 8.54-42.63), or who used a pacifier and were not exclusively breastfed (OR = 13.74; 95%CI 6.11-30.92), showed worse occlusal conditions, compared with the children who were exclusively breastfed and never used a pacifier. Pacifier use modifies the relationship between breastfeeding and occlusal status.

Prevalence and determinants of the use of pacifiers and feedingbottle: a study in Southwest Bahia

“…1 This instruction takes into account the possibility of "nipplesconfusion" by the infant, resulting in an oral configuration and sucking pattern inappropriate for breastfeeding after exposure to the artificial nipples, 2 which contributes to early weaning. 3 Studies have shown that the use of pacifiers and/or feeding bottle favors early breastfeeding discontinuance, interferes with the development of orofacial structures, alterschild chewing and swallowing functions, 4 is associated with higher risk of cariesoccurrence 5 and teeth malocclusion, 6 besides it has been considered an important source of contamination by microorganisms harmful to health. 7 In Brazil, some regulations were established in order to supervise the trade of infant products, including pacifiers and baby bottles.…”

Relationship between Breastfeeding and Malocclusion: A Systematic Review of the Literature

“…As regards to vertical discrepancy, 12 studies [3,10,14,15,18,34,36,38,39,44,45,47] investigated the relationship between breastfeeding and abnormal anterior overbite/openbite in deciduous teeth. Finally regarding sagittal discrepancy, seven studies [2,15,18,36,38,39,44]…”

“…Several studies have investigated the connection between occlusion and breastfeeding and they often came to different conclusions. Some studies [15,29] found no evidence of a connection between breastfeeding duration and malocclusion while others were able to define a precise relationship between reduced or no breastfeeding and the development of different kinds of malocclusion, i.e., skeletal class II [35], open bite [36] or posterior crossbite [37][38][39].…”

Effects of Pacifiers on Peripheral Capillary Oxygen Saturation during Wake Time

“…The relationship between malocclusions and pacifier use is a much-debated issue. Although no definite conclusions that are consistent with the principles of evidence-based medicine have been drawn, the general consensus regards pacifier use as harmful if it does not comply with the recommended timing and modalities [1][2][3][4] Suction is an innate reflex that appears in the prenatal stage and is one of the first muscular coordination abilities of a fetus [5]. A pacifier stimulates this reflex.…”