The effect of pacifier sucking on orofacial structures: a systematic literature review

Abstract

BackgroundNon-nutritive sucking habits may adversely affect the orofacial complex. This systematic literature review aimed to find scientific evidence on the effect of pacifier sucking on orofacial structures.MethodsA search on MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science databases was conducted to find all pertinent articles published from inception until February 2018, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of the studies was evaluated using the risk of bias judgements in non-randomized studies of interventions (ROBINS-I).ResultsAmong the 2288 articles found, 17 articles met the selection criteria: seven prospective cohort studies, nine cross-sectional studies, and one randomized clinical trial. Using ROBINS-I, 12 studies were evaluated to have a serious overall risk of bias and five, a moderate one.These studies claimed a strong association between a pacifier sucking habit and the presence of an anterior open bite and posterior crossbite. Functional/orthodontic pacifiers were shown to cause significantly less open bites than the conventional ones.ConclusionsHigh level of evidence of the effect of sucking habits on orofacial structures is missing. The available studies show severe or moderate risk of bias; hence, the findings in the literature need to be very carefully evaluated.There is moderate evidence that the use of pacifier is associated with anterior open bite and posterior crossbite, thus affecting the harmonious development of orofacial structures.Functional/orthodontic pacifiers reduce the prevalence of open bite when compared to the conventional ones, but evidence is needed concerning the effects on posterior crossbite. Well-designed randomized controlled trials are needed to further analyze the effects of functional/orthodontic and conventional pacifiers on orofacial structures.

Influence of non-nutritive sucking habits on anterior open bite

“…According to Table 5, there was a significant difference between G1 and G2 regarding the use of pacifiers and digital sucking, demonstrating that they favored the development of MAA in both genders indistinctly, corroborating the findings of other authors 20,[25][26][27][28][29][30] by emphasizing that such habits may compromise the stomatognathic system similarly in both genders.…”

Influence of pacifier use on the association between duration of breastfeeding and anterior open bite in primary dentition

“…Using a pacifier has been associated with occlusal alterations [ 10 – 12 ] due to the hyperfunction of the buccinator muscle, causing restriction in the transverse growth of the mandible; and the low position of the tongue, preventing the necessary pressure against the hard palate and, consequently, the adequate growth and transversal development of the maxillary arch [ 1 , 8 , 13 , 14 ].…”

Effect of orthodontic management and orofacial muscle training protocols on the correction of myofunctional and myoskeletal problems in developing dentition. A systematic review and meta‐analysis

“…Systematic reviews have been implemented dealing with individual treatment outcomes of anterior open bite related problems, or nonnutritive oral habits in children . However, only one combined two randomized controlled trials quantitatively, revealing evidence that Frankel's Functional Regulator (FR‐4) combined with lip sealing exercises and removable palatal crib together with high‐pull chin cup facilitated anterior open bite correction .…”