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

Malocclusion in deciduous dentition: a cross-sectional study in a Portuguese preschool population

PURPOSE

To determine the prevalence of malocclusion in Portuguese preschool children, to characterise occlusion in the deciduous dentition, and to study the relationship between malocclusion, sex, and age.

METHODS

This cross-sectional study included 3-6 years old children, from 25 randomly selected kindergartens from the Lisbon district. Data were collected through an oral examination. Malocclusion was defined as the presence of any type of occlusion anomaly (anterior crossbite, edge-to-edge, increased overjet, open bite, deep overbite, posterior crossbite, scissor bite), spacing anomaly (crowding), or dentition anomaly (supernumerary teeth, agenesis, malformations). Canine class, terminal plane of the deciduous second molars and type of Baume arch were also recorded. Statistical analysis included descriptive and chi-squared test (α = 0.05).

RESULTS

The sample included 426 children with a global prevalence of malocclusion of 60.6%. Occlusion anomalies were the most prevalent (59.2%), the most frequent being deep overbite (27%), increased overjet (22.1%) and posterior crossbite (14.1%). Crowding had a prevalence of 1.6% and agenesis of 1.4%. Class I canine (57.3%), straight second molar terminal plane (60.1%) and type I Baume arch (53.3%) were the most common. The mean overjet was 2.6 mm (sd = 2.1) and the mean overbite was 2.2 mm (sd = 2.1). Age was associated with the presence of occlusion anomalies (p = 0.03), and increased overjet prevalence was found to be higher in girls (p = 0.03).

CONCLUSIONS

The prevalence of malocclusion was high, with occlusion anomalies being the most prevalent. It is important to identify modifiable risk factors associated with malocclusion to prevent this condition in both the deciduous and permanent dentitions.

Mechanical stress distribution over the palate by different pacifiers assessed by finite element analysis and clinical data

The mechanical behavior of each type of pacifier on rigid structures and their various impacts on orofacial growth have yet to be discovered. The study aimed to evaluate the stress distribution over a child's palate by three types of pacifiers using finite element analysis and clinical and laboratory data. Modulus of elasticity was obtained from 30 specimens comprising 10 of each conventional (A), orthodontic (B), and breast-shaped (C) pacifiers. Tongue strength was assessed in eight 3-year-old children (kPa). A hemi-maxilla model was obtained from 2- to 3-year-old skull tomography, and the images of pacifiers A, B, and C were captured using 3D scanning. The Hypermesh® program generated a mesh of 6-node tetrahedral elements for applying forces in the X, Y, and Z directions to enable a nonlinear analysis. Pacifier B exhibited the highest values for distributed stress on the palate, followed by pacifier A. Pacifier B stimulated the maxilla forward and sideways. In contrast, pacifier A promoted a forward and upward load, favoring a more atresic palate. Pacifiers A and B tended to rotate in the sagittal plane, generating tensions in the anterior incisors and favoring the open bite. Pacifier C exhibited lateral expansion by stress induction over the mid-palatal suture with less influence on incisor inclination. Pacifiers showed different detrimental stress distributions on the palate. This information can be helpful for improving recommendations given to parents.

Relationship between Nutrition and Development of the Jaws in Children: A Pilot Study

Craniofacial growth and development have been shown to be influenced by various environmental factors that impact child development. This study aims to analyze the different patterns of feeding during early childhood, starting from birth, and assess the variability of nutrition during the first stage of childhood, along with the habits developed, to study their impact on jaw development. The study was conducted on a sample of twenty-five patients aged 3 to 5, following approval from the ethics committee of the Catholic University of Valencia. Informed consent was obtained from the fathers, mothers, and/or legal guardians, who were administered surveys on habits and diet. Cephalometric measurements within the parameters of ideal occlusion were subsequently taken. While previous studies examined this subject, the findings are challenging to evaluate. However, this study identified significant associations (p = 0.001) between clinical measurements and children's eating habits. The growth and development of the craniofacial cavity are influenced by multiple factors, including a child's diet and habits. Nonetheless, further research is required to determine whether diet can be considered a determining factor in proper jaw growth.

The Impact of Mode of Delivery and Postpartum Conditions on Breastfeeding: A Cross-Sectional Study

Breast milk is the optimal and essential source of nutrients for babies. Many women, however, do not breastfeed or stop early after giving birth, often due to lack of support. For newborns delivered by caesarean section, there is often a delay, or no skin-to-skin contact after birth; thus, early breastfeeding is not achieved. Separation, complementary feeding or pacifier use also limits the mother's ability to breastfeed. A quantitative, cross-sectional study was conducted. Sociodemographic data, the mode of delivery and postpartum circumstances, information on breastfeeding, and the method and duration of feeding were collected (n = 2008). Two-thirds of children born by caesarean section did not have skin-to-skin contact after birth (p < 0.001). Lack of rooming-in placement increased the incidence of more frequent complementary feeding (p < 0.001) and shortened the duration of exclusive breastfeeding (p < 0.001). The duration of breastfeeding may also be negatively affected by scheduled feeding (p = 0.007) and pacifier utilization (p < 0.001). The mode of delivery and postpartum circumstances directly affecting the mother and the newborn can affect the feasibility of breastfeeding and the duration of exclusive and partial breastfeeding. For positive breastfeeding outcomes, skin-to-skin contact immediately after birth, rooming-in and unrestricted, demand breastfeeding, as well as the avoidance of the use of pacifiers, are recommended.

Evaluation and Comparison of Oral Health Status between Spanish and Immigrant Children Residing in Barcelona, Spain

The present study aimed to evaluate and compare the level of oral health among Spanish and immigrant children residing in Barcelona, Spain. Oral health status was evaluated in 1400 children aged 3 to 14 years between September 2018 and June 2019. Multiple variables (dental caries lesions, exodontia, trauma, malocclusions, gingivitis, fillings, stainless steel crowns in primary dentition, and pit and fissure sealings in permanent dentition) were compared in both populations. Statistically significant differences (p < 0.001) were found in the prevalence of caries in the primary dentition, which was higher in the immigrant group (62.3%) than in the Spanish group (42.6%). For the permanent dentition, the prevalence of dental caries lesions was 12.2% in Spanish children and 16.4% in immigrant children, showing statistically significant differences (p = 0.026) between the two groups. The prevalence of fillings in the primary dentition was 14.6% in Spanish and 12.5% in immigrant children (p = 0.253). Regarding the permanent dentition, the number of fillings was also higher in the Spanish population (6.8%) compared to the immigrant population (3.5%), again evidencing statistically significant differences (p = 0.006). Our findings suggest a better oral health status in Spanish children than in immigrant children.

All day-long pacifier use and intelligence quotient in childhood: A birth cohort study

BACKGROUND

Literature on pacifier use remains controversial, but mostly suggests an inverse association with childhood intelligence.

OBJECTIVES

The objective of this study was to assess the association between pacifier use and intelligence quotient (IQ) in six-year-old children from a birth cohort.

METHODS

Data from 3532 children from the 2004 Pelotas (Brazil) Birth Cohort were analysed. Children were recruited and assessed at birth and followed up at 3 months, and 1, 2, 4, and 6 years. Data on pacifier use duration and intensity were obtained via interviews with mothers in all six follow-up visits. IQ was estimated at 6 years using the Wechsler Intelligence Scale for Children and standardised for the analyses. Crude and adjusted coefficients were calculated (linear regression) for all the data collected in follow-up assessments for pacifier use.

RESULTS

IQ was inversely associated with all pacifier use indicators. Children who used a pacifier all day long (ADL) at any follow-up showed an IQ 0.18 (95% confidence interval [CI] 0.11, 0.24) standard deviations below those who never used it ADL, after adjusting for confounders. The strength of association increased with number of assessments reporting ADL pacifier use, from a reduction in IQ of 0.13 (95% CI 0.06, 0.21) to 0.34 (95% CI 0.15, 0.52) standard deviations for ADL use in one and in all four follow-up visits, respectively.

CONCLUSIONS

We found a strong association between intense pacifier use up to 4 years of age and lower IQ at 6 years. A dose-response gradient was observed, with greater IQ deficits in children who used a ADL pacifier for longer durations. The mechanisms underlying this association need to be clarified. One hypothesis is that children using a pacifier, especially those who use it more intensely, are less stimulated.