Maternal Education, Dental Visits and Age of Pacifier Withdrawal: Pediatric Dentist Role in Malocclusion Prevention

Although discouraged, pacifier usage is widespread and often practiced beyond two years of age. The current study explored the effects of maternal education and dental visits on the age of pacifier withdrawal. Study design: The dental histories of 213 children (53.1% male) attending a primary school in Madrid were obtained along with maternal education level and age at pacifier withdrawal. Data were analyzed by using independent samples t-test, one-way ANOVA two-way ANOVA and a complementary non-parametric approach was also used. Results: There was a significant effect of maternal education on the age of pacifier withdrawal; the higher the maternal education, the younger the age of withdrawal. The frequency of dental visits influenced the relationship between maternal education and the age of pacifier withdrawal . Dental visits considerably shortened pacifier use among children with low- and medium- educated mothers. Conclusions: Pediatric dentists play a critical role in the correction of unhealthy oral habits such as prolonged pacifier use. The educational component of peediatric dentistry could reverse the lack of knowledge or misinformation among high-risk groups (e.g. low maternal education). As a consequence, we recommend that children start dental visits at an early age and maintain visits with a high frequency.

pacifier use, maternal education, dental visits, malocclusion prevention.

1. Gili D. And another thing! A diatribe on dummies. Arch Dis Child, 86: 222, 2002.

2. Ravin JJ. The prevalence of dummy and finger sucking habits in Copenhagen children the age of 3 years. Community Dent Oral, 2: 316-322, 1974.

3. Adair SM. Pacifier use in children: a review of recent literature. Pediatr Dent, 25: 449-458, 2003.

4. Warren JJ, Levy SM, Nowak AJ, Tang S. Non nutritive sucking behaviors in preschool children: a longitudinal study. Pediatr Dent, 22: 187-191, 2000.

5. Ovsenik M, Farcnik FM, Korpar M, Verdenik I. Follow-up study of functional and morphological malocclusion trait changes from 3 to 12 years of age. Eur J Orthodont, 29: 523-9, 2007.

6. World Health Organization. Protecting, promoting and supporting breastfeeding: the special role of maternity services. Int J Gynaecol Obstet, 31: 171-183, 1990.

7. Adair S M, Milano M, Lorenzo I , Russel C. Effects of current and former pacifier use on the dentition of 24- to 59-month-old children . Pediatr Dent, 17: 437 – 444, 1995.

8. Hauck FR, Omojokun OO, Siadaty MS. Do pacifiers reduce the risk of sudden infant death syndrome? A meta-analysis. Pediatrics, 116: 716-723, 2005.

9. Scavone H Jr, Ferreira RI, Mendes TE, Ferreira FV. Prevalence of posterior crossbite among pacifier users: a study in the deciduous dentition. Braz Oral Res, 21: 153-158, 2007.

10. Warren JJ, Bishara SE, Steinbock KL, Iones T, Nowack AJ. Effects of oral habits’ duration on dental characteristics in the primary dentition. J Am Dent Assoc, 132: 1685-1693, 2001.

11. Zardetto CGC, Rodrigues CRMD, Stefani FM. Effects of different pacifiers on the primary dentition and oral myofunctional structures of preschool children. Pediatr Dent, 24: 552-560, 2002.

12. Bishara SE, Warren JJ, Broffitt B, Levy SM. Changes in the prevalence of nonnutritive sucking patterns in the first 8 years of life. Am J Orthod Dentofac, 130: 31-36, 2006.

13. Duncan K, McNamara C, Ireland AJ, Sandy JR. Sucking habits in child - hood and the effects on the primary dentition: findings of the Avon Longitu - dinal Study of Pregnancy and Childhood. Int J Paediatr Dent, 18:178-188, 2008.

14. Heimer MV, Tornisiello Katz CR, Rosenblatt A. Non-nutritive sucking habits, dental malocclusions, and facial morphology in Brazilian children: a longitudinal study. Eur J Orthodont, 30: 580-585, 2008.

15. Macena MC, Katz CR, Rosenblatt A 2009 Prevalence of a posterior cross - bite and sucking habits in Brazilian children aged 18-59 months. Eur J Orthodont, 3: 357-361, 2009.

16. Päivi Ollila. Assessment of caries risk in toddlers. A longitudinal cohort study. Oulu: University of Oulu; 2010.

17. Peressini S. Pacifier use and early childhood caries: an evidence-based study of the literature. J Can Dent Assoc, 69: 16-19, 2003.

18. Zhang M, McGrath C, Hägg U. Who knows more about the impact of malocclusion on children’s quality of life, mothers or fathers? Eur J Ortho - dont, 29:180-5, 2007.

19. Hebling SR, Cortellazzi KL, Tagliaferro EP, Hebling E, Ambrosano GM, Meneghim Mde C, et al. Relationship between malocclusion and behav - ioral, demographic and socioeconomic variables: a cross-sectional study of 5-year-olds. J Clin Pediatr Dent, 33: 75-79, 2008.

20. North K, Fleming P, Golding J. Pacifier use and morbidity in the first six months of life. Pediatrics, 103: 34, 1999. 21. Farsi NMA, Salama FS: Sucking habits in Saudi children: prevalence, contributing factors and effects on the primary dentition. Pediatr Dent, 19:28-33, 1997.

22. Ostberg AL, Ericsson JS, Wennström JL, Abrahamsson KH. Socio-eco - nomic and lifestyle factors in relation to priority of dental care in a Swedish adolescent population. Swed Dent J, 34: 87-94, 2010.

23. López R, Fernández O, Baelum V. Social gradients in periodontal diseases among adolescents. Community Dent Oral, 34: 184-196, 2006.

24. Blinkhorn AS, Wainwright-Stringer YM, Holloway PJ. Dental health knowledge and attitudes of regularly attending mothers of high-risk, pre-school children. Int Dent J, 51: 435-438, 2001.

25. Soares MEM, Giugliani ERJ, Braun ML, Salgado ACN, Oliveira AP, Aguiar PR . Pacifier use and its relationship with early weaning in infants born at a Child-Friendly Hospital. J Pediatr, 79: 309-316, 2003.

26. Kramer MS, Barr RG, Dagenais S, Yang H, Jones P, Ciofani L, et al. 2001 Pacifier use, early weaning, and cry/fuss behavior: a randomized controlled trial. JAMA, 286: 322-326, 2001.

27. Victora CG, Behague DP, Barros FC, Olinto MTA, Weiderpass E. Pacifier use and short breastfeeding duration: cause, consequence, or coincidence? Pediatrics, 99: 445-453, 1997.

28. Chan SC, Tsai JS, King NM. Feeding and oral hygiene habits of preschool children in Hong Kong and their caregivers’ dental knowledge and atti - tudes. Int J Paediatr Dent, 12: 322-331, 2002.

29. Lewis CW, Grossman DC, Domoto PK, Deyo RA. The role of the pediatri - cian in the oral health of children: a national survey. Pediatrics, 106: 84, 2000.

30. Primozic J, Ovsenik M, Richmond S, Kau CH, Zhurov A. Early crossbite correction: a three-dimensional evaluation. Eur J Orthodont, 31:352-6, 2009.

31. Degan VV, Puppin-Rontani RM. Prevalence of pacifier-sucking habits and successful methods to eliminate them: a preliminary study. J Dent Child, 71: 148-151, 2004.