Changes in the prevalence of nonnutritive sucking patterns in the first 8 years of life

Resident’s Name: Jessica Wilson

Article title: Changes in the prevalence of nonnutritive sucking patterns in the first 8 years of life

Author(s): Bishara, S et al.

Journal: American Journal of Orthodontics and Dentofacial Orthopedics

Year. Volume (number). Page #’s: 2006. 30:1. 31-36.

Major topic: Nonnutritive sucking patterns

Overview of method of research: Scientific Article

Background:
It is estimated that the prevalence of pacifier use is up to 70% and recently, the trend is for children to prolong their pacifier habits. Studies have also shown a significantly higher proportion of girls having digit habits.

Purpose:
To determine prospectively the duration of nonnutritive sucking behaviors of children between the ages of 1 and 8 and the effect of persistent habits on selected occlusal characteristics in the late deciduous dentition.

Methods:
The investigation was part of the Iowa Fluoride Study, a prospective cohort study. Questionnaires were mailed to participant’s mothers at 3, 6, 9, 12, 16, 20, and 24 months and yearly thereafter. Questionnaires included questions on nonnutritive sucking behaviors. The children were examined at 4 1/2-5 years old and alginate impressions along with a bite registration were taken on the majority of the patients. 372 of the participant’s models met the full primary dentition requirement and were analyzed for canine relationship, posterior crossbite, overjet, overbite and open bite. A total of 797 children were included in the sucking behavior analysis. The McNemar test was used to compare various findings.

Results:
At the end of the first year, there were significantly more children using a pacifier than having a digit habit. Throughout the next 4 years, the incidence of children still using pacifiers was significantly less than those with finger habits. The incidence of pacifier habits decreased between the ages of 3 and 8 years from 10% to 0.3% whereas, the incidence of digit sucking only decreased from 14% to 4%.
When looking at digit habits, there was a statistically significant decrease in incidence from the ages of 1 to 4 years, from 4 to 7 years the decrease reached a plateau, followed by another significant decrease from 7 to 8 years of age.
Children with prolonged (>4 years) pacifier habits had a significantly greater incidence of posterior crossbite than those with a digit habit, while prolonged digit habit had a significantly greater incidence of excessive overjets. Class II canine relationships and anterior openbites were not significantly different between these groups.

Key points/Summary:
1. There were no significant differences in prevalence of digit or pacifier habits between boys and girls between the ages of 1 and 8.
2. Children with habits lasting less than 12 months did not have significantly different occlusal characteristics than those who were breast-fed for 6-12 months.
3. Habits lasting >48 months have detrimental effects on occlusion in the late deciduous dentition.
4. When comparing changes in pacifier and digit habits, more children with digit habits had difficulty in stopping after 4 years of age. “As a result, it might be useful to attempt to substitute the digit habit with a pacifier habit as soon as possible.”

Assessment of Article:
I am not sure how I feel about that last statement made by the authors about substituting a digit habit with a pacifier habit, but overall the article presented some pretty interesting findings. Me sorta likey.