Effects of pacifiers on early oral development.

OBJECTIVE

Pacifier use and its effects on the developing cranio-facial structures has long been debated and filled with controversy. The aim of this meta-analysis is to investigate whether pacifiers have a harmful effect on the developing dentition, and if so, what those effects are and at what age they begin.

METHODS

The existing literature was researched using PubMed and NLM for articles published in English between Jan-Feb 1992 and Oct 2003. The search utilized the words or phrases "pacifiers," "nonnutritive sucking", "pacifiers and malocclusion", "effects ofpacifiers", and "pacifier sucking". The book Essentials of Facial Growth by Enlow and Hans was also included because of the classic research on growth and development.

RESULTS

Several articles showed that pacifier use beyond age 3 has an increasingly harmful effect on the developing dentition. The most notable changes are an increase in the prevalence of an anterior open bite, posterior cross bite, narrow intercuspid width of the maxillary arch, and a high narrow palate. If the pacifier was used beyond the age of 5, the effects became more severe. Pacifier use is prevalent in most countries and does not alter the dentition if its use is stopped by age 2 to 3.

CONCLUSION

Pacifier use beyond the age of 3 contributes to a higher incidence in anterior open bite, posterior cross bite and narrow intercuspid width. The greater the longevity and duration ofpacifier use, the greater the potential for harmful results.