University of Turku, Faculty of Medicine, Lemminkäisenkatu 2, 20520 Turku.
Institute of Dentistry, Department of Community Dentistry, Turku, Finland.
Eur J Orthod. 2024 Oct 1;46(5). doi: 10.1093/ejo/cjae024.
BACKGROUND/RATIONALE: Systematic reviews on the effects of pacifiers on occlusion have highlighted the need for quality RCTs.
Single region, three parallel-armed, prospective, randomized controlled trial.
To investigate the correlations between early childhood non-nutritive sucking habits and malocclusion. Specifically to test whether the use of a study pacifier has differing effects compared to other pacifiers and control, and whether the duration of pacifier use or digit sucking influence the occlusion.
The subjects were firstborn children, born in 2008 in Vantaa, Finland.
One-third of participants were offered study pacifiers, free of charge, from birth up to 2 years of age. The history of the subjects' sucking habits, including pacifier use was screened in a questionnaire at the age of 2 years, and clinical examinations were performed at the age of 7 years. In addition, the subjects were divided into groups that were equally matched regarding their mother's level of education.
Posterior crossbite, anterior crossbite, overjet, deep bite, open bite, and crowding.
Three districts were randomly allocated to three study groups by drawing lots.
It was not possible to blind the clinicians or parents from the intervention. Blinding during data analysis was performed.
From the original cohort of 2715 children born in the town of Vantaa, 1911 were excluded and 353 were lost to follow-up. The remaining 451 children were divided into three groups according to the use of pacifiers. The prevalence of posterior crossbite at the age of 7 years was higher if a non-study pacifier had been used (P = .005) even when matched for the mother's level of education (P = .029). The prevalence of posterior crossbite was higher if the pacifier habit had continued for 12 months or more compared to 11 months or less, 7% and 1%, respectively, (P = .003). Digit sucking for 12 months or more was associated with crowding (P = .016). The prevalence of crossbite in the study pacifier group was less than in control pacifiers.
No adverse harms were reported other than effects on the dentition.
The use of pacifiers is associated with the posterior crossbite, especially if their use continues for a year or more. Parents/guardians should be advised to stop the use or reduce the use of pacifiers to a minimum after their child's first birthday.
ClinicalTrials.gov NCT01854502.
背景/原理：关于安抚奶嘴对咬合影响的系统评价强调了高质量 RCT 的必要性。
单区域、三臂平行、前瞻性、随机对照试验。
研究幼儿非营养性吸吮习惯与错颌畸形的相关性。具体来说，测试使用研究用安抚奶嘴是否与其他安抚奶嘴和对照组有不同的效果，以及安抚奶嘴使用时间或手指吸吮是否会影响咬合。
研究对象为 2008 年在芬兰万塔出生的第一胎儿童。
三分之一的参与者从出生到 2 岁免费获得研究用安抚奶嘴。在 2 岁时通过问卷筛查研究对象吸吮习惯的历史，包括安抚奶嘴的使用情况，并在 7 岁时进行临床检查。此外，根据母亲的教育水平，将研究对象分为三组进行匹配。
从万塔镇出生的 2715 名儿童的原始队列中，排除了 1911 名，失访 353 名。剩余的 451 名儿童根据使用安抚奶嘴的情况分为三组。如果使用非研究用安抚奶嘴，7 岁时后牙反颌的患病率更高（P=0.005），即使在匹配母亲教育水平的情况下也是如此（P=0.029）。与使用安抚奶嘴 11 个月或更短时间相比，使用 12 个月或更长时间的奶嘴习惯与后牙反颌的患病率更高，分别为 7%和 1%（P=0.003）。12 个月或更长时间的手指吸吮与拥挤有关（P=0.016）。研究用安抚奶嘴组的反颌患病率低于对照组。
除了对牙齿的影响外，没有报告其他不良危害。
安抚奶嘴的使用与后牙反颌有关，尤其是如果使用时间持续一年或更长时间。应建议家长/监护人在孩子满一岁后停止使用或尽量减少安抚奶嘴的使用。
ClinicalTrials.gov NCT01854502。
