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Bottle-feeds, pacifier affect teeth alignment

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Prolonged bottle-feeding and use of pacifiers in children predisposes them to the risk of dental problems in future. Many factors influence the development of the jaw, dental arches, tongue and facial muscles. Researchers suggest that one of those factors may be the use of pacifiers or children's preferences for thumb-sucking. To investigate whether thumb-sucking, using a pacifier or feeding with a bottle influences dental development, researchers from a local health unit in Italy surveyed the parents of 1130 children between the ages of 3 and 5 about their children's habits during the first months of life. Children also underwent a thorough dental examination. They found that children who sucked their thumbs or a pacifier after one year of age, or drank out of a bottle in the first three months of life, were more likely to have misaligned baby teeth at 3 to 5 years of age. More than one-third of children showed some type of bite problem. Around 13 per cent had an anterior open bite, in which their top and bottom front teeth did not connect when they bit down. Seven per cent had a posterior cross-bite, in which their top back teeth bite along the inside of the bottom back teeth. In normal alignment, the bottom back teeth hit the inside of the top back teeth. Nearly 9 out of 10 children with an open bite had sucked a pacifier or thumb after one year of life. Children who started bottle-feeding before 3 months of age were more likely to develop a posterior cross-bite. Children who sucked on a pacifier or thumb after one year of age were also more likely to develop a posterior cross-bite. However, those who breastfed exclusively for longer than the first 3 months of life were less likely to develop the misalignment as compared to the bottle-fed children, suggesting that breastfeeding protects children from dental alignment problems. Most of the head and facial structures grow in the first 4 years of life. Excessive thumb or pacifier sucking sets up abnormal forces in the oral cavity i.e. the lips, tongue, dental arcades and the palate, which affects the development of the muscles of the mouth, face, and the palate. These changes are likely due to the difference in how the child sucks a bottle or pacifier and how it feeds from the breast. Children should not be encouraged to use a pacifier but those who do should stop using it before they turn 2 years old. Bottle-feeding may also affect jaw alignment because using a bottle requires more powerful sucking from the lips and cheeks than feeding from a breast.

Archives of Disease in Childhood,
November 2004

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