Uso del chupete: beneficios y riesgos

All day-long pacifier use and intelligence quotient in childhood: A birth cohort study

BACKGROUND

Literature on pacifier use remains controversial, but mostly suggests an inverse association with childhood intelligence.

OBJECTIVES

The objective of this study was to assess the association between pacifier use and intelligence quotient (IQ) in six-year-old children from a birth cohort.

METHODS

Data from 3532 children from the 2004 Pelotas (Brazil) Birth Cohort were analysed. Children were recruited and assessed at birth and followed up at 3 months, and 1, 2, 4, and 6 years. Data on pacifier use duration and intensity were obtained via interviews with mothers in all six follow-up visits. IQ was estimated at 6 years using the Wechsler Intelligence Scale for Children and standardised for the analyses. Crude and adjusted coefficients were calculated (linear regression) for all the data collected in follow-up assessments for pacifier use.

RESULTS

IQ was inversely associated with all pacifier use indicators. Children who used a pacifier all day long (ADL) at any follow-up showed an IQ 0.18 (95% confidence interval [CI] 0.11, 0.24) standard deviations below those who never used it ADL, after adjusting for confounders. The strength of association increased with number of assessments reporting ADL pacifier use, from a reduction in IQ of 0.13 (95% CI 0.06, 0.21) to 0.34 (95% CI 0.15, 0.52) standard deviations for ADL use in one and in all four follow-up visits, respectively.

CONCLUSIONS

We found a strong association between intense pacifier use up to 4 years of age and lower IQ at 6 years. A dose-response gradient was observed, with greater IQ deficits in children who used a ADL pacifier for longer durations. The mechanisms underlying this association need to be clarified. One hypothesis is that children using a pacifier, especially those who use it more intensely, are less stimulated.

[Pacifier sucking habit and associated dental changes. Importance of early diagnosis]

INTRODUCTION

The non-nutritive sucking habits are a physiological activity during the first months of life of a child, but if they persist afterwards, these habits can affect the development of dental occlusion.The aim of this study was to determine the frequency of past pacifier-sucking habits in a sample of school children and its role in the genesis of dental malocclusion in primary dentition, as well as to follow up these alterations until the next phase of the dentition (mixed dentition).

MATERIAL AND METHODS

We performed a longitudinal epidemiological study on a sample of 225 children from age 2 to 10 years in the Basque Autonomous Region.Data were obtained by means of a questionnaire of children habits, filled in by parents, and clinical tests carried out on the children, recording the presence of alterations in dental occlusion, such as anterior open bite and posterior crossbite.

RESULTS

We found a significant increase of malocclusion in the primary dentition of children who prolonged the pacifier-sucking habit. If this habit was abandoned early, anterior open bites improved, while posterior crossbites clutch remained or even got worse.

CONCLUSIONS

The pacifier sucking habit influences the development of the teeth, thus, it is necessary to detect early changes in order to prevent the establishment of dental malocclusion.

Pacifiers: A microbial reservoir

The permanent contact between the nipple part of pacifiers and the oral microflora offers ideal conditions for the development of biofilms. This study assessed the microbial contamination on the surface of 25 used pacifier nipples provided by day-care centers. Nine were made of silicone and 16 were made of latex. The biofilm was quantified using direct staining and microscopic observations followed by scraping and microorganism counting. The presence of a biofilm was confirmed on 80% of the pacifier nipples studied. This biofilm was mature for 36% of them. Latex pacifier nipples were more contaminated than silicone ones. The two main genera isolated were Staphylococcus and Candida. Our results confirm that nipples can be seen as potential reservoirs of infections. However, pacifiers do have some advantages; in particular, the potential protection they afford against sudden infant death syndrome. Strict rules of hygiene and an efficient antibiofilm cleaning protocol should be established to answer the worries of parents concerning the safety of pacifiers.

Prevalencia de los hábitos bucales y alteraciones dentarias en escolares valencianos

INTRODUCTION

Oral habits are acquired through the repetition of actions that serve to calm an emotional need of the child. All these oral habits can change the position of the teeth and arches. Pediatricians should identify these habits to instigate successful treatment.

OBJECTIVE

The aim of the present study was to determine the prevalence of oral habits in 1,100 Valencian schoolchildren and identify the dental alterations associated with these habits.

MATERIAL AND METHODS

Between January and June 2003, 1,100 children aged between 4 and 11 years old were examined by two observers, a dentist and a pediatrician, who were specially trained to detect anomalous habits.

RESULTS

The prevalence of each of the distinct habits studied varied.

CONCLUSIONS

The conclusions of our study were: a) the prevalence of oral habits was 53 %; b) no differences in oral habits were found between boys and girls, and c) open bite, maxillary cross-bite and overjet can be related to oral habits, although this association was not statistically significant.