{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:25:52Z","timestamp":1791228352245,"version":"4.1.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2024,8,9]],"date-time":"2024-08-09T00:00:00Z","timestamp":1723161600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"The Regional State Administrative Agency of Southern Finland"},{"name":"DentoBon"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background\/rationale<\/jats:title>\n                    <jats:p>Systematic reviews on the effects of pacifiers on occlusion have highlighted the need for quality RCTs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial design<\/jats:title>\n                    <jats:p>Single region, three parallel-armed, prospective, randomized controlled trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>The subjects were firstborn children, born in 2008 in Vantaa, Finland.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>One-third of participants were offered study pacifiers, free of charge, from birth up to 2 years of age. The history of the subjects\u2019 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\u2019s level of education.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes<\/jats:title>\n                    <jats:p>Posterior crossbite, anterior crossbite, overjet, deep bite, open bite, and crowding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Randomization method<\/jats:title>\n                    <jats:p>Three districts were randomly allocated to three study groups by drawing lots.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Blinding<\/jats:title>\n                    <jats:p>It was not possible to blind the clinicians or parents from the intervention. Blinding during data analysis was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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\u2005=\u2005.005) even when matched for the mother\u2019s level of education (P\u2005=\u2005.029). 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\u2005=\u2005.003). Digit sucking for 12 months or more was associated with crowding (P\u2005=\u2005.016). The prevalence of crossbite in the study pacifier group was less than in control pacifiers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Harms<\/jats:title>\n                    <jats:p>No adverse harms were reported other than effects on the dentition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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\u2019s first birthday.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov NCT01854502.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejo\/cjae024","type":"journal-article","created":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T10:36:17Z","timestamp":1718793377000},"source":"Crossref","is-referenced-by-count":12,"title":["The effect of early childhood non-nutritive sucking behavior including pacifiers on malocclusion: a randomized controlled trial"],"prefix":"10.1093","volume":"46","author":[{"given":"Irma","family":"Arpalahti","sequence":"first","affiliation":[{"name":"University of Turku, Faculty of Medicine , Lemmink\u00e4isenkatu 2, 20520 Turku"},{"name":"Institute of Dentistry, Department of Community Dentistry , Turku , Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krista","family":"H\u00e4nninen","sequence":"additional","affiliation":[{"name":"Orthodontics, Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital , Haartmaninkatu 1, 00290 Helsinki , Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mimmi","family":"Tolvanen","sequence":"additional","affiliation":[{"name":"University of Turku, Faculty of Medicine , Lemmink\u00e4isenkatu 2, 20520 Turku"},{"name":"Institute of Dentistry, Department of Community Dentistry , Turku , Finland"},{"name":"National Rescue Services College ,\u00a0 PL 1122 (Hulkontie 83), 70821 Kuopio , Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juha","family":"Varrela","sequence":"additional","affiliation":[{"name":"University of Turku, Faculty of Medicine , Lemmink\u00e4isenkatu 2, 20520 Turku"},{"name":"Institute of Dentistry, Department of Community Dentistry , Turku , Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9301-3078","authenticated-orcid":false,"given":"David P","family":"Rice","sequence":"additional","affiliation":[{"name":"Orthodontics, Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital , Haartmaninkatu 1, 00290 Helsinki , Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,8,9]]},"reference":[{"key":"2024080910260865300_CIT0001","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1093\/ejo\/7.3.172","article-title":"The prevalence and etiology of prolonged dummy and finger-sucking habits","volume":"7","author":"Larsson","year":"1985","journal-title":"European Journal of Orthodontics"},{"key":"2024080910260865300_CIT0002","first-page":"47","article-title":"Oral and dental state in Helsinki preschool children. 3. Prevalence of dummy and finger sucking habits","volume":"69","author":"Myllarniemi","year":"1973","journal-title":"Proceedings of the Finnish Dental Society."},{"key":"2024080910260865300_CIT0003","first-page":"13","article-title":"Evaluation of the effects of orthodontic pacifiers on the primary dentitions of 24- to 59-month-old children: preliminary study","volume":"14","author":"Adair","year":"1992","journal-title":"Pediatric Dentistry"},{"key":"2024080910260865300_CIT0004","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1179\/14653120722761","article-title":"Digit sucking in children resident in Kettering (UK)","volume":"35","author":"Patel","year":"2008","journal-title":"Journal of Orthodontics"},{"key":"2024080910260865300_CIT0005","first-page":"CD008694","article-title":"Interventions for the cessation of non-nutritive sucking habits in children","volume":"2015","author":"Borrie","year":"2015","journal-title":"Cochrane Database of Systematic Reviews (Online)"},{"key":"2024080910260865300_CIT0006","first-page":"116","article-title":"Sucking, chewing, and feeding habits and the development of crossbite: a longitudinal study of girls from birth to 3 years of age","volume":"71","author":"Larsson","year":"2001","journal-title":"The Angle Orthodontist"},{"key":"2024080910260865300_CIT0007","doi-asserted-by":"crossref","first-page":"23","DOI":"10.3109\/00016359309041144","article-title":"The Finnish Family Competence Study: the effects of living conditions on sucking habits in 3-year-old Finnish children and the association between these habits and dental occlusion","volume":"51","author":"Paunio","year":"1993","journal-title":"Acta Odontologica Scandinavica"},{"key":"2024080910260865300_CIT0008","first-page":"445","article-title":"Effects of nonnutritive sucking habits on occlusal characteristics in the mixed dentition","volume":"27","author":"Warren","year":"2005","journal-title":"Pediatric Dentistry"},{"key":"2024080910260865300_CIT0009","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1111\/j.1365-263X.2007.00905.x","article-title":"Sucking habits in childhood and the effects on the primary dentition: findings of the Avon Longitudinal Study of Pregnancy and Childhood","volume":"18","author":"Duncan","year":"2008","journal-title":"International Journal of Paediatric Dentistry"},{"key":"2024080910260865300_CIT0010","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1016\/j.adaj.2016.08.018","article-title":"Establishing the association between nonnutritive sucking behavior and malocclusions: a systematic review and meta-analysis","volume":"147","author":"Dogramaci","year":"2016","journal-title":"Journal of the American Dental Association"},{"key":"2024080910260865300_CIT0011","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1016\/j.ajodo.2021.05.012","article-title":"Orofacial dysfunction, nonnutritive sucking habits, and dental caries influence malocclusion in children aged 8\u201310 years","volume":"162","author":"Granja","year":"2022","journal-title":"American Journal of Orthodontics and Dentofacial Orthopedics"},{"key":"2024080910260865300_CIT0012","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1093\/ejo\/cjab032","article-title":"The impact of co-sleeping less than 6 months on children\u2019s anxiety, oral habits, and malocclusion in a Spanish sample between 2 and 5 years old: a cross-sectional study","volume":"44","author":"Carrillo-Diaz","year":"2022","journal-title":"European Journal of Orthodontics"},{"key":"2024080910260865300_CIT0013","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1007\/s40368-019-00487-9","article-title":"Maxillary arch dimensions in the first 6 months of life and their relationship with pacifier use","volume":"21","author":"Zen","year":"2020","journal-title":"Eur Arch Paediatr De"},{"key":"2024080910260865300_CIT0014","first-page":"173","article-title":"Different geometric patterns of pacifiers compared on the basis of finite element analysis","volume":"8","author":"Levrini","year":"2007","journal-title":"European Journal of Paediatric Dentistry"},{"key":"2024080910260865300_CIT0015","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1186\/s12903-022-02087-4","article-title":"Functional comparison of pacifiers using finite element analysis","volume":"22","author":"Tesini","year":"2022","journal-title":"BMC Oral Health"},{"key":"2024080910260865300_CIT0016","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/S0889-5406(94)70034-6","article-title":"The effect of sucking habits, cohort, sex, intercanine arch widths, and breast or bottle-feeding on posterior crossbite in Norwegian and Swedish 3-year-old children","volume":"106","author":"Ogaard","year":"1994","journal-title":"American Journal of Orthodontics and Dentofacial Orthopedics"},{"key":"2024080910260865300_CIT0017","doi-asserted-by":"crossref","first-page":"728","DOI":"10.2319\/080414-542.1","article-title":"Prevalence and change of malocclusions from primary to early permanent dentition: a longitudinal study","volume":"85","author":"Dimberg","year":"2015","journal-title":"The Angle Orthodontist"},{"key":"2024080910260865300_CIT0018","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1093\/ejo\/cjac054","article-title":"Anterior open bite self-correction after cessation of non-nutritive sucking habits: a systematic review","volume":"45","author":"Adriano","year":"2023","journal-title":"European Journal of Orthodontics"},{"key":"2024080910260865300_CIT0019","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/s40510-018-0206-4","article-title":"The effect of pacifier sucking on orofacial structures: a systematic literature review","volume":"19","author":"Schmid","year":"2018","journal-title":"Progress in Orthodontics"},{"key":"2024080910260865300_CIT0020","volume-title":"Evaluation of novel programs in health counseling. Their effectiveness in the oral health of young children, and their acceptance by parents and professionals in public dental service","author":"Arpalahti","year":"2015"},{"key":"2024080910260865300_CIT0021","first-page":"219","article-title":"Dummy- and finger-sucking habits in 4-year-olds","volume":"68","author":"Larsson","year":"1975","journal-title":"Sven Tandlak Tidskr."},{"key":"2024080910260865300_CIT0022","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1002\/(SICI)1097-0258(19980430)17:8<873::AID-SIM779>3.0.CO;2-I","article-title":"Interval estimation for the difference between independent proportions: comparison of eleven methods","volume":"17","author":"Newcombe","year":"1998","journal-title":"Statistics in Medicine"},{"key":"2024080910260865300_CIT0023","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.5811\/westjem.2017.8.35985","article-title":"Understanding the intention-to-treat principle in randomized controlled trials","volume":"18","author":"McCoy","year":"2017","journal-title":"The Western Journal of Emergency Medicine."},{"key":"2024080910260865300_CIT0024","first-page":"182","article-title":"Interference of conventional","volume":"28","author":"Correa","year":"2016","journal-title":"Codas."},{"key":"2024080910260865300_CIT0025","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1007\/s40368-018-0359-3","article-title":"Malocclusion prevention through the usage of an orthodontic pacifier compared to a conventional pacifier: a systematic review","volume":"19","author":"Medeiros","year":"2018","journal-title":"European Archives of Paediatric Dentistry : Official Journal of the European Academy of Paediatric Dentistry"},{"key":"2024080910260865300_CIT0026","first-page":"437","article-title":"Effects of current and former pacifier use on the dentition of 24- to 59-month-old children","volume":"17","author":"Adair","year":"1995","journal-title":"Pediatric Dentistry"},{"key":"2024080910260865300_CIT0027","first-page":"552","article-title":"Effects of different pacifiers on the primary dentition and oral myofunctional strutures of preschool children","volume":"24","author":"del Zardetto","year":"2002","journal-title":"Pediatric Dentistry"},{"key":"2024080910260865300_CIT0028","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1111\/ipd.12227","article-title":"Effects of conventional and orthodontic pacifiers on the dental occlusion of children aged 24-36 months old","volume":"27","author":"Lima","year":"2017","journal-title":"International Journal of Paediatric Dentistry"},{"key":"2024080910260865300_CIT0029","first-page":"97","article-title":"Effect of dummy-sucking on the prevalence of posterior cross-bite in the permanent dentition","volume":"10","author":"Larsson","year":"1986","journal-title":"Swedish Dental Journal"},{"key":"2024080910260865300_CIT0030","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.ajodo.2004.11.033","article-title":"Changes in the prevalence of nonnutritive sucking patterns in the first 8 years of life","volume":"130","author":"Bishara","year":"2006","journal-title":"American Journal of Orthodontics and Dentofacial Orthopedics"},{"key":"2024080910260865300_CIT0031","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1542\/peds.4.4.418","article-title":"Thumbsucking; frequency and etiology","volume":"4","author":"Klackenberg","year":"1949","journal-title":"Pediatrics"},{"key":"2024080910260865300_CIT0032","first-page":"667","article-title":"Dummy- and finger-sucking habits with special attention to their significance for facial growth and occlusion. 1. Incidence study","volume":"64","author":"Larsson","year":"1971","journal-title":"Sven Tandlak Tidskrift"},{"key":"2024080910260865300_CIT0033","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1016\/0002-9416(85)90203-9","article-title":"The prevalence and the etiology of the initial dummy- and finger-sucking habit","volume":"87","author":"Larsson","year":"1985","journal-title":"American Journal of Orthodontics and Dentofacial Orthopedics"},{"key":"2024080910260865300_CIT0034","first-page":"35","article-title":"Prevalence of malocclusion traits and sucking habits among 3-year old children","volume":"34","author":"Dimberg","year":"2010","journal-title":"Swedish Dental Journal"},{"key":"2024080910260865300_CIT0035","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1093\/ejo\/cjx005","article-title":"Impact of adenotonsillectomy on the dentofacial development of obstructed children: a systematic review and meta-analysis","volume":"39","author":"Becking","year":"2017","journal-title":"European Journal of Orthodontics"},{"key":"2024080910260865300_CIT0036","doi-asserted-by":"crossref","first-page":"110006","DOI":"10.1016\/j.ijporl.2020.110006","article-title":"Is securing normal dentofacial development an indication for tonsil surgery in children? A systematic review and meta-analysis","volume":"133","author":"Markkanen","year":"2020","journal-title":"International Journal of Pediatric Otorhinolaryngology"}],"container-title":["European Journal of Orthodontics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ejo\/article-pdf\/46\/5\/cjae024\/58781601\/cjae024.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejo\/article-pdf\/46\/5\/cjae024\/58781601\/cjae024.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,9]],"date-time":"2024-08-09T14:03:15Z","timestamp":1723212195000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejo\/article\/doi\/10.1093\/ejo\/cjae024\/7730440"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,9]]},"references-count":36,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,10,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ejo\/cjae024","relation":{},"ISSN":["0141-5387","1460-2210"],"issn-type":[{"value":"0141-5387","type":"print"},{"value":"1460-2210","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,10]]},"published":{"date-parts":[[2024,8,9]]},"article-number":"cjae024"}}