Pathways to anterior open bite after changing of pacifier sucking habit in preschool children: a cohort study.

BACKGROUND Pacifiers use is a major cause of anterior open bite (AOB), which negatively impacts the quality of life of children affected. AIM Assess the direct and indirect pathways related to pacifier sucking habit and AOB in preschool children. DESIGN This 2-year cohort study evaluated a random sample of preschool children (2 to 5 years of age) from Southern Brazil. Caregivers answered a questionnaire addressing socioeconomic and behavioral characteristics. AOB was recorded following the criteria recommended by Foster and Hamilton. Structural equation model was performed to assess the direct and indirect pathways among variables at baseline (T1) to predict the AOB at follow-up (T2). RESULTS Regarding the AOB, 407 children were evaluated at T1 and 187 at T2. The prevalence of AOB was 32.9% at baseline and 16.0% at follow-up. The presence of AOB at follow-up was directly affected by the change in pacifier sucking habit from T1 to T2. Considering the indirect paths, the AOB at T1 influenced the AOB in T2 via a change of pacifier sucking habit. CONCLUSION These findings suggest that the non-habit of sucking pacifiers is a fundamental strategy for the prevention of AOB as well as the promotion of health in childhood.