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Journal of Indian Society of Pedodontics and Preventive Dentistry Official publication of Indian Society of Pedodontics and Preventive Dentistry
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ORIGINAL ARTICLE
Year : 2019  |  Volume : 37  |  Issue : 1  |  Page : 8-11
 

Prevalence of pacifier use and the impact of maternal education and regularity of dental visits on the age of pacifier withdrawal


Department of Pediatric Dentistry, Preventive division, Riyadh Elm University, Riyadh, Saudi Arabia

Date of Web Publication25-Feb-2019

Correspondence Address:
Dr. Ateet Ashok Kakti
Department of Pediatric Dentistry, Preventive division, Riyadh Elm University, Riyadh
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JISPPD.JISPPD_76_17

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   Abstract 


Aim: The aim of this study was to assess the prevalence of pacifier use among Saudi children and analyze the effects of maternal education and dental visits on the age of pacifier withdrawal. Methods: The dental histories of mothers of 300 children with age group of 2–7 years were obtained along with their educational level, frequency of dental checkups, and age of pacifier withdrawal. Data were analyzed using the cross-tabulation and Chi-square tests. Results: Forty percent (n = 133) of the children used pacifier. There was an effect of maternal education on the age of pacifier withdrawal: higher the maternal education, younger the age of pacifier withdrawal. The frequency of dental visits influenced the relationship between maternal education and age of pacifier withdrawal. Conclusions: Unhealthy oral habits such as prolonged pacifier use can be reduced with regular dental checkups and higher levels of mother education. Hence, we recommend that children should start dental visits at an early age and maintain visits at regular intervals.


Keywords: Dental visits, maternal education, pacifier use, pacifier withdrawal


How to cite this article:
Kakti AA, Alabdullah AS, Alahmed A, Alhowajji Z, Alswailem E, Alhassan H. Prevalence of pacifier use and the impact of maternal education and regularity of dental visits on the age of pacifier withdrawal. J Indian Soc Pedod Prev Dent 2019;37:8-11

How to cite this URL:
Kakti AA, Alabdullah AS, Alahmed A, Alhowajji Z, Alswailem E, Alhassan H. Prevalence of pacifier use and the impact of maternal education and regularity of dental visits on the age of pacifier withdrawal. J Indian Soc Pedod Prev Dent [serial online] 2019 [cited 2019 Sep 21];37:8-11. Available from: http://www.jisppd.com/text.asp?2019/37/1/8/252863





   Introduction Top


The use of pacifiers to satisfy the sucking instinct is a widely extended practice. Digits, pacifiers, or toys could serve primarily to satisfy instinctive needs, while pacifier use at 4 years or older is considered an extended habit. The World Health Organization (WHO) and the American Academy of Pediatrics have condemned pacifier use due to the negative impact on breastfeeding and child health. Depending on the intensity, frequency, and length of pacifier use, occlusal development may be impaired. The use of a pacifier beyond 2 years of age can lead to jaw and dental arch malformation.[1],[2],[3]

Previous research has reported that the use of pacifiers may be associated with “nipple confusion,” early weaning, risk of otitis and other infections, and malocclusions. On the positive side, pacifiers may protect against sudden infant death syndrome. Others have suggested that pacifier use improves a child's ability to breathe through the mouth if the nasal airway becomes obstructed. Furthermore, it has been argued that sucking on a pacifier requires forward positioning of the tongue, which could reduce the risk of oropharyngeal obstruction.[4],[5],[6]

Bueno et al. evaluated the association of breastfeeding duration, pacifier use, and nasal airflow with occlusal disorders among children. There was a significant association between nonnutritive sucking, particularly the use of a pacifier and occlusal disorders. The persistent nonnutritive sucking affected the prevalence of malocclusion and compromised nasal breathing.[7] On the other hand, Pérez-Suárez et al. explored the effects of maternal education and dental visits on the age of pacifier withdrawal, and the results emphasized that regular dental visits with pediatric dentists contribute in decreasing the use of pacifier, and the extended use of pacifier was more particularly among children of mothers with low and medium educational levels.[8]

Moimaz et al. recorded the prevalence of nonnutritive sucking habits (thumb and pacifier sucking) in children at 6 and 12 months of age and tested its association with family social profile and breastfeeding pattern. The frequency of breastfeeding was lower than that recommended by WHO for children in the age groups assessed. Pacifier sucking was more prevalent than thumb sucking and was associated with a lower rate of breastfeeding in the 12-month-old children. Family social profile does not seem to be related to nonnutritive sucking habits.[9] The aim of the current study is to assess the prevalence of pacifier use among Saudi children and analyze both separate and combined influences of maternal education level and visits to the dentist on prolonged pacifier use.


   Methods Top


The study was conducted in Riyadh Colleges of Dentistry and Pharmacy (RCsDP), Riyadh, Kingdom of Saudi Arabia. Mothers of children aged between 2 and 7 years visiting the RCsDP completed a structured questionnaire pertaining to their child's oral health habits and dental history, age, time, duration, frequency, and type of pacifier use. Informed consent was obtained from mothers who completed a structured questionnaire, including sociodemographic items (age, gender, and educational level) and questions about their child's dental history and oral health habits (frequency of dental checkups, age of pacifier withdrawal, and oral health problems).

The questionnaire was piloted on a representative sample of mothers who were not part of the study. During the pilot study, face validity of each item of the questionnaire was examined, and the collected data were used to assess the internal reliability of the questionnaire. The questionnaire was distributed, and the study was briefly explained and queries were answered. Mother's educational level was characterized as low, medium, or high based on the highest official academic degree obtained by the mother. The child's visit to the dentist for regular checkups was assessed by a yes/no question (“Did you bring your child to the dentist for periodical check-ups?”).

The age at which the child stopped using the pacifier was indicated by the mothers, through the question “How old (years and months) was your child at the age of pacifier withdrawal?” The quantitative data were entered into a computer for the analysis using theIBM SPSS Statistics for Windows, Version 25.0. (Armonk, NY: IBM Corp). Descriptive analysis was undertaken to present an overview of the findings from this population. The effect of maternal education on the age, at which pacifier usage was stopped, was assessed using the cross-tabulation and Chi-square tests.


   Results Top


In this study, the mean child's age at the time of the survey was 28.2 months ranging from 1 to 82 months. The majority of the mothers had bachelor's degree (55%, n = 182). Forty percentage (n = 133) of the children used pacifier. The majority (56%, n = 183) started using pacifier at 0–3 months. Eighty percentage (n = 262) of mothers were aware that the pacifier withdrawal or discontinuation has to be done between the ages of 2 and 3 years and 55% (n = 176) have tried stopping pacifier use for their child earlier. Sixty-nine percentage (n = 228) were aware of the availability of physiological pacifiers.

[Figure 1] shows the age of withdrawal/discontinuation of pacifier use (in months) and [Figure 2] shows the frequency of dental checkups of children. The majority (77%) visited the dentist only when there was a dental problem. It was observed that the age of pacifier withdrawal was affected by maternal educational level. The age of pacifier withdrawal decreased as maternal education level increased as shown in [Table 1]. However, there was no statistically significant difference between maternal education levels and age of pacifier withdrawal (P > 0.05). The frequency of dental checkups with higher maternal education level is shown in [Table 2].
Figure 1: Age of withdrawal/discontinuation of pacifier use

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Figure 2: Frequency of dental checkups of children

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Table 1: Comparison of educational levels of mothers with the age of pacifier withdrawal of their children

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Table 2: Comparison of the educational levels of mothers with the frequency of dental checkups of their children

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   Discussion Top


The present study focuses the importance of children dental visits in promoting oral health among parents with low education. The results showed significant effects of maternal educational level and regular checkups on the age of pacifier withdrawal. Low maternal education and infrequent dental visits prolonged pacifier use. Regular dental visits can significantly decrease the age at which pacifier is withdrawn among children of mothers with low and middle educational levels. Children who do not regularly receive dental checkups tend to use the pacifier longer. Hence, pacifier use depends on maternal education and regular dental visits rather than maternal educational level alone.[10]

A study reported that mothers with a minimal education level were more likely to give their child a pacifier in comparison to mothers with a higher degree.[11] Past research has reported that maternal education affects the use of dental care services and child dental health.[12] Another study reported a significant effect of maternal education on the age of pacifier withdrawal. The study concluded that higher the maternal education younger the age of pacifier withdrawal. Furthermore, the frequency of dental visits influenced the relationship between maternal education and age of pacifier withdrawal.[13] The findings from the current study on Saudi children are similar to the previous studies.

Very limited studies have previously considered the relationship between maternal education and pacifier use. One study found that mothers of preschool children at risk had superficial knowledge, attitudes, and behaviors about their child's dental health, despite regular visits to the pediatric dentist.[14] Dental professionals must be made aware of their influence on patient knowledge and behavior by providing parents and caregivers with reliable information on maintaining good oral health habits. It has been reported that the advice given by dental professionals is the most efficient method for decreasing pacifier use.[15]


   Conclusions Top


The main contribution of the current study was the finding that regular dental visits could moderate the negative contribution of low maternal education to pacifier usage, indicating the critical role of pediatric dentists, particularly among children of mothers with low and medium educational levels. Thus, this study emphasizes educational issues involved in pediatric dentistry, the vital role of dental care practitioners in the promotion of healthy oral habits, and the need for identifying specific target groups (e.g., lower educated or socially disadvantaged mothers) to enhance child oral health care.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Gill D. A diatribe on dummies. Arch Dis Child 2002;86:222.  Back to cited text no. 1
    
2.
Ravin JJ. The prevalence of dummy and finger sucking habits in Copenhagen children until the age of 3 years. Community Dent Oral Epidemiol 1974;2:316-22.  Back to cited text no. 2
    
3.
Adair SM. Pacifier use in children: A review of recent literature. Pediatr Dent 2003;25:449-58.  Back to cited text no. 3
    
4.
Protecting, promoting and supporting breastfeeding: The special role of maternity services. A joint WHO/UNICEF statement. Int J Gynaecol Obstet 1990;31 Suppl 1:171-83.  Back to cited text no. 4
    
5.
Adair SM, Milano M, Lorenzo I, Russell C. Effects of current and former pacifier use on the dentition of 24- to 59-month-old children. Pediatr Dent 1995;17:437-44.  Back to cited text no. 5
    
6.
Hauck FR, Omojokun OO, Siadaty MS. Do pacifiers reduce the risk of sudden infant death syndrome? A meta-analysis. Pediatrics 2005;116:e716-23.  Back to cited text no. 6
    
7.
Bueno SB, Bittar TO, Vazquez Fde L, Meneghim MC, Pereira AC. Association of breastfeeding, pacifier use, breathing pattern and malocclusions in preschoolers. Dental Press J Orthod 2013;18:30.e1-6.  Back to cited text no. 7
    
8.
Pérez-Suárez V, Carrillo-Diaz M, Crego A, Romero M. Maternal education, dental visits and age of pacifier withdrawal: Pediatric dentist role in malocclusion prevention. J Clin Pediatr Dent 2013;37:315-9.  Back to cited text no. 8
    
9.
Moimaz SA, Lolli LF, Garbin CA, Saliba O, Saliba NA, Azevedo PS. Harmful oral suction habits in children: association with breastfeeding and family social profile. Rev Odonto Ciência 2010;25:355-60.  Back to cited text no. 9
    
10.
Hebling SR, Cortellazzi KL, Tagliaferro EP, Hebling E, Ambrosano GM, Meneghim Mde C, et al. Relationship between malocclusion and behavioral, demographic and socioeconomic variables: A cross-sectional study of 5-year-olds. J Clin Pediatr Dent 2008;33:75-9.  Back to cited text no. 10
    
11.
North K, Fleming P, Golding J. Pacifier use and morbidity in the first six months of life. Pediatrics 1999;103:E34.  Back to cited text no. 11
    
12.
Ostberg AL, Ericsson JS, Wennström JL, Abrahamsson KH. Socio-economic and lifestyle factors in relation to priority of dental care in a Swedish adolescent population. Swed Dent J 2010;34:87-94.  Back to cited text no. 12
    
13.
Korlahalli A, Shivaprakash PK, Noorani H. Impact of maternal education and dental visits on age of pacifier withdrawal and caries incidence. J Dent Panacea 2014;1:77-83.  Back to cited text no. 13
    
14.
Blinkhorn AS, Wainwright-Stringer YM, Holloway PJ. Dental health knowledge and attitudes of regularly attending mothers of high-risk, pre-school children. Int Dent J 2001;51:435-8.  Back to cited text no. 14
    
15.
Duijster D, de Jong-Lenters M, Verrips E, van Loveren C. Establishing oral health promoting behaviours in children – Parents' views on barriers, facilitators and professional support: A qualitative study. BMC Oral Health 2015;15:157.  Back to cited text no. 15
    


    Figures

  [Figure 1], [Figure 2]
 
 
    Tables

  [Table 1], [Table 2]



 

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