Scientific Article

Effects on Tooth Position of a Pacifier With Especially Thin Nipple Neck - A Randomized Clinical Study

Dr. Yvonne Wagner


Background

Sucking is a basic need for babies. Worldwide, 60 to 80% of young children use a pacifier. It is used to calm, for help going to sleep and helps protect against SIDS. Ideally, weaning off non-nutritive sucking with a pacifier should take place between the 24th and 36th month of life to prevent jaw and tooth misalignment. Prolonged and intensive use of pacifiers can lead to undesirable developments such as an anterior open bite, increased overbite (overjet) and cross bite.

In 2009, an innovative pacifier with an especially thin nipple neck (MAM Perfect) was developed. Compared to 64 conventional pacifiers it is on average 60% thinner and 4 times more flexible* (Wild Hi-Precision Institut, Vienna University Dental Clinic). This pacifier should allow children to suck, minimize the known risks and promote healthy oral, tooth and jaw development. 

Study design

The randomized clinical study was conducted at the Jena University Clinic for Preventive and Pediatric Dentistry. The goal was to evaluate the effect of switching from a conventional pacifier to the MAM Perfect on malocclusions in the primary dentition.

For the study, 86 children between the ages of 16 and 24 months who already exhibited a pacifier related malocclusion such as an anterior open bite or enlarged overbite were recruited. They were randomly assigned to 3 groups. Group I switched to the MAM Perfect. Group II continued to use their regular pacifiers while the children in Group III should wean off the pacifier during the study period. Follow up examinations were conducted after 3, 6, 9 and 12 months by 2 calibrated dentists, of which one was blinded, meaning he did not know which group the children belonged to. 

Results

The results show significant differences between the 3 groups in terms of horizontal and vertical overbite. The comparison between Groups I and II regarding the degree of horizontal overbite and anterior open bite shows statistically significant benefits of the special pacifier over a conventional pacifier. The children in Group III, who had to have weaned of the pacifier for at least 3 months, showed the best results. It can be confirmed then, that after weaning off a pacifier, a so called spontaneous healing and self-correction occurs. Nevertheless, weaning is often the most difficult option. 6 children in the study could not be successfully weaned off the pacifier and another 3 children started thumb sucking. In summary it can be said that the pacifier with especially thin nipple neck is a good alternative and reduces the risk of developing a malocclusion in the primary dentition.

The detailed results of the study can be found in the Journal "Orthodontics and Craniofacial Research": Y. Wagner, R. Heinrich-Weltzien, “Effect of a thin-neck pacifier on primary dentition: a randomized controlled trial”, Orthodontics & Craniofacial Research, Volume 19, Issue 3, pages 127–136, August 2016.

*Between 32% – 83% thinner / 1.1 – 19.5 times more flexible than regular silicone pacifier

Dr. Yvonne Wagner

Pediatric Dentist

Dr. Yvonne Wagner is a paediatric dentistry specialist in Germany. She has been published in professional journals around the world. Dr. Wagner provides training for midwives, dentists and doctors as well as courses for parents.