title: Pacifiers and dental structure as risk factors for otitis media.
abstract: The purpose of the study was to examine the relationship between ear infections and dentition, sucking habits, pacifier sucking and atopic and allergic diseases in a historic cohort survey. The series comprised 944 5-year-old children representing about 3/4 of the whole age cohort. The parents completed a questionnaire that asked for details of the children's ear infections, sucking habits and atopic or allergic diseases diagnosed by a physician. The dental status was examined by the child's own local dentist. The children who had used a pacifier had a greater risk of having recurrent attacks of acute otitis media in their history than those who had not used a pacifier (risk ratio (RR), 1.43; 95% confidence interval (CI), 1.06-1.93; P = 0.02). Mouth breathing was significantly associated with acute otitis media (RR, 1.87; CI, 1.28-2.73; P = 0.01), as was open bite (RR, 1.36; CI, 1.01-1.84; P = 0.04), but no other mode of malocclusion. The population attributable risk of otitis media caused by pacifier amounted to a total of 478 attacks or 0.7 per child. The association between otitis media and the use of a pacifier remained even after adjusting for mouth breathing and the measures of malocclusion. Neither thumb sucking nor atopic eczema showed such an association.
authors.affiliation: Department of Pediatrics, University of Oulu, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Niemelä
authors.forename: M
authors.initials: M
authors.lastname: Uhari
authors.forename: A
authors.initials: A
authors.lastname: Hannuksela
mesh_terms: D000208:Acute Disease; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000150:complications; D007223:Infant; D007224:Infant Care; D008297:Male; D008310:Malocclusion / Q000150:complications*; D009058:Mouth Breathing; D010033:Otitis Media / Q000209:etiology*; D012008:Recurrence; D012307:Risk Factors