title: Children using Day Nurseries' Facilities can be Associated with more Risk to Nonnutritive Sucking Habits.
abstract: BACKGROUND
  This study evaluated the expression of nonnutritive sucking habits and the presence of malocclusion in children using day nurseries' facilities.
  
  
  METHODS
  The 195 children (7-40 months) attending 18 public day nurseries were evaluated clinically in Ponta Grossa, Brazil. Statistical package software was used for descriptive, univariate, bivariate, and multiple logistic regressions of the data about the socioeconomic condition, educational family status, malocclusions, and prevalence of nonnutritive sucking habits among the children.
  
  
  RESULTS
  The pacifier users had a statistically significant, explanatory association with open bite [odds ratio (OR) = 10.97; 95% confidence interval (CI): 4.95, 24.31; p < 0.0001]. The children older than 25 months had more open bite than younger children (OR = 6.07; 95% CI: 2.81, 13.11; p < 0.0001). Of the children examined, 35.4% had an anterior open bite, 0.51% had posterior cross-bite, and 1.03% showed finger-sucking habits. A high frequency of pacifier-sucking habits was found (52%), with a significant association between this habit and anterior open bite (p < 0.0001, OR = 7.49; 95% CI: 3.71, 15.15). The 126 children without open bite (36.5%) were pacifier users. There was suggestive, though nonsignificant, evidence of a difference in pacifier use by gender (males, 34%; females, 46%; p = 0.07). The 69 children with open bite (81.16%) were pacifier users and (18.84%) nonusers. The boys showed a slightly greater association with open bite (OR = 21.33; 95% CI: 6.12, 74.40; p < 0.0001) than girls (OR = 5.03; 95% CI: 1.26, 20.00; p = 0.02) in the age group of 25 to 40 months; however, it was not observed in younger children.
  
  
  CONCLUSIONS
  Pacifier use is a predictor for open bite in children from the lower socioeconomic classes using day nurseries' facilities.
  
  
  CONCLUSIONS
  The parents, guardians, and caregivers working in public day nurseries should be advised to monitor nonnutritive sucking habits in order to avoid or minimize the occurrence of malocclusion. It demonstrates that the permanence of the children in day nurseries may be linked with deleterious oral habits, and it discusses strategies to minimize the occurrence of alterations in the normal occlusion.
authors.affiliation: Department of Dentistry, Ponta Grossa State University Paraná, Brazil.
authors.forename: Fabiana Bt
authors.initials: FB
authors.lastname: Alves
authors.affiliation: Department of Dentistry, Ponta Grossa State University Paraná, Brazil.
authors.forename: Denise S
authors.initials: DS
authors.lastname: Wambier
authors.affiliation: Department of Orthodontics and Pediatric Dentistry, University of São Paulo, São Paulo, Brazil.
authors.forename: Jenny Ha
authors.initials: JH
authors.lastname: Alvarez
authors.affiliation: Department of Informatics, Ponta Grossa State University Paraná, Brazil.
authors.forename: José Cf
authors.initials: JC
authors.lastname: da Rocha
authors.affiliation: Department of Dentistry, Centro Universitario de União da Vitoria, Paraná, Brazil.
authors.forename: Thais R
authors.initials: TR
authors.lastname: Kummer
authors.affiliation: Department of Orthodontics, Federal University of Paraná Paraná, Brazil.
authors.forename: Vanessa C
authors.initials: VC
authors.lastname: de Castro
authors.affiliation: Department of Biostatistics, Boston University School of Public Health, Boston University Medical Campus, Boston Massachusetts, USA.
authors.forename: Howard
authors.initials: H
authors.lastname: Cabral
authors.affiliation: Forsyth Institute, Harvard University, Boston, Massachusetts USA, Department of Dentistry, Ponta Grossa State University Paraná, Brazil, Phone: +554232203104, e-mail: vakozlowski@uepg.br.
authors.forename: Vitoldo A
authors.initials: VA
authors.lastname: Kozlowski
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002656:Child Day Care Centers; D002675:Child, Preschool; D005260:Female; D005386:Fingersucking / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D008297:Male; D008310:Malocclusion / Q000453:epidemiology* / Q000209:etiology; D024343:Open Bite / Q000453:epidemiology / Q000209:etiology; D041361:Pacifiers / Q000009:adverse effects*; D012959:Socioeconomic Factors
keywords: Cross-bite; Day care; Day nurseries; Malocclusion; Open bite; Pacifier; Socioeconomic classes Sucking habits.