Non-Cochrane · prognostic · PM41590179

The Role of Digit- and Pacifier-Sucking Habits on Malocclusion Development in Children: Anterior Open Bite and Posterior Crossbite-A Systematic Review & Meta-Analysis.

Faryad Arvin, Muwaquet Rodriguez Susana, Hijazi Alsadi Tawfiq · Dentistry journal · 2026 · PubMed · doi:10.3390/dj14010055

Findings

Population Children (primary dentition, mainly 5-year-olds)

16 findings


Pacifier-sucking habit (PSH)	Digit-sucking habit (DSH)	Anterior open bite (AOB) prevalence	Ratio of ORs (PSH/DSH) 1.77 GRADE not reported 9 studies
Pacifier-sucking habit (PSH)	Digit-sucking habit (DSH)	Anterior open bite (AOB) prevalence	MD (difference in log OR, PSH minus DSH) 0.572 [-0.206, 1.350] GRADE not reported 9 studies
Pacifier-sucking habit (PSH)	Digit-sucking habit (DSH)	Posterior crossbite (PCB) prevalence	MD (difference in log OR, PSH minus DSH) 0.981 [0.723, 1.240] GRADE not reported 10 studies
Pacifier-sucking habit (PSH)	Digit-sucking habit (DSH)	Posterior crossbite (PCB) prevalence	Ratio of ORs (PSH/DSH) 2.66 GRADE not reported 10 studies
No digit-sucking habit (non-DSH)	None	Anterior open bite (AOB) prevalence non-DSH group	Pooled prevalence (mean rate, %) 15.8 GRADE not reported 10 studies · 4453 participants
No digit-sucking habit (non-DSH)	None	Posterior crossbite (PCB) prevalence non-DSH group	Pooled prevalence (mean rate, %) 11.6 GRADE not reported 10 studies · 6193 participants
Digit-sucking habit (DSH)	None	Posterior crossbite (PCB) prevalence DSH group	Pooled prevalence (mean rate, %) 11.9 GRADE not reported 10 studies · 943 participants
Digit-sucking habit (DSH)	No non-nutritive sucking habit	Anterior open bite (AOB) prevalence	OR 5.0 GRADE not reported 10 studies
Digit-sucking habit (DSH)	None	Anterior open bite (AOB) prevalence DSH group	Pooled prevalence (mean rate, %) 42.6 GRADE not reported 10 studies · 557 participants
Digit-sucking habit (DSH)	No non-nutritive sucking habit	Posterior crossbite (PCB) prevalence	OR 1.27 GRADE not reported 10 studies
Pacifier-sucking habit (PSH)	None	Posterior crossbite (PCB) prevalence PSH group	Pooled prevalence (mean rate, %) 23.0 GRADE not reported 10 studies · 3081 participants
No pacifier-sucking habit (non-PSH)	None	Anterior open bite (AOB) prevalence non-PSH group	Pooled prevalence (mean rate, %) 9.1 GRADE not reported 9 studies · 3206 participants
No pacifier-sucking habit (non-PSH)	None	Posterior crossbite (PCB) prevalence non-PSH group	Pooled prevalence (mean rate, %) 6.9 GRADE not reported 10 studies · 4894 participants
Pacifier-sucking habit (PSH)	No non-nutritive sucking habit	Posterior crossbite (PCB) prevalence	OR 2.80 GRADE not reported 10 studies
Pacifier-sucking habit (PSH)	No non-nutritive sucking habit	Anterior open bite (AOB) prevalence	OR 7.39 GRADE not reported 9 studies
Pacifier-sucking habit (PSH)	None	Anterior open bite (AOB) prevalence PSH group	Pooled prevalence (mean rate, %) 47.8 GRADE not reported 9 studies · 1805 participants

Included primary studies 12

Open in Studies

Study	Year	Also included by	Outcomes it informs here	Trial data
Cardoso 2014 matched by author and year (probable)	NR	this review only	not stated	not extracted yet
Davidopoulou 2022 Occlusal features of 5-year-old Greek children: a cross-sectional national study. PMID:35810281	2022	this review only	not stated	not extracted yet
de Sousa 2014 Prevalence and associated factors for the development of anterior open bite and posterior crossbite in the primary dentition. PMID:25250499	2014	this review only	not stated	not extracted yet
dos Santos 2012 Prevalence of malocclusion and related oral habits in 5- to 6-year-old children. PMID:23301231	2012	this review only	not stated	not extracted yet
Freire 2016 Non-nutritive sucking habits and their effects on the occlusion in the deciduous dentition in children. PMID:28045318	2016	this review only	not stated	not extracted yet
Germa 2016 Early risk factors for posterior crossbite and anterior open bite in the primary dentition. PMID:26998889	2016	this review only	not stated	not extracted yet
Hebling 2008 Relationship between malocclusion and behavioral, demographic and socioeconomic variables: a cross-sectional study of 5-year-olds. PMID:19093656	2008	this review only	not stated	not extracted yet
Macena 2009 Prevalence of a posterior crossbite and sucking habits in Brazilian children aged 18-59 months. PMID:19336627	2009	this review only	not stated	not extracted yet
Peres 2007 Effects of breastfeeding and sucking habits on malocclusion in a birth cohort study. PMID:17515986	2007	this review only	not stated	not extracted yet
Pimenta 2023 Malocclusion in primary dentition: a cross-sectional study in a Lisbon population DOI:10.24873/j.rpemd.2023.03.1048	2023	this review only	not stated	not extracted yet
Tanny 2021 Characterisation of anterior open bite in primary school-aged children: A preliminary study with artificial neural network analysis. PMID:33222319	2021	this review only	not stated	not extracted yet
Traebert 2020 Nutritional and non-nutritional habits and occurrence of malocclusions in the mixed dentition. PMID:32321028	2020	this review only	not stated	not extracted yet

Review question

Element	Planned (methods)	Found (results)
Population	Children and teenagers, deciduous, mixed or permanent dentition, normal tooth number, size and shape	Children and infants (teenagers excluded from the meta-analysis); n=12 studies
Intervention	History of digit-sucking habit; history of pacifier-sucking habit	Digit-sucking habit; pacifier-sucking habit
Comparison	Patients without any non-nutritive sucking habits	No digit-sucking habit; no pacifier-sucking habit
Outcomes	Prevalence of anterior open bite and posterior crossbite	Anterior open bite (9 to 10 studies per comparison); posterior crossbite (10 studies per comparison)
Study designs	Observational studies (case-control, cohort, cross-sectional, longitudinal) and experimental studies, English, 2000 to 2024	Mostly cross-sectional studies (n=12)
Timing	Not specified	Not specified