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 Table of Contents  
ORIGINAL ARTICLE
Year : 2016  |  Volume : 4  |  Issue : 1  |  Page : 9-12

Influence of infant feeding patterns on the deciduous second molar relationship


Department of Pedodontics and Preventive Dentistry, Yenepoya Dental College, Yenepoya University, Mangalore, Karnataka, India

Date of Web Publication2-Jun-2016

Correspondence Address:
Sharan S Sargod
Department of Pedodontics and Preventive Dentistry, Yenepoya Dental College, Yenepoya University, Mangalore - 575 018, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2321-4848.183348

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  Abstract 

Background: Pediatricians and pediatric dentists coincide in the great importance of breastfeeding during the first 6 months of life for the correct development of the mouth and for occlusion, breathing and swallowing during childhood. Lower prevalence and severity of malocclusions in breastfed children, in comparison with those that were bottle fed, have been reported. There exists substantial documentation that further credits breastfeeding with enhanced oral development and the formation of proper swallowing technique. Aim: The aim of the study was to evaluate the influence of infant feeding patterns on the deciduous second molar relationship in 3-5-year-old children of selected preschools in and around Mangalore. Materials and Methods: Semi-structured questionnaires were given to parents of children between the ages of 3 and 5 years. Clinical examination was performed with the children comfortably seated, and the molar relationship was checked in maximal habitual intercuspation. Results: The results were statistically analyzed using Chi-square. There was a significant difference between children who were breastfed (84.09% mesial step) and those who were bottle fed (22.2% mesial step). Among the bottle-fed children, the conventional nipple group showed 23.52% of mesial step occlusion while in the physiologic nipple group, 55.26% had a mesial step occlusion. Conclusion: This study supports a correlation between infant feeding methods and primary molar relationship. Exclusively breastfed children showed better development of dental arches with a higher incidence of mesial step occlusion when compared to bottle-fed children.

Keywords: Bottle feeding, breastfeeding, malocclusions


How to cite this article:
Sargod SS, Bhat SS, Abdul RS. Influence of infant feeding patterns on the deciduous second molar relationship. Arch Med Health Sci 2016;4:9-12

How to cite this URL:
Sargod SS, Bhat SS, Abdul RS. Influence of infant feeding patterns on the deciduous second molar relationship. Arch Med Health Sci [serial online] 2016 [cited 2022 Jan 26];4:9-12. Available from: https://www.amhsjournal.org/text.asp?2016/4/1/9/183348


  Introduction Top


Infant feeding is the feeding of a child from birth to 1 year of age. “Normal” infant feeding is defined as breastfeeding for at least the 1st year of life and introduction of iron-rich complementary foods around 6 months of life.[1]

The period between a woman's pregnancy and her child's second birthday with focus on nutrition for mothers and children offers a unique window of opportunity which is bound to have a profound impact on the child's growth and development and also, one of the best investments to achieve lasting progress in global health and development. Despite numerous recognized advantages, early, and exclusive breastfeeding rates in most states of the India are low.[2]

The different infant feeding practices practiced are:

  • Exclusive breastfeeding.
  • Exclusive bottle feeding.
  • Complementary bottle feeding.


According to World Breastfeeding Trends Initiative (2012), only 46.8% of women practiced exclusive breastfeeding up to 6 months. 12.5% practiced bottle feeding and 57.1% practiced complementary feeding.[2]

Pediatricians and pediatric dentists coincide in the great importance of breastfeeding during the first 6 months of life for the correct development of the mouth and for occlusion, breathing and swallowing during childhood.[3]

The American Academy of Pediatric Dentistry considers breast milk an ideal nutrition as it provides innumerable health-related advantages to infants, mothers, and society. Breastfeeding is usually recommended by healthcare professionals and pediatricians to be continued as long as mutually desired by mother and child.[4]

Lower prevalence and severity of malocclusions in breastfed children, in comparison with those that were bottle fed, have been reported.[5] There exists substantial documentation that further credits breastfeeding with enhanced oral development and the formation of proper swallowing technique.[6]

Aims and objectives

To evaluate the influence of different patterns of infant feeding on the position of the deciduous second molar in 3-5-year-old children in Mangalore.


  Materials and Methods Top


The study is a cross-sectional survey. Ethical clearance was obtained from Yenepoya University, Mangalore. Schools were selected by purposive sampling in rural and urban Mangalore until sample size of 100 was achieved. Children in schools in and around Mangalore in the age group 3-5 years of age were selected based on the inclusion and exclusion criteria. Written consent was obtained from the parents/guardian.

The inclusion criteria were:

  • Age group 3-5 years.
  • Systemically healthy patients.
  • Children with a complete set of primary teeth.


The exclusion criteria were:

  • Children with extensive carious lesions, crown destruction, or proximal restorations that can compromise occlusion.
  • Children with early primary tooth loss and/or dental anomalies.
  • Cleft palate or lip, or any other developmental anomaly that can preclude breastfeeding.
  • History of orthodontic or speech therapy.
  • Any other craniofacial anomaly.


The children were divided into three groups based on their feeding:

  1. Exclusive breastfeeding:Children who were exclusively breastfed from birth up to 6 months of age.

  2. Exclusive bottle feeding:Children who were exclusively bottle-fed from birth up to 6 months of age.

  3. Complementary bottle-feeding:


When bottle feeding was given in addition to breastfeeding during the first 6 months.

Clinical examination

The clinical examination was performed using mouth mirrors and explorers under a suitably directed source of artificial lighting with the children comfortable seated. The relationship between the maxillary and mandibular second deciduous molar was recorded in maximum intercuspation as mesial step, distal step, or flush terminal plane.


  Results Top


A total of 100 children who met the selection criteria were included in the study to assess the influence of infant feeding patterns on the position of the deciduous second molar in the age group of 3-5 years.

Of the 100 children, 45% were exclusively breastfed, 18% were exclusively bottle fed, and 37% were bottle fed in addition to breastfeeding [Figure 1].
Figure 1: Distribution of subjects in each group

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In children, who were exclusively breastfed, 37 (84.09%) had a mesial step occlusion, 4 (9.09%) had a distal step occlusion, and 4 (9.09%) had a flush terminal plane occlusion. In those children who were exclusively bottle-fed, only 4 (22.2%) had a mesial step occlusion, while 9 (50%) had a distal step occlusion and 5 (27.7%) showed a flush terminal plane occlusion. In the children who had a combination feeding, i.e., complementary bottle feeding along with breastfeeding, 29 (78.37%) showed a mesial step occlusion, 4 (10.8%) had a distal step occlusion, and 4 (10.8%) showed a flush terminal plane occlusion [Figure 2].
Figure 2: Relationship between feeding patterns and molar relationship

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The bottle fed children were divided into two groups based on the type of nipple used. In the conventional nipple group, 4 (23.52%) showed a mesial step occlusion, 13 (76.47%) had a distal step occlusion. In the physiologic nipple group, 21 (55.26%) had a mesial step occlusion, while 8 (21.05%) had a distal step occlusion, and 9 (23.68%) showed a flush terminal plane occlusion [Figure 3].
Figure 3: Relationship between nipple used for bottle feeding and molar relationship

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  Discussion Top


By 3 years of age, the maxilla mandibular relationship gets established. The key diagnostic feature regarding future occlusion status is determined by the relationship of the primary second molars.

Likelihood of Class I molar relation is highest when a mild mesial step occlusion exists while a distal step occlusion is predictive of a developing class II permanent molar relationship.

Based on the functional matrix hypothesis of Moss and Salentijn,[7] one can infer that the breastfeeding process would work as a matrix that provides the biomechanical stimuli ideally necessary for craniofacial development.[8]

Because a breast nipple lactates in noncontinuous fine streams from its pores, the active sucking requires substantial energy expenditure and strenuous muscle activity. This allows for proper development of the muscles involved: The orbicularis oris, masseter, buccinator, pharyngeal constrictors, and posterior digastric.[9] The contractive forces these muscles supply additionally influence the thrust and physiological growth of the mandible.[10] The flexible and soft human breast nipple tissue is beneficial in shaping the hard palate because it flattens and broadens in response to the infant's tongue action. As the infant uses a peristaltic-like motion to “strip” milk from the mother's nipple/areolar area, the hard palate is gently shaped by the infant's tongue to a rounded U-shaped configuration. A physiologically and appropriately shaped palate aligns the teeth properly and reduces the incidence of malocclusions.[10]

The movements of the tongue resemble a piston-like movement in the bottle-fed child. To get a eucaloric meal required for normal growth, the infant needs to exercise less orofacial muscle activity when fed from bottle than when breastfed.[11] However; an artificial teat is already formed, with a specific shape, and is made from a material stiffer than breast tissue. The piston-like action used to obtain milk from the bottle is more explosive and more powerful than the action used in breastfeeding. Therefore, greater pressure is applied to the artificial teat than is applied to the breast nipple. This pressure is produced predominantly by the oral musculature.[12] It has been estimated that bottle-fed children have five times higher chances of developing malocclusions as compared with those who are breastfed.[13] Meyers and Hertzberg similarly found an increasing prevalence of need for orthodontic treatment with increasing degree of exposure to the bottle.[14]

The primary second molar relationship can give clues to the eventual permanent molar relationship. If the deciduous arches terminate in a mesial step, the permanent molars may erupt directly into a normal, Angle's Class I occlusion; in few cases, it may develop into Class III relationship. A definite distal step guides the molars into a distal relationship which generally does not improve with age, instead detoriates.[15]

Our study evaluated the effect of infant feeding patterns on the deciduous second molar relationship. We found that children who were exclusively breastfed had a higher percentage (84.09%) of mesial step occlusion which is favorable. On the other hand, children who were exclusively bottle-fed showed a higher risk of presenting a distal step occlusion (50%). Children who were bottle-fed in addition to breastfeeding showed 78.37% of mesial step occlusion. These findings were in accordance with the studies conducted by Nahás-Scocate et al.[16]

Among the bottle-fed children, a higher prevalence of mesial step occlusion was seen with the physiological nipple (55.26%) when compared with the conventional nipple (23.52%).


  Conclusion Top


This study supports a correlation between infant feeding methods and primary molar relationship. When bottle feeding becomes unavoidable, it is recommended to use the physiological nipple.

It is important for parents to be educated about the benefits of exclusive breastfeeding up to 6 months of age for more favorable development of the primary dentition.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Haydu S, Sundquist J. California Food Guide. www.cdph.ca.gov  Back to cited text no. 1
    
2.
World Breastfeeding Trends Initiative (WBTI)-India Report 2012.   Back to cited text no. 2
    
3.
Agarwal M, Ghousia S, Konde S, Raj S. Breastfeeding: Nature's Safety Net. Int J Clin Pediatr Dent 2012;5:49-53.  Back to cited text no. 3
    
4.
Reference Manual: Pediatric Dentistry. journal of the American Academy of Pediatric Dentistry, Special Issue 1995-1996;17:25.  Back to cited text no. 4
    
5.
Warren JJ, Bishara SE. Duration of nutritive and nonnutritive sucking behaviors and their effects on the dental arches in the primary dentition. Am J Orthod Dentofacial Orthop 2002;121:347-56.  Back to cited text no. 5
    
6.
Charchut SW, Allred EN, Needleman HL. The effects of infant feeding patterns on the occlusion of the primary dentition. J Dent Child (Chic) 2003;70:197-203.  Back to cited text no. 6
    
7.
Moss ML, Salentijn L. The primary role of functional matrices in facial growth. Am J Orthod 1969;55:566-77.  Back to cited text no. 7
    
8.
Linder-Aronson S. Respiratory function in relation to facial morphology and the dentition. Br J Orthod 1979;6:59-71.  Back to cited text no. 8
    
9.
Westover KM, DiLoreto MK, Shearer TR. The relationship of breastfeeding to oral development and dental concerns. ASDC J Dent Child 1989;56:140-3.  Back to cited text no. 9
    
10.
Labbok MH, Hendershot GE. Does breast-feeding protect against malocclusion? An analysis of the 1981 Child Health Supplement to the National Health Interview Survey. Am J Prev Med 1987;3:227-32.  Back to cited text no. 10
    
11.
Weber F, Woolridge MW, Baum JD. An ultrasonographic study of the organisation of sucking and swallowing by newborn infants. Dev Med Child Neurol 1986;28:19-24.  Back to cited text no. 11
    
12.
Agarwal JH, Gupta B, Behrani V, Saigal P. Breast Feeding v/s bottle feeding: Effects on occlusion. Indian J Dent Educ 2012;5:169-73.  Back to cited text no. 12
    
13.
Leite-Cavalcanti A, Medeiros-Bezerra PK, Moura C. Breast-feeding, bottle-feeding, sucking habits and malocclusion in Brazilian preschool children. Rev Salud Publica (Bogota) 2007;9:194-204.  Back to cited text no. 13
    
14.
Meyers A, Hertzberg J. Bottle-feeding and malocclusion: Is there an association? Am J Orthod Dentofacial Orthop 1988;93:149-52.  Back to cited text no. 14
    
15.
Tandon S. Development of occlusion. Textbook of Pedodontics. Ch. 11. 2nd ed. p. 113.  Back to cited text no. 15
    
16.
Nahás-Scocate AN, de Moura PX, Marinho RB, Alves AP, Ferreira RI, Guimarães FM. Association between infant feeding duration and the terminal relationships of the primary second molars. Braz J Oral Sci 2011;10:140-5.  Back to cited text no. 16
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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