Breastfeeding Protects from Overjet in Adolescence by Reducing Pacifier Use: A Birth Cohort Study
Abstract
Increased dental overjet in adolescence is a clinically relevant outcome associated with the complexity and high cost of treatment, indicating the need for prevention strategies. We investigated the long-term impact of breastfeeding and pacifier use on increased overjet (IOVJ) in permanent dentition. A prospective cohort nested in a randomized controlled trial was conducted from birth to 12 years of age (n = 214). Breastfeeding and pacifier use were recorded monthly until 12 months. Overjet was assessed at age 12 years. We employed a causal mediation analysis using parametric regression models assuming no interaction between breastfeeding and pacifier usage. We found a total protective effect of breastfeeding on IOVJ (OR 0.49; 95% CI 0.28–0.96), where 63.1% were mediated by pacifier use (OR 0.61; 95% CI 0.44–0.87). Breastfeeding directly decreased the odds of IOVJ by 20%; however, the confidence interval included the null estimate (OR 0.81; 95% CI 0.41–1.60). In conclusion, breastfeeding protects by half of the IOVJ in adolescence through reducing pacifier use. Oral and general health professionals should collaborate to support WHO breastfeeding guidelines during individual patient counseling. Guidelines for practice, policy or public information require messages that include a common risk approach to oral and general health.
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BibTeX
@article{feldens2026breastfeeding,
title = {{Breastfeeding Protects from Overjet in Adolescence by Reducing Pacifier Use: A Birth Cohort Study}},
author = {Carlos Alberto Feldens and Laura Boianovsky Petracco and Gustavo G. Nascimento and Huihua Li and Márcia Regina Vítolo and Karen Glazer Peres},
journal = {Nutrients},
year = {2026},
month = oct,
doi = {10.3390/nu15153403},
url = {https://hal.science/hal-05791950v1},
note = {CC BY},
}
RIS
TY - JOUR
TI - Breastfeeding Protects from Overjet in Adolescence by Reducing Pacifier Use: A Birth Cohort Study
AU - Carlos Alberto Feldens
AU - Laura Boianovsky Petracco
AU - Gustavo G. Nascimento
AU - Huihua Li
AU - Márcia Regina Vítolo
AU - Karen Glazer Peres
PY - 2026
DA - 2026/10/11
JO - Nutrients
DO - 10.3390/nu15153403
UR - https://hal.science/hal-05791950v1
AB - Increased dental overjet in adolescence is a clinically relevant outcome associated with the complexity and high cost of treatment, indicating the need for prevention strategies. We investigated the long-term impact of breastfeeding and pacifier use on increased overjet (IOVJ) in permanent dentition. A prospective cohort nested in a randomized controlled trial was conducted from birth to 12 years of age (n = 214). Breastfeeding and pacifier use were recorded monthly until 12 months. Overjet was assessed at age 12 years. We employed a causal mediation analysis using parametric regression models assuming no interaction between breastfeeding and pacifier usage. We found a total protective effect of breastfeeding on IOVJ (OR 0.49; 95% CI 0.28–0.96), where 63.1% were mediated by pacifier use (OR 0.61; 95% CI 0.44–0.87). Breastfeeding directly decreased the odds of IOVJ by 20%; however, the confidence interval included the null estimate (OR 0.81; 95% CI 0.41–1.60). In conclusion, breastfeeding protects by half of the IOVJ in adolescence through reducing pacifier use. Oral and general health professionals should collaborate to support WHO breastfeeding guidelines during individual patient counseling. Guidelines for practice, policy or public information require messages that include a common risk approach to oral and general health.
SN - 2072-6643
ER -