Longitudinal analysis of the development of orofacial morphology and physiology in children with sucking habits

Abstract

Morphological changes due to the presence of sucking habits at an early age can lead to significant functional changes. Thus, the aim of this study is to investigate the influence of sucking habits removal (pacifier and bottle-feeding) using the Clarification Method in the development of oro-myofunctional functions and dentofacial morphology. As a secondary objective, the development of these functions in a group of children who do not have these habits (controls) will be evaluated. The sample will consist of 80 children from public schools of Pi-racicaba (SP), with three years, divided into two groups: experimental group, consisting of children with non-nutritive sucking habits (pacifier) and nutritive sucking habits (bottle-feeding), and control group, consisting of children without sucking habits and with normal occlusion, matched for age and gender. Both groups will be evaluated and followed up for a period of 18 months. The physical examination will involve height and weight measurements to be obtained using a stadiometer and digital scale, respectively, and the evaluation of facial morphology. In the clinical examination, caries experience, dental anomalies of shape or number and occlusal morphology will be evaluated. The maximum bite force and labial and lingual pressure will be determined using a digital gnathodynamometer and Iowa Oral Performance Instrument, respectively. The evaluation of masticatory function will be carried out using the instrument Mastication Observation and Evaluation (MOE). The functions of speech, swallowing and breathing will be evaluated by the "Orofacial Myofunctional Rating - MBGR Pro-tocol" using standardized methodology and recorded on video for later blinded evaluation by two trained and calibrated speech therapists. The gustatory sensitivity will be verified by hedonic scale, in which the child will express their emotional state or emotional reaction in relation to the four basic tastes: sweet, sour, salty and bitter at low concentrations. Food consumption will be estimated by the Diet Quality Index Revised (DQI-R), which allows to in-vestigate the consumption of fibrous foods such as fruits, raw vegetables and whole grains. Statistical analysis will consist of the description of the variables in study and the use of nor-mality tests, correlation tests between the studied variables (Pearson or Spearman), intra-group comparison in the different stages (ANOVA for repeated measures / Friedman) and inter-group comparison (ANOVA / Kruskal-Wallis), considering ± = 0.05.