Effects of feeding on non‐nutritive sucking habits and implications on occlusion in mixed dentition

International Journal of Paediatric Dentistry 2011; 21: 68–73 Background. Several studies have determined the effects of non‐nutritive sucking habits on malocclusions, but provided conflicting results. Aim. To analyse the influence of infant feeding In the presence of non‐nutritive sucking habits in children after the first year of life and to assess the effects of non‐nutritive sucking habits on occlusion in mixed dentition. Design. Data were collected by self‐reported questionnaire and confirmed by personal interview. Parents of 1451 children (aged 7–11) were asked about their children’s infant feeding and non‐nutritive sucking habits. A clinical evaluation of dental arches included classification of molar relationship (Angle classification), presence or absence of crossbite and open bite. Results. Children with bottle or complementary feeding showed a higher risk of acquiring non‐nutritive sucking habits after the first year of life (P < 0.01). Non‐nutritive sucking habits are associated with a greater risk of crossbite, open bite, Class II molar relationship (P < 0.01). Conclusions. Parents should be educated about benefits of the exclusive breast feeding in the first 6 months of age on mixed dentition. The activity of non‐nutritive sucking should be diagnosed in a timely manner in order to reduce the development of posterior crossbite, anterior open bite, and Class II molar relationship.     

Effects of nonnutritive sucking habits on occlusal characteristics in the mixed dentition

PURPOSE: Little is known about the extent to which nonnutritive sucking habits contribute to malocclusion in the mixed dentition. The purpose of this study was to report on the relationship between certain occlusal traits in the mixed dentition and longitudinal sucking behaviors. METHODS: Dental examinations were conducted on 630 children in the mixed dentition who participated in a large, ongoing longitudinal study. Five hundred eighty consented to impressions, and 524 adequate study models were obtained. Of these, 444 also had adequate longitudinal nonnutritive sucking data obtained via mailed questionnaires to parents at 3- to 6-month intervals from birth to 8 years. Sucking behaviors were grouped by predominant type and duration. Study models were hand articulated using wax bites to evaluate the occlusion for the presence of open bite, crossbite, molar relationship, and excessive overjet. Bivariate statistical analyses related presence of these malocclusions to sucking duration and type. RESULTS: Fifty-five percent of the children had malocclusions (anterior open bite, posterior crossbite, bilateral Class II molar relationship, or overjet >4 mm). Class II molar relationship was most common (30%). Overall, anterior open bite and posterior crossbite was associated with habits of 36 months or more. Sustained pacifier habits, including those of 24 to 47 months, were associated with anterior open bite and Class II molar relationships, while digit habits were associated with anterior open bite when sustained for 60 months or longer. CONCLUSIONS: Malocclusions are quite prevalent in the mixed dentition, and anterior open bite and posterior crossbite may be preventable by modifying nonnutritive sucking behaviors.     

Sucking habits and facial hyperdivergency as risk factors for anterior open bite in the mixed dentition.

INTRODUCTION: The aim of this study was to evaluate sucking habits and hyperdivergency as risk factors for anterior open bite in mixed-dentition subjects. METHODS: Anamnestic and pretreatment cephalometric records of 1710 mixed-dentition subjects were assessed for sucking habits, dental open bite, and facial hyperdivergency. RESULTS: The rate of anterior open bite was 17.7%. Multiple logistic regression showed that both prolonged sucking habits and hyperdivergent vertical relationships significantly increased the probability of an anterior dentoalveolar open bite, with a prevalence rate of 36.3%. This was 4 times the prevalence of sucking habits and facial hyperdivergency in subjects without anterior open bite (9.1%). CONCLUSIONS: Prolonged sucking habits and hyperdivergent facial characteristics are significant risk factors for anterior open bite in the mixed dentition.     

Duration of nutritive and nonnutritive sucking behaviors and their effects on the dental arches in the primary dentition.

The purpose of this study was to determine the association between the duration of nutritive and nonnutritive sucking behaviors and various occlusal characteristics in the primary dentition. Sucking behavior data were collected on 372 children followed longitudinally from birth by using periodic questionnaires completed by parents. Study models were obtained from the children at 4 to 5 years of age and assessed for posterior crossbite, anterior open bite, and overjet. Dental arch parameters including arch widths, arch lengths, and arch depths were measured directly from the models. The subjects were grouped according to type of habit (pacifier or digit) and duration of nonnutritive sucking behaviors (less than 12, 12 to 24, 24 to 36, 36 to 48, and more than 48 months). Children with nonnutritive sucking of less than 12 months were further grouped according to the duration of breast-feeding. The dental arch and the occlusal characteristics were then compared among these groups. The results indicated no relationship between duration of breast-feeding during the first year of life and any dental arch or occlusal parameters. The study found that prolonged pacifier habits resulted in changes to the dental arches and the occlusal parameters that were different from the effects of digit sucking. In addition, some changes in the dental arch parameters and occlusal characteristics (eg, prevalence of posterior crossbite and increased amount of overjet) persisted well beyond the cessation of the pacifier or digit habit. Although further study is needed to determine the effects of nonnutritive sucking behavior in the mixed dentition, the results suggest that current recommendations for discontinuing these habits may not be optimal in preventing habit-related malocclusions.     

Effects of oral habits' duration on dental characteristics in the primary dentition.

BACKGROUND: Studies dating to the 1870s have demonstrated that long-term nonnutritive sucking habits may lead to occlusal abnormalities, including open bite and posterior crossbite. However, little is known as to whether habits of shorter durations have lasting effects. METHODS: The authors collected longitudinal data on nonnutritive sucking among children through a series of questionnaires regularly completed by parents. Researchers examined the children at ages 4 to 5 years and obtained study models. The models were measured for dental arch parameters (including arch width, arch length and arch depth) and assessed for overjet, overbite and posterior crossbite. The authors compared the dental arch and occlusal conditions among groups of children with nonnutritive sucking habits of different durations. RESULTS: Children with nonnutritive sucking habits that continued to 48 months of age or beyond demonstrated many significant differences from children with habits of shorter durations: narrower maxillary arch widths, greater overjet and greater prevalence of open bite and posterior crossbite. In addition, compared with those who ceased their habit by 12 months of age, those with habits at 36 months of age had significantly greater mandibular canine arch widths, maxillary canine arch depths and overjet, while those with habits at 24 months and 36 months had significantly smaller palatal depths. Prevalence of anterior open bite, posterior crossbite and excessive overjet (> 4 millimeters) increased with duration of habits. CONCLUSIONS: While continuous nonnutritive sucking habits of 48 months or longer produced the greatest changes in dental arch and occlusal characteristics, children with shorter sucking durations also had detectable differences from those with minimal habit durations. CLINICAL IMPLICATIONS: It may be prudent to revisit suggestions that sucking habits continued to as late as 5 to 8 years of age are of little concern.     

Combined effect of anterior malocclusion and inadequate lip coverage on dental trauma in primary teeth

Abstract – Objectives: The main objective of this study was to investigate whether the interaction of malocclusion (open bite or increased overjet) combined with inadequate lip coverage strengthens its association with traumatic dental injury (TDI) in the primary teeth of preschool children compared to the presence of malocclusion alone. Subjects and methods: A cross‐sectional survey was conducted with 376 children aged 36–59 months who attended the National Day of Children’s Vaccination. Presence of TDI, tooth discoloration, and sinus tract were evaluated in the children. Variables associated with occlusion were also evaluated. A Poisson regression analysis was performed to verify the association between the explanatory variables and TDI as well as possible interactions among the variables. Then, the prevalence ratio was calculated. Results: The prevalence of TDI was 27.7%. The maxillary central incisor was the most affected tooth, without differences between the right and left sides. Boys had more dental trauma than girls (P = 0.04). The most common TDI was crown fracture restricted to the enamel (58.4%). Children with a combination of anterior open bite or increased overjet and inadequate lip coverage presented a higher prevalence of TDI than when the malocclusions were presented alone (P < 0.05). The same trends were observed when we included, in the final adjusted model, increased overjet instead of open bite. Conclusions: Anterior malocclusions of primary teeth such as increased overjet and anterior open bite are statistically significantly associated with dental trauma only when inadequate lip coverage is also present.     

Association between malocclusion in the mixed dentition with breastfeeding and past nonnutritive sucking habits in school-age children

ObjectivesTo evaluate the association between malocclusion characteristics in the mixed dentition stage, breastfeeding, and past nonnutritive sucking habits in school-age children.Materials and MethodsA total of 547 school children in the mixed dentition, in the age range between 7 and 13 years, were evaluated by means of questionnaire and clinical examination. Binomial and multinomial logistic regression models were used to evaluate the associations between breastfeeding and finger and pacifier sucking habits, the malocclusion characteristics of posterior crossbite, and excessive or deficient overjet and overbite.ResultsIndividuals who had nonnutritive sucking habits had 2.16 times greater chance of having anterior open bite (odds ratio [OR] 2.16; 95% confidence interval [CI], 1.07–4.33) and 2.39 times greater chance of having posterior crossbite (OR 2.39; 95% CI, 1.56–5.49). Children who were exclusively breastfed up to at least 6 months of age had a higher frequency of normality for overjet and overbite and the lowest posterior crossbite index. However, in adjusted analysis, breastfeeding showed no association with malocclusion characteristics in the mixed dentition stage.ConclusionsBreastfeeding was not associated with the presence of malocclusion in the mixed dentition, whereas past nonnutritive sucking habits were associated with the occurrence of malocclusion.     

Oral habits,dental trauma,and occlusal characteristics among 4‐ to 12‐year‐old institutionalized orphan children in Riyadh,Saudi Arabia

The aim of this study was to assess the oral habit practices, dental trauma, and occlusal characteristics of 4‐ to 12‐year‐old orphans living in governmental orphanages in Riyadh. This cross‐sectional study was conducted in three government orphanages and three ordinary schools. All 90 orphans, residing in the orphanage, were included. Ninety schoolchildren were selected to serve as the controls. Demographic data, oral habit history, and dental trauma history were obtained through a questionnaire. All children were examined to confirm the presence of signs of oral habits, dental trauma, and associated occlusal characteristics. Pearson chi‐square was used for statistical analysis. Orphans were found to have more digit sucking and oral self‐mutilation habits; however, the control children were found to have more nail biting habit. Nearly 21% of the orphans had dental trauma compared to 10% of the control group. About 70% of the dental trauma affected permanent teeth among orphans, whereas, 85% affected primary teeth in the control children. Dental trauma increased as the orphans got older; however, it decreased significantly as the control children got older. Orphans were found to have more cross‐bite, increased over‐jet, and open‐bite. Digit sucking habit was positively associated with class II molar relation, presence of posterior cross‐bite, and open‐bite. Orphans had increased prevalence of digit sucking habit, self‐mutilation, dental trauma, and malocclusion.     

Prevalence and change of malocclusions from primary to early permanent dentition: A longitudinal study

Objective:To follow a group of children from primary to early permanent dentition and determine the prevalence, self-correction, and new development of malocclusions; the need for orthodontic treatment; and the possible influences of habits, breathing disturbances, and allergies.Materials and Methods:Two hundred and seventy-seven children were followed at 3, 7, and 11.5 years of age. Malocclusions and orthodontic treatment need were determined by clinical examinations. Data on sucking habits, breathing disturbances, allergies, dental trauma, and orthodontic treatments were collected from a questionnaire and dental records.Results:Malocclusions were found in 71% of participants at 3 years of age, 56% at 7 years of age, and 71% at 11.5 years of age. Self-correction was noted for anterior open bite, sagittal malocclusions, and posterior crossbite, while deep bite developed. A high number of contact point displacements and spacings contributed to the prevalence of malocclusion rate of 71% at 11.5 years. Severe or extreme orthodontic treatment need was apparent in 22%. Habits, allergies, or breathing disturbances found at 3 years of age had no associations with malocclusions at 11.5 years of age.Conclusions:This sample revealed a significant percentage of malocclusions and orthodontic treatment need. A substantial number of self-corrections and establishment of new malocclusions occurred during the transition from primary to early permanent dentition.     

Association between early weaning, non-nutritive sucking habits and occlusal anomalies in 3-year-old Finnish children

Objectives, design and subjects . Earlier results on the effect of breastfeeding on the one hand, and non-nutritive sucking habits (pacifier and/or digit sucking) on the other, on the orofacial development of infants are inconclusive. Thus we studied the prevalence of malocclusions and their relationship to the duration of breastfeeding and to non-nutritive sucking habits in a group of randomly selected 3-year-old children ( n  = 148).
Results . Posterior crossbite was detected in 13%, anterior open bite in 18% and large overjet (> 3 mm) in 26% of the children. The proportion of children with anterior vertical open bite was significantly larger among children with non-nutritive sucking habits than among the other children ( P < 0·001). Neither posterior crossbite nor large overjet were associated with non-nutritive sucking habits. The duration of exclusive breastfeeding was 5·8 ± 3·6 months while that of total breastfeeding was 7·3 ± 3·8 months on average. The exclusive and total breastfeeding periods of children with posterior crossbite were both significantly shorter than those of the other children ( P < 0·01 and P  < 0·002, respectively). Children's height and weight were unrelated to the duration of breastfeeding or occlusal anomalies.
Conclusion . We suggest that an early introduction of bottlefeeding, indicating a pattern of low-impact muscular activity, may interfere with the normal development of alveolar ridges and hard palate, and hence lead to posterior crossbite.     

The occlusal effects of digit sucking habits amongst school children in Northamptonshire (UK)

Abstract

Objective: To compare the occlusal characteristics of persistent digit suckers with those of a group of individuals who reported never to have sucked their thumb or finger.

Setting: School children and regular attenders to four general dental practices in Kettering, UK.

Design: Cross‐sectional, observational.

Outcome measures: Prevalence of anterior open bite, posterior crossbite, size of overjet, overbite and buccal segment relationship.

Subjects and methods: The exposed group consisted of 7–13‐year‐old children with a persistent digit sucking habit or those who had given up the habit less than 2?years previously, compared with an unexposed group of children who had never reported a history of the habit. Upper and lower alginate impressions were taken and the resultant study models were used to measure occlusal differences between the two groups.

Results: Following exclusions, 39 digit suckers were compared to 36 non‐suckers. The odds of a reduced overbite being present were significantly higher in the digit sucking group compared to the non‐suckers (OR: 5·6, 95% CI: 1·6–20·8). The prevalence of anterior open bites was higher in the digit suckers (P<0·001). Although the overjet was slightly increased in the digit suckers compared with the non‐suckers (mean difference: 1?mm, P?=?0·036), this result needs to be interpreted with caution. No significant differences were seen in the presence of posterior crossbites or buccal segment relationships between the two groups.

Conclusions: This study has shown that reduced overbite and anterior open bites were significantly more prevalent in digit suckers. The orthodontic management of anterior open bites can involve complex and prolonged treatment. Early intervention to eliminate digit sucking habits is therefore recommended on both oral health and health economic grounds.     

Breastfeeding and non-nutritive sucking patterns related to the prevalence of anterior open bite in primary dentition

Objective

Nutritional, immunological and psychological benefits of exclusive breastfeeding for the first 6 months of life are unequivocally recognized. However, mothers should also be aware of the importance of breastfeeding for promoting adequate oral development. This study evaluated the association between breastfeeding and non-nutritive sucking patterns and the prevalence of anterior open bite in primary dentition.

Material and Methods

Infant feeding and non-nutritive sucking were investigated in a 3-6 year-old sample of 1,377 children, from São Paulo city, Brazil. Children were grouped according to breastfeeding duration: G1 – non-breastfed, G2 – shorter than 6 months, G3 – interruption between 6 and 12 months, and G4 – longer than 12 months. Three calibrated dentists performed clinical examinations and classified overbite into 3 categories: normal, anterior open bite and deep bite. Chi-square tests (p<0.05) with odds ratio (OR) calculation were used for intergroup comparisons. The impact of breastfeeding and non-nutritive sucking on the prevalence of anterior open bite was analyzed using binary logistic regression.

Results

The prevalence estimates of anterior open bite were: 31.9% (G1), 26.1% (G2), 22.1% (G3), and 6.2% (G4). G1 would have significantly more chances of having anterior open bite compared with G4; in the total sample (OR=7.1) and in the subgroup without history of non-nutritive sucking (OR=9.3). Prolonging breastfeeding for 12 months was associated with a 3.7 times lower chance of having anterior open bite. In each year of persistence with non-nutritive sucking habits, the chance of developing this malocclusion increased in 2.38 times.

Conclusion

Breastfeeding and non-nutritive sucking durations demonstrated opposite effects on the prediction of anterior open bite. Non-breastfed children presented significantly greater chances of having anterior open bite compared with those who were breastfed for periods longer than 12 months, demonstrating the beneficial influence of breastfeeding on dental occlusion.     

Non-nutritive sucking habits, anterior open bite and associated factors in Brazilian children aged 30-59 months

The aim of the present study was to investigate the prevalence of non-nutritive sucking habits and anterior open bite as well as their main causes (associated factors) in Brazilian children aged 30-59 months. A cross-sectional study was carried out during the National Immunization Day for polio in the city of Recife in the northeastern region of Brazil. The sample was made up of 1,308 children. Data were collected from interviews with mothers or guardians as well as from clinical examinations carried out by previously trained dental students. The chi-square test was used for statistical analysis at 5% significance level. The prevalence of non-nutritive sucking habits was 40%, and the habits were associated with gender (p=0.001), age (p=0.003) and feeding type (p<0.001). Anterior open bite was detected in 30.4% of children, and it was significantly associated with feeding type (p<0.001) and non-nutritive sucking habits (p<0.001). The variables found to be associated factors in the present study for the occurrence of non-nutritive sucking habits and anterior open bite emphasize the need to establish strategies that include orientation regarding health promotion based on the “common determining factors” approach. Public health policies should be adopted to encourage a longer duration of breastfeeding, thereby contributing towards reducing the prevalence of non-nutritive sucking habits and anterior open bite.     

Social and biological early life influences on the prevalence of open bite in Brazilian 6-year-olds

OBJECTIVE: Little is known about the effects of social and biological risk factors for open bite on the primary dentition. The aim of this study was to assess the early-life risk factors affecting anterior open bite. METHODS: A cross-sectional study using a birth cohort was carried out in Pelotas, Brazil. A sample of 400, 6-year-old children was employed. The Foster and Hamilton criteria were used to classify open bite. Data concerning social conditions, and perinatal and childhood health and behaviour were obtained from birth to 12 months of age and during the fifth year of the children's lives. Unconditional bivariate and multiple logistic regression analysis were performed. RESULTS: The prevalence of anterior open bite was 46.3%. Risk factors included: a maternal age of between 30 and 39 years, as compared with children whose mothers were younger; breast-feeding for < 9 months; dental caries experience; pacifier sucking between 12 months and 5 years, as compared to no sucking or a shorter duration of sucking; and the presence of finger-sucking at 6 years of age. CONCLUSION: Open bite in the primary dentition was associated with older mothers, early weaning, dental caries occurrence, long-term use of a pacifier and finger-sucking at 6 years of age. These findings support the common risk approach for intervention to prevent open bite in the primary dentition.     

Feeding and nonnutritive sucking habits and prevalence of open bite and crossbite in children/adolescents with Down syndrome

Objective:To analyze the influence of breastfeeding, bottle feeding, and nonnutritive sucking habits on the prevalence of open bite and anterior/posterior crossbite in children with Down syndrome (DS).Materials and Methods:A cross-sectional study was carried out in 112 pairs of mothers/children with DS between 3 and 18 years of age at a maternal/children''s hospital in Rio de Janeiro, Brazil. The children with DS were clinically examined for the presence of open bite as well as anterior and posterior crossbite. Information on breastfeeding, bottle feeding, and nonnutritive sucking habits was collected using a structured questionnaire. The control variables were age and mouth posture of children/adolescents and mother''s schooling. Statistical analysis of the data was performed using the chi-square test and multiple logistic regression.Results:The prevalence of anterior open bite was 21%, anterior crossbite was 33%, and posterior crossbite was 31%. The use of bottle feeding for more than 24 months (prevalence ratio [PR]  =  1.6) was associated with the occurrence of open bite. Having breastfed for less than 6 months (PR  =  1.4) and pacifier sucking for more than 24 months (PR  =  3.1) were associated with the prevalence of anterior crossbite. Finger sucking (PR  =  2.9) and the use of bottle feeding for more than 24 months (PR  =  2.6) were associated with posterior crossbite.Conclusion:The prevalence of open bite and crossbite in children with DS was associated with the use of bottle feeding and pacifier sucking for more than 24 months, breastfeeding for less than 6 months, and finger sucking.     

Nonnutritive sucking habits and anterior open bite in Brazilian children: a longitudinal study

PURPOSE: The purpose of this longitudinal study was to assess the relationship between nonnutritive sucking habits and anterior open bite in 305 4- to 5-year-old children attending state schools in the city of Recife, Brazil. METHODS: The data were collected by interviewing the children's mothers or guardians and through clinical examinations carried out by 1 calibrated examiner (K = 1). Bivariate analyses (Pearson chi-square, McNemar, and Stuart-Maxwell tests) were used for the statistical analysis. RESULTS: The prevalence of sucking habits was low, and the sample showed reductions after 1 year of follow-up. The prevalence of anterior open bite decreased from 33% to 29% after 1 year. A significant association was found between anterior open bite and sucking habits. Open bite self-correction was associated with the abandoning of deleterious habits. CONCLUSIONS: The low prevalence of nonnutritive sucking habits and its reduction during the period studied seem to reflect a natural tendency in preschool children. Even presenting a slight reduction, the high prevalence of anterior open bite draws attention to the importance of longitudinal studies to support scientific evidences for early clinical intervention.     

Prevalence and factors associated with non-nutritive sucking behavior. Cross sectional study among 5- to 6-year-old Senegalese children

Sucking behaviours have been described in the literature under two facets i.e. nutritive and non nutritive. Nutritive sucking refers to breast feeding, bottle feeding or a combination of both. Non nutritive sucking habits are mentioned when children suck their thumb or another finger(s), a pacifier or any other object. Non nutritive sucking habits (NNSH) are suspected to potentially induce dentoalveolar anomalies and thus may constitute a public dental health problem. Anthropological and historical data suggest that non nutritive sucking habits are associated with modern pattern of life. The aim of this study is to investigate the prevalence and factors associated with NNSH in Senegalese children 5/6 years old. Data of this study were collected using a structured questionnaire administered by the investigators to mothers or caregivers of 443 children (231 boys and 212 girls) aged 5/6 years. Three types of data were collected: data on the social background of the children including place of residence (urban, suburban and rural) and the mother's occupation (workers, employee, executive, housewife), data regarding former and present sucking habits and information on the feeding pattern of the children when they were infants (breast feeding, bottle feeding or a combination of both). The results indicated a prevalence rate of 16.50% and 17.20% respectively for digit and pacifier sucking in this population. Also, a significant association was found between children's non nutritive sucking habits in one hand and the mothers' occupation and feeding pattern on the other hand. Breast fed children are less prone to develop a non nutritive sucking habit than bottle fed children. Longitudinal studies are necessary to verify the nature of these associations. The identification of factors associated with non nutritive sucking habits would permit to develop and target recommendations for the prevention of such habits.     

Bottle feeding, increased overjet and Class 2 primary canine relationship: is there any association?

The aim of this study was to investigate the association between bottle feeding and prevalence rates of increased overjet and Class 2 primary canine relationship. The sample consisted of 911 children (461 boys, 450 girls) aged 3 (13.9%), 4 (40.8%), 5 (34%) and 6 (11.3%) years, with complete primary dentition. Information about nutritive and nonnutritive (pacifier and/or digit) sucking habits was collected through questionnaires. Three calibrated dentists (κ: 0.9-1.0 and Rs > 0.90) performed the clinical assessments. The children were divided into four groups: G1 - not bottle-fed; G2 - exclusively bottle-fed; G3 - breast- and bottle-fed, bottle feeding ceased before 3 years of age; and G4 - breast- and bottle-fed, bottle feeding ceased between 3 and 4 years of age. Associations between nutritive and nonnutritive sucking behaviors and the malocclusions studied were analyzed by multiple binary logistic regression (α= 0.05). The frequencies of increased overjet were: 25.3% (G1), 38.8% (G2), 39.2% (G3) and 47.8% (G4). The percentages of Class 2 canine relationship were: 27.9% (G1), 48.8% (G2), 43.4% (G3) and 43% (G4). No significant effect of bottle feeding was found. The chances of diagnosing increased overjet (O.R. = 4.42, p < 0.001) and Class 2 canine relationship (O.R. = 4.02, p < 0.001) were greater for children with pacifier and/or digit-sucking habits, compared to those without a history of nonnutritive sucking behavior. It may be suggested that bottle feeding alone is not directly associated with higher prevalence rates of increased overjet and Class 2 canine relationship in the primary dentition.     

Passive correction of an anterior open bite related to non-nutritive sucking habits: report of a case

The term anterior open bite refers to a vertical space between the upper and lower front teeth in maximum intercuspation. This malocclusal trait can accompany many malocclusions of the Angle's classification. Two types of anterior open bite have been described: skeletal and dental open bite. The latter may have Non Nutritive Sucking Habits (NNSH) as causal factor and is deemed to aggravate without treatment. This article presents an interceptive approach based on the use of a fixed passive appliance interfering with sucking habit. It consists of a crib soldered to bands adjusted to the maxillary first permanent or temporary second molars. The device was globally well accepted by the patient and has been effective in breaking the sucking habit and subsequently in closing the bite after only 5 month. When psychological approach is not effective, a fixed deterrent device may be recommended for weaning children off nonnutritive sucking habits.