Objective: Determine the association between nun-nutritive sucking habits and anterior open bite in children.
Materials and methods: This systematic review and meta-analysis followed the PRISMA guidelines. A systematic searched of four databases was conducted through the end of February 2025. Study designs included observational and interventional studies. Nun-nutritive sucking habits was evaluated in three categories: (1) ever versus never; (2) longer periods versus shorter periods; (3) daily versus not daily. We considered anterior open bite as the outcome. Based on meta-analyses, the pooled adjusted odds ratio and its 95% confidence interval (95%CI) were calculated. We assessed heterogeneity with both Q-test and I-square. An assessment of publication bias was conducted using funnel plots and Egger's test.
Result: Thirty three studies were included in this meta-analysis. We found that NNSH (eg, pacifier sucking and digit sucking) was associated with varying risks of developing anterior open bite (p < 0.01). Children with longer non-nutritive habits (for example, pacifier sucking and digit sucking) had a greater risk of developing anterior open bite than those with shorter habits. (p < 0.05) In addition, daily pacifier user has been linked to increased risk of developing anterior open bites. [N = 3, OR = 10.22 (5.36,19.49), p < 0.05].
Conclusion: In conclusion, prolonged and daily non-nutritive sucking habits, such as pacifier and digit sucking, are associated with a significantly increased risk of anterior open bite in children.
Clinical relevance: Thus, this study provides clinical support on early orthodontic treatment of AOB to inform preventative and management strategies.
Keywords: Anterior open bite; Digit sucking; Meta-analysis; Non-nutritive sucking habits; Pacifier sucking.
© 2025. The Author(s).