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Problems involved with the use of comforters
  1. G B Winter
  1. Emeritus Professor of Children's Dentistry, 1 Hartfield Close, Elstree, Herts WD6 3JD, UK

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While I share many of the concerns expressed by Gill1 in his diatribe on dummies there are a number of matters mentioned which require amplification or correction. The first patent on the India rubber nipple resembling the present day dummy was recorded in 1845 and was described in use in its present form in London in 1927. Unfortunately by this time the practice of dipping the dummy in a variety of sweetening agents to make it a more effective pacifier had become established and this habit was noted to be associated with the early onset of dental caries. No doubt the loss of primary incisors mentioned by Gill is due to their destruction by rampant dental caries associated with the persistent use of sweetened pacifiers and their subsequent extraction due to spreading infection, pain, and loss of sleep. The association of dummy sucking with malocclusion is more complex than stated. While there is a general agreement on the effect of prolonged dummy sucking producing malocclusions in the primary dentition, these abnormalities are mainly self corrective on cessation of the habit which is usually before 5 years of age.2

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