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5th Oral Disease - Other > Cleft Lip and Palate > Flashcards

Cleft Lip and Palate Flashcards

1
Q

How are cleft lip and palate caused?

A

Due to interaction between crania-facial and embryological processes

Likely due to issue w/ volume or failure of flow of mesenchyme = failure to fuse

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2
Q

What is cleft lip and palate?

A

Failure of fusion

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3
Q

How chart cleft lip and palate?

A

LAHSHAL
Dental charting - right to left
Lip, alveolus, hard palate, soft palate, hard palate, alveolus, lip

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4
Q

Difference LAHSHAL and lahshal?

A

lower case denote incomplete

upper case complete cleft

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5
Q

How denote left hand side complete cleft affecting lip, alveolus, hard palate and soft palate?

A

….SHAL

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6
Q

How chart complete bilateral cleft?

A

LAHSHAL

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7
Q

How chart incomplete cleft lip?

A

Depends on side

l…..

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8
Q

What are incomplete cleft lip referred to as?

A

Forme Fustra

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9
Q

How to incomplete cleft lip present?

A

Defect vermillion border and minor degree asymmetry of nose

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10
Q

What is often cause of incomplete cleft lip?

A

Lack of failure rather lack mesenchyme

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11
Q

How to chart isolated cleft palate?

A

..HSH../…S….

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12
Q

Issue w/ isolated palatal clefts?

A

Speech

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13
Q

How do sub-mucosal cleft palate present clinically?

A

Bifid uvula
Blue translucent zone
Abnormal muscle insertion

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14
Q

What hx may see in sub-mucosal palatal cleft?

A

Hx of problems feeding

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15
Q

How common is CL&P

A

1 in 650 births

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16
Q

Aetiology of CL&P

A

Genetic
Environment
Likely genetic triggered by environment

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17
Q

What are environmental factors in CL&P

A

Anti-convulsant drug, nutritional defect, anaemia

Smoking, alcohol, obesity

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18
Q

Diagnosis of CLP?

A

Ante natal scan - around 20-40 weeks

Screening offered to all women

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19
Q

What feature of ante-natal scan may increase suspicion?

A

Incorrect naso-labial angle

20
Q

What happens if suspicion CLP on scan?

A

Have 3D scan - extent of cleft lip - hard know palate involved

21
Q

What happens if child dx w/ cleft lip before birth?

A

Family seen before birth and within 24 hours of birth

22
Q

Why are babies visited cleft service within 24 hr birth?

A

Help issue w/ breathing/ feeding

Check co-morbidities

23
Q

What are 3 syndromes associated w/ CP?

A

Van de Woude
Pierre Robin sequence
Foetal Alcohol Spectrum Disorder

24
Q

What see in Van de Woude?

A

Lip pits
Hypodontia
Cardiac abnormalities
CP

25
Q

What see in Pierre Robin sequence?

A

CP

Mandibular retrognathia - head to chest during foetal growth

26
Q

Issue w/ mandibular retrognathia in Pierre Robin?

A

Small jaw - issue maintaining airway and issue w/ feeding

27
Q

What see is FASD?

A

Small head, low body weight, learning diff, co-ordination issue

28
Q

When are cleft lip and palate repaired?

A

When baby thriving - good circulating volume

29
Q

When can cleft lip be repaired?

A

From 3 month

30
Q

When can cleft palate be repaired?

A

From 6 month

31
Q

What impact on growth can be seen following CLP surgery?

A

Development class II

32
Q

What should do with neonatal teeth?

A

Removal w/ topical LA if impede feeding/ risk inhalation

If not XLA time CLP repair

33
Q

What abnormality can see in pt w/ CLP?

A

Neonatal teeth

34
Q

Why is there neonatal teethn in CLP?

A

Disruption dental lamina

35
Q

Common dental abnormalities in CLP?

A

Class III incisor - inhibition maxillary development
Hypoplastic enamel
Displaced teeth at cleft site

36
Q

Dental consideration CLP?

A

OH and dental advice

Hypoplastic enamel - prone plaque build up

37
Q

Why CLP pt higher risk of caries?

A

Diet - cariogenic, communication makes hard to eat some foods
OH - limited access, reluctance brush near site
Reduced salivary flow
Access care

38
Q

Preventative advice for CLP?

A 
Water night
F- toothpaste
Diet advice 
Preserve primary teeth - maintain space
Referral specialist
39
Q

What can also be issue in CLP pt?

A

Speech and hearing

40
Q

What do all CLP pt receive?

A

Speech therapy

41
Q

What ear issues do CLP pt suffer from?

A

Glue ear - issue drainage from Eustachian tube (linked palatal movement) - less issue as older and tube become more vertical

42
Q

What age is alveolar bone grafting considered?

A

Age 9-11

43
Q

Aim of alveolar bone grafting?

A

Address bony alveolar deficit
Aims encourage eruption maxillary canine
Close oronasal fistula

44
Q

What do to if CLP pt has adverse facial growth?

A

Orthognathic referral

45
Q

What age are CLP pt seen up to?

A

20 years

46
Q

What may older CLP pt complain of ?

A

Nasal drip
Food nose
Unhappy appearance

47
Q

What team provides cleft care?

A

MDT

5th Oral Disease - Other (13 decks)

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