Cleft Lip and Palate

Question 1

Teams involved in Cleft lip and Palate management (4)

Answer 1

Multifactorial

Multidisciplinary team

Dental team

Caries

Question 2

What is the classification for CL(P)

Answer 2

LAHSHAL

Question 3

What does LAHSH stand for?

Answer 3

L - lip
A - alveolus
H - hard palate
S - soft palate

small letter = not complete

Question 4

Incidence of CL(P)

Answer 4

1:700 live births
70% sporadic
CL(P) - M>F

Question 5

Aetiology (Causes) of CL(P)

Answer 5

Genetic
- Syndromes
- FH (child with cleft already)
- Sex ratio
- Laterality
- Ethnicity

Environment
- Social deprivation
- Smoking
- Alcohol
- Anti-epileptics
- Multivitamins

Question 6

Tx Plan for Cleft lip

Answer 6

3 mths - lip closure
6-12mths - palate closure
8-10yrs - alveolar bone graft
12-15yrs - definitive ORTHO
18-20 - surgery

Question 7

Dental impacts of CL(P)

Answer 7

• Missing teeth
• Impacted teeth
• Crowding
• Growth
• Caries

Question 8

List of dental team involved in CL(P)

Answer 8

• Paediatric dentist
• Dental therapist
• Restorative dentist
• OS
• Orthodontist
• Orthodontic therapist

Question 9

Why is strapping not used in UK anymore

Answer 9

Babies = obligate nasal breathers
Fill mouth with alginate can’t breathe = hypoxia whilst alginate sets

Question 10

Bone graft assessment age

Answer 10

7-8yrs

Question 11

Central incisor features in CL(P)

Answer 11

Central next to cleft smaller + slightly hypo plastic

Question 12

What aspects make orthognathic surgery more difficult in CL(P) pt

Answer 12

More scarring at back of soft palate
Lack of flexibility