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Peds 2 (Exam 3) > Cleft Lip and Palate > Flashcards

Cleft Lip and Palate Flashcards

1
Q

what is the dentist’s role on a craniofacial team?

A

-be a liaison btw the team and the family dentist or private peds dentist who provides the child’s routine dental care.

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2
Q

what % of clefts are cleft lips only?

A

20-30%

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3
Q

what % of clefts are cleft lip and alveolus?

A

1-10%

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4
Q

what race is most likely to get clefts?

A

2:1 whites than non-whites

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5
Q

what is a class I cleft lip?

A

vermilion border

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6
Q

what is a class II cleft lip?

A

Vermilion border + part of the lip

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7
Q

what is a class III cleft lip?

A

Unilateral complete cleft lip

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8
Q

what is a class IV cleft lip?

A

Bilateral cleft of lip only

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9
Q

what is a class I cleft palate?

A

soft palate only

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10
Q

what is a class II cleft palate?

A

Unilateral soft and hard palate/lip

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11
Q

what is a class III cleft palate?

A

Unilateral soft/hard thru alveolus

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12
Q

what is a class IV cleft palate?

A

total bilateral palate/lip thru alveolus

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13
Q

what is the tx of a cleft for a newborn

A

palatal molding/lip bands

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14
Q

what is the tx of a cleft for 2-3 month old

A

surgical correction

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15
Q

what is the tx of a cleft for early childhood?

A

pharyngeal flap

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16
Q

what is the tx of a cleft for 7-10 years?

A

alveolar bone graft

17
Q

what is the tx of a cleft for childhood?

A

orho tx and prostodontics

18
Q

what is the tx of a cleft after growth?

A

orthognathic surgery, cosmetic surgery, dental restoration

19
Q

what is the rate of caries like for cleft lip/palate pts?

A

high prevalence in primary and permanent teeth

*poor hygiene, delayed oral clearance, nutritional issues (high caloric diet to gain weight), higher level of sucrose and starches in diet, colonization of appliances, parent overindulgence

20
Q

which teeth have the highest prevalence for caries in cleft lip/.palate pts?

A
  • incisors then second molars

* no good studies on prevention of CLP

21
Q

what is perio disease like in CLPs?

A

no sig differences among different type of cleft regarding plaque control, calculus, gingivitis, attachemnt loss and perio microbiota

***one exception is that probe depths are shallower in CLP pts who have not had ORTHO tx

22
Q

what is the importance of prevention for CLPs?

A

ultimate success of bone graft dependent on controlling/eliminating gingivitis before the graft

*perio status is normalized after bone grafting

23
Q

what are the ways to prevent disease for CLPs?

A
  • diet
  • oral hygiene
  • fluride
  • early intervention (tooth deftects)
  • recall frequency
  • patient/parent education
24
Q

is it the dentist’s tole to provide dental home services to families?

A

yes

25
Q

what is facing the parents of CLP and you as the dentist?

A
  • shock, loss, grief and worry in accomplishing daily tasks
  • development of a concept of normalcy for their child
  • buy in on the need for them to be experts in care
  • buy in to be able to make informed choices for their child
26
Q

what are the frustrations for families of CLP?

A
  • repetition of health history for multiple providers
  • dealing with varying understandings of CLP by providers **
  • less available quality social support
  • family stresses on marriage

** families place high value on the quality of knowledge of health providers

27
Q

by what age do kids with CLP have dissatisfaction with facial appearance and psychosocial problems significantly associated

A

10-15

28
Q

in girls with CLP, self-worth seems to decline when?

A

teens

*in boys it goes up

29
Q

are parents of CLP pts more/less tolerant of behavior problems

A

less

30
Q

what is the realistic approach you should take of your pts with CLP?

A
  • perfection is not always achievable
  • small improvements may be significant
  • parents accept small improvement
  • broaden your concept of success
  • accept non-dental accomplishments as part of your job
31
Q

what is the main role of treatment of CLP pts that are school aged children?

A
  • adjustments to appearance and function to facilitate assimilation into the school environment
  • fabrication of an obturator, ant tooth replacement, encourage effective speech, discussion of the timing fo surgeries
32
Q

what do you do for a school aged CLP pt post graft?

A

PROSTHETIC HABILITATION

  • tooth recontouring
  • make canine/premolar look like lateral incisor/canine
  • coorect crowding/spacing
  • early implants// later implants
  • fixed vs removable prost

Peds 2 (Exam 3) (9 decks)

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