Cleft Lip & Palate Flashcards

1
Q

What history should be taken for a child with cleft lip and palate?

A
  • medical history
    • surgeries and hospitalisations
    • upcoming surgeries
    • other specialties visited
    • medications
    • allergies
  • pain history
  • dental history
    • previous treatment
    • dentally anxious
    • parental dental attitude
  • diet history
  • social history
    • social work involvement
  • family history
    • clefts
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2
Q

What dental findings are more commonly found with a cleft lip and palate?

A
  • hypodontia
  • supernumerary teeth
  • increased caries rate
  • enamel defects
  • malocclusion
  • crowding
  • delayed eruption
  • ectopic teeth
  • misshapen teeth
  • shortened roots
  • larger crowns
  • taurodontism
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3
Q

Who is involved in the multidisciplinary care of patients with cleft lip and palate?

A
  • GDP
  • orthodontist
  • cleft surgeon
  • ENT
  • speech therapy
  • plastic surgeon
  • psychologist
  • specialist restorative dentistry
  • audiology
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4
Q

When do patients undergo surgical treatment and what procedures are involved?

A
  • 6-12 months
    • lip repair surgery
  • 18 months
    • palate repair surgery
      • gap in palate closed
      • muscles and lining rearranged
      • bone graft in alveolar ridge
  • 12-15 years old
    • ortho treatment
    • monitoring jaw growth
  • rhinoplasty can be considered to improve nose shape
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5
Q

What support is available for children and families with cleft lip and palate?

A
  • clinical psychologist
  • support nurse
  • CLAPPA
  • Facebook support groups
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6
Q

What is the caries risk of patients with cleft lip and palate?

A

high caries risk

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7
Q

What preventive plan should patients with cleft and palate be on and what does it involve?

A
  • enhanced prevention regime
    • high caries risk
  • fluoride varnish
    • 22,600ppmF
    • 4 times annually
  • fluoride toothpaste
    • 2,800ppmF or 5,000ppmF
    • must be over 10 years old
  • fissure sealants
    • all first permanent molars on eruption
      • occlusal pits and fissures
      • palatal of upper
      • buccal of lower
  • toothbrushing advice
    • spit don’t rinse
    • 2 minutes twice a day
  • check ups
    • every 3 months
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8
Q

How can caries in deciduous molars be managed in patients with cleft lip and palate?

A
  • do nothing
    • pain
    • infection risk
    • not recommended
  • extraction
    • LA
      • over multiple appointments
    • inhalation sedation
      • consider contraindications
    • GA
  • SDF carious lesions
  • SSC
    • must be enough tooth tissue to support
      • more than 2/3 marginal ridge
      • if broken down must be extracted
    • mostly enamel caries
      • must have clear band of dentine
      • between caries and pulp
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