CLP

Question 1

Why do cleft lip and palate patients have higher caries risk?

Answer 1

Difficulty doing OH in cleft area

Supernumerary or crowding in cleft area

Fistula with nasal cavity

Reduced salivary flow

Increased mouth breathing

Question 2

What is the most common abnormality in cleft patients?

Answer 2

Hypotonia - 40% of patients with CLP. More likely in males.

Most common is maxillary lateral incisor

Question 3

What is the second most common abnormality associated with CLP?

Answer 3

Supernumerary teeth

4 - 42%

Maxillary lateral most common, distal to the cleft

Question 4

What other two defects may commonly appear in CLP patients

Answer 4

Macro/micro dontia

Developmental enamel defects
- hypomineralisation
- hypoplasia of enamel

Question 5

As the paeds dentist, what should be done with a CLP child at <12 months?

Answer 5

Discuss importance of teeth, role of paediatric dentist, role of GDP

Initial prevention advice, brushing, diet, toothpaste

Letter to GDP

Question 6

As the paeds dentist, what should be done with a CLP child at 18mo - 2 years?

Answer 6

Assess shape and form of teeth for developmental abnormalities

Check for decalcification or easily caries

Reperform preventative advice and advice on cleaning cleft

Letter to GDP

Question 7

As the paeds dentist, what should be done with a CLP child at 3 years?

Answer 7

Asses shape, form of teeth

Check developmental abnormalities

Preventative advice

Letter t GDPO

Question 8

As the paeds dentist, what should be done with a CLP child at 5 years?

Answer 8

Check caries, erosion, wear

Reiterate preventative advice

Fluoride varnish application

Discuss what to expect with adult teeth

Letter to GDP

Question 9

As the paeds dentist, what should be done with a CLP child at 7-9 years? (PRE AGB )

Answer 9

Consult orthodontist and ABG surgeon to prep for ABG

Check progress of permanent dentition, shape and form of incisors

Assess prescience and viability of incisors

Reiterate prevention advice

Arrange any dental work needed pre ABG

Check sufficiency of oral hygiene

Letter to GDP

Question 10

As the paeds dentist, what should be done with a CLP child at 10 years?

Answer 10

Assess and arrange treatment, if indicated, for discoloured and/or misshapen incisors

Repeat prevention advice

Letter to GDP

Question 11

As the paeds dentist, what should be done with a CLP child at 15 years?

Answer 11

Ensure dentally fit to transition to care within general dental services, special care services or specialist restorative services