Module 14 Exam 3 part 1 Flashcards
what is the failure of normal fusion of embryonic process during developmen
cleft lip and palate
when does the formation of the lip occur
between the 4th or 7th week in utero
when is the cleft lip apparent
end of second month in utero (8 month)
when does the development of the palate happen
takes place during the 8th to 12th week
when is the cleft palate evident
by the end of the 3rd month 12thweek
what is a class one cleft palate
cleft of the tip of the uvula
what is a class two cleft palate
cleft of the uvula
what is a class three cleft palate
cleft of the soft palate
what is a class four cleft palate
cleft of the soft and hard palate
what is a class five cleft palate
cleft of the soft and hard palate that continues through the alveolar ridge on one side, associated with cleft lip of the same side
what is a class six cleft palate
cleft of the soft and hard palates that continues through the alveolar ridge on both sides, free premaxilla, bilateral cleft lip
what is a class seven cleft palate
submucous clef in which the muscle union is imperfect across the soft palate, short palate, uvula is often bifid, groove situated at midline, closure of pharynx isnt complete
what are risk factors for a cleft lip or palate
multifactoral, genetic and environmental
what are environmental factors for a cleft lip or palate
-tobacco, alcohol consumption, teratogenic agents, inadequate diet
what occurs more frequently in patients with clefts than in the general population
disturbances in normal tooth development
what is there a higher incidence of in cleft lip and palate
missing and supernumerary teeth, missing max laterals correspond to side of mouth with cleft
do people with cleft lip or palate require ortho care
yes, may be required after each stage of surgical tx
what is there a lack of in coordinated movements in patients with a cleft lip or palate which may cause the pt to have compensatory habits
-coordinated movement of lip, tongue, cheeks, floor of mouth, throat,
what is dental biofilm accumulation influenced by in patients with cleft palate or lip
irregular positioned teeth, inability to keep lips closed, mouth breathing, difficulties in personal oral care
what is common in periodontal tissues at the cleft site in adolescents
loss of bone and clinical attachment
where is periodontal tissue loss greatest at
cleft sites
what puts patients with a cleft lip or palate at a higher risk for caries
-malpositioned teeth, mastication problems, diet selection, dental biofilm
what contributes to ECC in patients with cleft lip or palate
-feeding difficulties of infants
in more than 300 disorders, cleft lip, palate or both represent one feature of what
a syndrome
what do factial deformities include in cleft lip or palate
- depression of nostril on side with cleft
- deficiency of upper lip
- overprominent lower lip
what infections are common in cleft lip or palate
upper respiratory infections, middle ear infections
craniofacial anomilies of the nose and throat predispose the child with a cleft palate to
airway obstruction and breathing problems
do patients with a cleft lip or palate have difficulty making certain sounds
yes
what contributes to speech problems
-anatomic structure, airway and breathing problems and hearing difficulties
hearing loss is ______ than in individuals with a cleft palate
higher
when is surgical union of the cleft lip made
at 2 to 3 months of age, 10 weeks of age, weighs 10 lbs, serum hemoglobin of 10 mg/ml
what are purposes of early tx of a cleft lip
-aids in feeding
encourages dev of premaxilla
partial closure of a cleft
when is primary surgery to closure of the palate done
by age 18 months or earlier when possible
what are the goals for tx of closure of cleft palate
achieve normal function, (speech)
relive problems of airway and breathing
-dental esthetics and functional occlusion
what may secondary surgery of the cleft palate include
-lips, nose, palate and jaw
what are the objectives of secondary surgical procedures of a cleft palate
improve function for coherent communication, improve appearance
what are specific procedures of secondary surgical procedures
- rhinoplasty, nasal septal surgery
- velopharyngeal flap
- closure of palatal fistuale
- tonsillectomy or adenoidectomy
When is an alveolar graft placed in palatal surgery
before eruption of maxillary teeth at the cleft site
what does an alveolar graft do
creates a normal archetecture, support is provided for teeth
what are teh 2 types of prosthesis in clefts
obturator- removable prosethesis closure of palatal opening
speech aid prosthesis- removable, completes palatopharyngeal valving
what are the purposes and functions of a prosthesis for a cleft
-closure of palate replacement of teeth fill out upper lip masicatory function restoration of vertical dimension postorthodontic retainer
when may orthodontic treatment be initiatied in a cleft
as early as 3 years old
when is speech therapy training started and what is the emphasis
- with very young children
- emphasis after the surgical or prosthodontic tx
what is a major problem in restorative dentistry in cleft patients
dental caries
what is the frequency of maintenence of cleft patients
3 or 4 months, difficult to keep teeth clean
what are some of the objectives of appointment planning
- review dental biofilm control
- provide encouragement
- to remove all calc and smooth surfaces
- supervise a caries prevention program
why may patients have apprehension at appointments
- clinic tired
- low self esteerm, difficulties in social interactoins
what should we know about speech in patients with clefts
-speech may be almost indiscernible, referral for speech assessment
what would we know about hearing in patients with cleft
approach is similar to speech difficulties
what kind of instructions should we provide in a patient with clefts
- personal daily care- select tb and method
- fluoride- fl2 dentifrice and diet supplements
- rinsing instruction for older pts (over 6)
- prostesis or speech aid- halitosis may be problem
what should you inform the patient and family about their smoking or family’s smoking
emphasise potential damage to the perio tissues
what should you prep a patients for presurgery of cleft palate
-prep mentally
what should patient be made aware of post surgically of personal oral care of cleft lip or palate
- rinse mouth carefully
- water irrigation
- great care to surgery site, careful
What may be done in preparation for dental surgery as far as dental hygiene care
- reduce oral bacterial count
- reduce inflammation of gingiva and improve tissue tone (promotes less bleeding better healing)
- remove cacl deposits
- instruct in presurgical OH
- instruct in use of foods
- interpret dentists direction
- motivate pt. who will have teeth remaining
what should be included in pre surgery tx planning of intial oral preparation
- need for pre med
- develp rapport
- explain and demonstrate biofilm control
- -preform scaling to prep for tissue healing
- provide post appt instruction
after surgery the mouth may be too sore for brushing, what should be done
frequent irrigations, can use saline, chx, fluoride rinse
