TUT - Cleft Flashcards
1
Q
What are important questions to ask about a cleft patient’s history?
A
- type of cleft LAHSHAL
- associated syndrome or condition
- surgery plan
- medication
- who else involved in the care?
- allergies
2
Q
At what age is cleft lip repair done and why?
A
- 3-6 months
- appearance can be distressing to parents
3
Q
At what age is cleft palate repair done and why?
A
- 6-12 months
- feeding is difficult, hard for baby to form oral seal for swallowing
4
Q
surgery timeline
A
- Lip: 3-6mo
- Palate 6-9mo
- bone graft 8-10yo
- ortho: 10-12yo
- orthognathic: 18yo
5
Q
What is a sign of an undiagnosed cleft palate?
A
Fluid coming our of baby’s nose when feeding
6
Q
What are common dental findings associated with CLP?
A
- hypodontia (commonly U2s and 5s)
- delayed exfoliation
- supernumeraries
- overcrowding
- hypoplastic / hypomineralised enamel
- micro/macrodontia
- talon cusps
- caries
7
Q
Who are involved in the CLP MDT?
A
- GDP
- paediatric dentist
- cleft surgical team
- specialist nurse
- Speech and Language therapist
- ENT consultant
- orthodontist
- restorative specialist
- psychologist
- play therapist
8
Q
At what age is an alveolus bone graft done and why?
A
- 9-10 years
- needs to be placed around time that canine is moving down to erupt (too early and graft won’t take, too late and canine won’t erupt)
- graft is taken from hip
9
Q
Describe the nature of treatment and prevention in CLP patients.
A
- high caries risk so require enhanced preventative measures as per SDCEP
- not possible to temporise teeth (eg SSC) in patients with CLP as mouth must be caries free before bone graft, teeth are sometimes temporised until surgery then require XLA prior (also supernumeraries removed)
10
Q
Cleft support
A
CLAPA
11
Q
cleft key points for dental
A
- assoc medical condition usually
- speech/ swallowing/ breathing
- prevention is key
- bone graft usually needed
- avoid XLA
- ortho usually needed
