Are people with an orofacial cleft at a higher risk of dental caries? A systematic review and meta-analysis

Worth, Victoria; Perry, Rachel; Ireland, Tony; Wills, Andrew K; Sandy, Jonathan R; Ness, Andy R

doi:10.1038/sj.bdj.2017.581

Cited by 61 publications

(45 citation statements)

References 30 publications

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“…Worth et al [27] reported that the dental caries prevalence in cleft lip palate patients is higher than that observed in healthy children, in both deciduous and permanent dentition, with a pooled mean difference in dmft of 0.63 (95%CI: 0.47-0.79) and in DMFT of 0.28 (95%CI: 0.22-0.34). In the present cleft population, caries experience was two-fold higher in primary than in permanent teeth.…”

Section: Variables Dmft Dmftmentioning

confidence: 98%

Impact of different surgical protocols on dental development in oro-facial cleft children

Guagnano¹,

Romano²,

Pepe³

et al. 2020

Plast Aesthet Res

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Aim: To determine the association between dental anomalies and type of facial cleft, gender, ethnicity and timing of hard palate repair surgery. Methods: This observational study comprised a total of 85 non-syndromic cleft children (mean age 9.7 ± 3.2 years) of different ethnicity (68 Caucasians, 7 Asians, 4 Africans, 5 Hispanics and 1 Indian). Sixty-four patients were affected by lip palate cleft, 11 by lip alveolus cleft and 10 by palate cleft. Sixty-one children underwent delayed palate repair at 4.3 years of age, while 21 underwent early palate periosteoplasty at 7.2 months of age. Patients were examined clinically and radiologically to assess dental anomalies. Dental cavities were registered using dmft/DMFT indexes in primary and permanent dentition, while enamel defects were evaluated only in permanent teeth using Aine index. Results: Tooth rotation and agenesis were the most common tooth anomalies affecting 59% and 42.2% of cleft patients, respectively. While a late closure of the cleft palate was associated with a higher number of rotations (P = 0.03), an early surgical correction was associated to a higher frequency of tooth agenesis (P = 0.02), number of carious lesions in primary dentition (P = 0.002) and more severe enamel defects in permanent teeth (P < 0.01). A late palate repair increased 3.5 times the likelihood of having at least one rotated tooth (P = 0.034), while decreased the odds of having agenesis by 70% (P = 0.029) compared to an early surgical repair. Conclusion: Early surgical approaches seem to have more detrimental effects on dental development in both primary and permanent dentition than late surgical protocols. Dental abnormalities in cleft patients have complex etiology combining genetic and external factors and their prevalence can also depend on timing of hard palate surgery.

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Section: Variables Dmft Dmftmentioning

confidence: 98%

Impact of different surgical protocols on dental development in oro-facial cleft children

Guagnano¹,

Romano²,

Pepe³

et al. 2020

Plast Aesthet Res

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“…A recent systematic review also concluded that children with CLP have higher dental caries prevalence than their counterparts without CLP (Worth et al 2017). The reason may be that the children born with a cleft are prone to dental caries and gingival diseases as they are at high-risk of poor oral hygiene (Wells 2013).…”

Section: Mean (Sd) Rangementioning

confidence: 99%

“…Clinicians must keep in mind that these children encounter the cleft team repeatedly including dentists until their adulthood. It is most important to focus on preventive procedures, as these children are even more at risk of oral diseases than children without cleft (Worth et al 2017). Future study should incorporate improvements in OHRQoL following each treatment including the speech therapy and psychological counselling.…”

Section: Mean (Sd) Rangementioning

confidence: 99%

Validating and assessing the oral health-related quality of life among Hungarian children with cleft lip and palate using Child-OIDP scale

Karki

Horváth

Laitala

et al. 2020

Eur Arch Paediatr Dent

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Aims To validate the Child-Oral Impact on Daily Performance (Child-OIDP) in the Hungarian language and to explore the oral health-related quality of life (OHRQoL) and associated factors among Hungarian children with cleft lip or/and palate (CLP). Methods This cross-sectional study consists of a survey and clinical examination among conveniently selected children with CLP visiting the Pécs cleft lip and palate clinic, Pécs, Hungary. OHRQoL was assessed using the Hungarian version of Child-OIDP. Additionally, a validated structural questionnaire was used for gathering information related to oral hygiene practice. Clinical examination was done to register the dental status using ICDAS criteria, consequences of untreated dental caries (pufa), and bleeding on probing. Results were presented as proportions, means, and standard deviations (SD). Construct validity and internal reliability of the Hungarian Child-OIDP was assessed using the Pearson and Spearman's correlation coefficients, respectively. The logistic regression model examined the association between OHRQoL and explanatory variables. Results A total of 45 children with CLP participated in this study. The Hungarian Child-OIDP had the Cronbach's alpha value 0.73, and the Spearman's correlation coefficient was 0.31. The mean (SD) Child-OIDP score among the study participants was 4.4 (7.0) and three-fifths (65.9%, n = 27) of the participants reported impact in one or more items of the OHRQoL scale. Tooth brushing was more frequent among 6−10-year-olds compared to 11−16-year-olds. The proportion of those requiring restorative treatment need (DS ≥ 1) was 90.2% (n = 37), those with PUFA/pufa (score ≥ 1) was 24.4% (n = 10), and those with bleeding on probing (> 15%) was 63.4% (n = 26). Children aged 11-16 years had a higher impact on OHRQoL compared to the younger ones. Girls had a higher impact on OHRQoL compared to boys. Children with clefts involving both lip and palate had poorer OHRQoL than the rest. The same was true for those having a high dental caries rate. Conclusion The Hungarian Child-OIDP was a reliable and valid measure. There was a substantial impact on OHRQoL among Hungarian children and adolescents with CLP. Age, gender, cleft type and dental caries were associated with poor OHRQoL.

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“…The anatomical and morphological alterations associated with CLP favour the buildup of dental plaque, and greatly difficult its removal. Thus, these children present a high prevalence of dental caries . This problem is minimized by preventive strategies involving dietary advice and antiseptic mouthwash .…”

Section: Introductionmentioning

confidence: 99%

Oral hygiene of children with cleft lip and palate: Efficacy of the cleft toothbrush ‐ A designed add‐on to regular toothbrushes

Rodrigues

Fernandes

Monteiro

et al. 2018

Int J Paed Dentistry

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Background The anatomical and morphological alterations associated with cleft lip and palate (CLP) favour the buildup of dental plaque. Aim To assess the efficacy of a new add‐on to regular toothbrush—the Cleft Toothbrush, in removing the dental plaque of CLP patients, compared to a regular toothbrush. Design Forty‐five children with CLP were randomly organized into two groups: A (n = 26, 2‐6 years old) and B (n = 19, 7‐12 years old). They were evaluated at days 0, 15, 30, and 60. After brushing their teeth with a regular toothbrush or with the Cleft Toothbrush, the dental plaque was recorded using an adapted Plaque Index (aPI). Data analyses were performed in IBM SPSS(c), and all statistic inference comparisons were made using non‐parametric tests. Results In the first 15 days, children used a new regular toothbrush and aPI‐C (teeth adjacent to the cleft) was recorded. The Cleft Toothbrush, used by all children from day 15 to day 30, showed high efficacy in removing dental plaque in the cleft area, evidenced by significantly lower aPI‐C values, compared to those observed with the regular toothbrush (P < 0.001). When given free option of brushing technique, from day 30 to day 60, most of the children (38 out of 45) chose the Cleft Toothbrush. Conclusions The Cleft Toothbrush showed high efficacy in removing dental plaque in the cleft area, and presented high level of acceptance by parents and children, compared to a regular toothbrush. This is expected to improve the health status of the local adjacent tissues, a requirement for their rehabilitation.

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Are people with an orofacial cleft at a higher risk of dental caries? A systematic review and meta-analysis

Cited by 61 publications

References 30 publications

Impact of different surgical protocols on dental development in oro-facial cleft children

Impact of different surgical protocols on dental development in oro-facial cleft children

Validating and assessing the oral health-related quality of life among Hungarian children with cleft lip and palate using Child-OIDP scale

Oral hygiene of children with cleft lip and palate: Efficacy of the cleft toothbrush ‐ A designed add‐on to regular toothbrushes

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