Systematic Review of Clinical Practice Guidelines for Oral Health in Children With Cleft Lip and Palate

Abstract

Objective: Clinical practice guidelines (CPGs) exist to present recommendations and policies aimed at optimizing the oral health of children and adolescents born with cleft lip and/or palate. The aim of this review is to identify and assess the scope, quality, adequacy, and consistency of CPGs related to oral health in children and adolescents with clefts, along with reporting any differences and shortcomings. Methods: A systematic review of the literature of CPGs following Preferred Reporting Items for Systematic Reviews guidelines was conducted. Assessment of selected CPGs was performed using the Appraisal of Guidelines for Research & Evaluation II methodological quality instrument. Results: Only 7 CPGs fulfilled the criteria. Of these, 4 were from the American Cleft Palate-Craniofacial Association, and 1 each from the American Academy of Pediatrics, the Academy of Breastfeeding Medicine, and the American Academy of Pediatric Dentistry. The lowest overall mean scores were in the domain “Rigor of Development” (mean 29.58%, SD 17.11), revealing lower quality in methodology of the guideline. The domain “Clarity of Presentation” (mean 73.80%, SD 7.87) revealed the best score. Conclusions: Our review results reveal a lack of integrated high-quality CPGs that can be used as universal guidelines by health workers in a range of disciplines for improving oral health in children and adolescents with cleft problems.

Current Treatment of Cleft Patients in Europe from a Provider Perspective: A Cross-Sectional Survey

“…Based on the results, the achievement of a consensus with regard to cleft care across Europe remains suboptimal and challenging. These results are in agreement with a recent systematic review that concluded a lack of integrated high-quality clinical practice guidelines that can be used as universal guidelines in cleft treatment [ 29 ]. Therefore, there is a need for better coordination between clinicians and national and international regulatory bodies and centers.…”

Clinical Practice Guidelines on the Treatment of Patients with Cleft Lip, Alveolus, and Palate: An Executive Summary

“…This is a background question on the organization of care, which is difficult to translate into a search question for a systematic review. A recently published systematic review of CPGs for oral health care in children with clefts identified seven, but none of them were rated as high quality for “Rigor of Development” [ 81 ]. This shows that there is no high-quality evidence on which to base a recommendation for organization of care.…”

Systematic review of clinical practice guidelines for traumatic dental injuries

“…The strengths of the current review are (1) the appraisal was performed by a specialised clinical team of paediatric dentists, oral radiologist, oral surgeon, periodontist, clinician researchers and experts from universities in India, Australia and the United Arab Emirates, (2) the other advantages include the use of internationally accepted, rigorously structured and validated CPGs appraisal tools such as the AGREE II and AGREE REX, (3) the appraisal of each CPGs by four appraisers including three clinical topic experts and two members from the Guidelines International Network (GIN) who had undergone training in guideline development and had published previous similar studies regarding the management of cleft lip and palate, 42 and (4) the reviewers carried out a comprehensive search within several core databases as well as ministries of health and various guideline related databases.…”