The Role of the Pediatric Dentist in the Multidisciplinary Management of the Cleft Lip Palate Patient

Abstract

The focus of this paper is the pediatric dental care of Cleft Lip and Palate (CLP) children and the role of the pediatric dentist in the CLP team. The management of children with cleft lip and palate presents many challenges and a multidisciplinary and prepared team is always required. Affected individuals present a multiplicity of problems: effective management involves a wide range of specialities. The value of a multidisciplinary team is widely known and mentioned in the literature, but very few papers focus on the role and the importance of the pediatric dentist. Therefore, the purpose of this article is to underline the role of the pediatric dentist as a member of the cleft lip and palate team which ranges from prenatal counseling, presurgical prevention and orthopedics, to post-treatment rehabilitation and restoration.

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

“…The most common dental anomalies in CLP patients are: hypodontia, supernumerary teeth, anomaly of shape and size of the teeth, enamel mineralization, and ectopic eruption. Additionally, the abnormal craniofacial development can lead to the development of malocclusion, such as crossbite (anterior or posterior), open bite, skeletal Class III, and crowding [ 17 ]. These features may also increase the rate of oral colonization, which is related to a higher risk of dental caries and gingivitis, but these results are still controversial in the literature [ 18 , 19 ].…”

“…The role of the pediatric dentist occurs from infancy to adulthood and may include prenatal counseling, preventive dental care, pre-surgical maxillary orthopedics to realign the maxillary segments, infant orthopedics (e.g., maxillary expansion and/or protraction), orthodontic treatment, restorative dentistry, and prosthetic treatment. Thus, dental services are crucial to supervise craniofacial growth and development, preserve healthy dentition and gums, and correct jaw and occlusion discrepancies to achieve normal speech, hearing, and occlusion with a normal facial appearance and psychological well-being [ 17 , 20 ].…”

An Ideal Multidisciplinary Cleft Lip and Cleft Palate Care Team

“…A speech‐language pathologist with a focus of pediatric management of oropharyngeal dysphagia works closely with the registered dietitian to ensure the child is able to consume adequate macronutrient intake in a safe and efficient manner to maximize growth and development. The role of a specially trained CL/CP dentist cannot be overstated as they work directly with every other team member to maximize oral motor function (Luzzi et al, 2021). As part of the initial phase of the care team, the CL/CP‐trained dentist can help in a variety of ways ranging from caries prevention and improvement of overall oral hygiene, to monitoring for dental eruption in order to aid in primary surgery planning and timing (Lewis et al, 2017).…”

“…The role of a specially trained CL/CP dentist cannot be overstated as they work directly with every other team member to maximize oral motor function (Luzzi et al, 2021). As part of the initial phase of the care team, the CL/CP-trained dentist can help in a variety of ways ranging from caries prevention and improvement of overall oral hygiene, to monitoring for dental eruption in order to aid in primary surgery planning and timing (Lewis et al, 2017).…”

Dental Anomalies in Maxillary Incisors and Canines among Patients with Total Cleft Lip and Palate

“…Orthodontic treatment is typically required for several years, usually starting shortly after birth and lasting until adulthood. In the deciduous and mixed dentition stages, removable appliances are primarily employed, whereas full orthodontic treatment involving fixed appliances is planned for permanent dentition [11].…”