Cooperation on Dental Treatment and Approach for Cleft-Lip and Palate in Meikai University Hospital

Background: Cleft lip and cleft palate (CLP), also known as orofacial cleft, can influence on structural growth and functional development in childhood. In our hospital, the cooperated treatment is carried out by oral surgery, orthodontic and feeding rehabilitation clinic. In this study, the actual condition survey was conducted to find out the outcome of these widespread approach including caries and oral function control.

The objectives were 57 infants 3 years old or younger with CLP who were referred from plastic surgery or pediatric clinic of Saitama Medical University and treated by the CLP team of Meikai University. Mean age at initial evaluation was 2.1 months (SD: 0.6 months).

Method: All the objectives were treated with palatal plate (Hotz plate). The flow of treatment mainly consisted of impression and preparing of palatal plate, feeding instruction, preventive dentistry and nasoalveolar molding. From first visit, the CLP team conducted mainly feeding instruction and adjusting the palatal plate. Then, the caregivers of the subjects had teeth brushing instruction from dental hygienist. At the age of around one, the subjects were referred to the pediatric dentistry and maintained during periodic intervals. Speech and language instruction was conducted by speech and language pathologist after the first year of life.

Results: Most of these subjects had no dental caries and had appropriate dental hygiene until age of one, however, the dental hygiene got worse in about 10% of the subjects between ages 1 and 2. Therefore, continuous approach and education must be needed to keep the oral environment clean and caries-free through early childhood.