How should dental care needs of children with cleft lips or palates be met?

How should dental care needs of children with cleft lips or palates be met?

Generally, the dental care needs of children who have clefts are the same as for other children. However, children with cleft lip and/or palate may have special problems related to missing, misshapen, or poorly positioned teeth that should be watched closely.

• Early dental care: Like other children, children born with cleft lip and/or cleft palate require proper cleaning, good nutrition, and fluoride treatment in order to have healthy teeth. Appropriate cleaning with a small, soft-bristled toothbrush should begin as soon as teeth appear. If a soft children’s toothbrush does not adequately clean the teeth because of the different shape of the mouth and teeth, the dentist may recommend a soft, mouthwash-containing sponge on a handle to swab the child’s teeth. Many dentists recommend that the first dental visit be scheduled at about 1 year of age, or earlier if there are special dental problems. Routine dental care can begin around 3 years of age.
• Orthodontic care: A first orthodontic evaluation occurs during the cleft and craniofacial clinic. After teeth appear, an orthodontist can further evaluate a child’s short and long-term dental needs. Most children with a cleft palate will require palatal expansion around age 6-7. After the permanent teeth erupt, an orthodontist can align the teeth. Orthodontic care is required also in preparation for jaw surgery (orthognathic surgery).
• Prosthodontic care: A prosthodontist may make a dental bridge to replace missing teeth, or special appliances called "speech bulbs" or "palatal lifts" to help close the nose from the mouth so that speech sounds more normal. The prosthodontist coordinates treatment with the oral or plastic surgeon and the speech pathologist.