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Patients with cleft lip and/or palate (CLP) have increased experience of dental anomalies compared to unaffected individuals. This article describes the common dental anomalies, namely, enamel defects, hypodontia, anomalies in tooth shape or form, supernumerary teeth, ectopic and impacted teeth, and tooth transposition. The respective prevalence and potential implications on dental health are also discussed alongside the role of the general dental practitioner.
CPD/Clinical Relevance: This article highlights the common dental anomalies for those with cleft lip and/or palate, and identifies clinical presentations that require GDPs' contribution to patients' dental care.
Article
Cleft lip and/or palate (CLP) is the most common congenital abnormality, with a reported incidence of between 1:600 and 1:700 live births.1 Patients with CLP commonly have impaired facial growth, difficulties with speech, feeding and hearing, psychological problems, dental disease and anomalies.1
The NHS standard contract for CLP services states that children born with CLP must have early dental intervention.1 This involves a combination of primary and secondary/tertiary care. By 6 months of age, the cleft team should provide oral health advice. Patients should subsequently have a dental review by 1 year of age by their primary care dentist.2 The timeline for cleft lip and primary palate repair is generally between 3 and 6 months, and that for cleft palate at 6–9 months. At this stage, preventive advice should be reinforced, including advice on breastfeeding, bottle-feeding and toothbrushing. Four-to six-monthly dental reviews should then continue with the primary care dentist to reinforce preventive advice and to monitor primary tooth eruption, noting any dental caries or dental anomalies.3 A specialist paediatric dentist should conduct a formal dental review at least at the age of 5 years. Before the age of 10 years, it is essential that the paediatric dentist reviews any child with dental anomalies.1 These timelines are essential to reduce the burden and impact of compromised dental health on the patient's overall wellbeing.
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