Dental Care for Children with Clefts

If your child has a cleft palate or cleft lip, a variety of health care professionals are likely to be involved in his or her care. The skills of many different areas are needed to help with the problems that can accompany cleft abnormalities. The good news? Much can be done to fix these problems.

One important component is dental care. According to the Cleft Palate Foundation, children with clefts may have special dental problems. Your child may need to be treated by dental specialists such as:¹

• A pediatric dentist, who is trained to care for routine dental needs such as fillings and cleanings

• An orthodontist, who evaluates the position and alignment of your child's teeth

• A prosthodontist, who makes appliances that can replace teeth or compensate for a palate that's too short or doesn't work properly

• Oral and maxillofacial surgeons, who perform surgery on the mouth and jaws

How a Cleft Affects Teeth

Children with clefts are more likely than children without clefts to have tooth decay. There are several reasons for this:¹

• The teeth next to the cleft sometimes have a defective enamel covering.

• The teeth around the cleft often erupt in abnormal positions, which makes them hard to clean.

• Some children eat only soft foods because of their dental problems, which also can make cleaning difficult.

Because of these risks, it's especially important for children with clefts to practice good dental hygiene, limit refined sugar, and see a pediatric dentist regularly.¹

Orthodontics

Orthodontic treatment focuses on improving the teeth's function, appearance, and stability. This type of treatment usually begins after permanent teeth have come in. It involves the use of wires, bonded brackets, bands, and retainers. Kids with clefts can have the same orthodontic issues as kids without clefts, such as crowding or an overbite. But the cleft may cause other problems. Teeth may be missing, defective in shape or enamel covering, or abnormally placed.¹

In addition, a cleft palate may cause crossbite. As a result, the middle part of the child's face may appear to be sunken in. To correct a crossbite, surgery is needed along with orthodontics.¹

Prosthodontics

If the cleft has led to missing or misshapen teeth, a prosthodontist can help. Missing teeth can be replaced via a denture, a fixed bridge, or a dental implant. However, implants aren�t suitable for children who are still growing.¹

¹ "The School-Aged Child." Cleft Palate Foundation, 2008. http://www.cleftline.org/docs/Booklets/SAC-01.pdf. Accessed 2009.