Dental care for a child with cleft lip or palate (1606)
Key points below
Early and regular dental care is important for everyone. Children with cleft lip or palate often have more dental problems. Working closely with a dental professional is needed to make sure your child has the best oral health possible.
Start dental care early. Your child should have their first dental visit by age 12 months. Then the dentist will tell you how often your child should be seen. Often, a child with cleft lip or palate may need to be seen every 6 months.
What problems might be seen?
- Teeth do not come in like they should. This could include teeth that come in (erupt) later than they should, crooked teeth, or teeth that erupt in the cleft site. Unless these teeth get decay, they can stay in place. Braces will be used to straighten the teeth once the adult (permanent) teeth are all in.
- Missing teeth or extra teeth. Teeth may be missing if the tooth bud never formed. Your child may have extra teeth if an extra tooth bud formed. This happens most often with the teeth near the cleft site. This may influence the timing of future dental treatment.
- Poor enamel quality. The tooth buds near the cleft site can be damaged while the cleft develops. This may lead to the enamel being discolored, having pits, or other irregularities. This happens during the developmental process and cannot be controlled. The poor enamel quality does increase the risk for cavities once the tooth erupts.
- Poor bite. This can happen because the cleft interferes with the growth and development of the jaws. Many children will have an underbite. This means the lower jaw looks stronger than the upper jaw. This bite may need to be corrected once the permanent teeth come in.
How are problems found and prevented?
- X-rays. Dental x-rays may need to be taken often to learn the extent of the cleft and the condition of the teeth. Results will be shared with other providers like a surgeon, orthodontist, or speech therapist to help create a treatment plan.
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Diet. A well-balanced diet is important. A diet high in sugar can lead to tooth decay and cavities.
- Limit how often candy and sugary snacks are given.
- Offer milk at mealtime only.
- Limit juice to less than 4 ounces a day.
- Offer water between meals.
If your child needs a bottle or sippy cup at bedtime, only fill with water.
- Brushing and flossing. Children do not have the skills needed to correctly brush and floss their teeth. Parents should help them until the age of 8 to 10 years old. Brushing is most easily done if you stand behind your child and gently support the head. Brush 2 times a day for 2 minutes each. Also be sure to floss every day.
- For children less than 3 years old, a tiny, rice size, amount of fluoride toothpaste should be used.
- For children over age 3, toothpaste should be the size of a pea.
- Fluoride. It is important to have other sources of fluoride besides toothpaste. This may include:
- Fluoride varnish that is applied during dental visits.
- Drinking fluoridated water.
- Braces. Early evaluation by an orthodontist is often needed. Many children will see the orthodontist during their growing years and often by age 6 to 7 years.
- Coordination of services. Children with cleft lip or palate benefit from a team approach. Dental exam findings will be reviewed during team conferences. They provide valuable information to other team members. Suggestions from other team members are also included in the dental plan.