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Journal of Indian Society of Pedodontics and Preventive Dentistry Official publication of Indian Society of Pedodontics and Preventive Dentistry
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ORIGINAL ARTICLE
Year : 2005  |  Volume : 23  |  Issue : 2  |  Page : 80-82
 

Primary dentition status and treatment needs of children with cleft lip and/or palate


Department of Preventive and Community Dentistry, K.L.E.S's Institute of Dental Sciences, Belgaum, Karnataka, India

Correspondence Address:
Anil V Ankola
Department of Preventive and Community Dentistry, K.L.E.S's Institute of Dental Sciences, Belgaum - 590 010
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-4388.16447

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   Abstract 

The aim of this study was to assess the primary dentition status and treatment needs in children with cleft lip, cleft palate and or both. A descriptive, cross-sectional study was done through oral examination on a sample of 83, 2-5 years old cleft lip/palate children (46 boys and 37 girls). A self-designed questionnaire to obtain pertinent data related to level of education of parents and infant-feeding practices was used for recording the data while examining the children. Majority of cleft affected children had dental caries experience and required different types of treatment. The result of this study shows that: (1) all age groups of cleft affected children had dental caries experience, (2) children with primary type of cleft had less dental caries prevalence than children with cleft of secondary or combination type ( P < 0.05), (3) treatment needs due to caries were more in combination type of cleft compared to primary and secondary.


Keywords: Cleft lip, cleft palate, dental caries, primary dentition status, treatment needs


How to cite this article:
Ankola AV, Nagesh L, Hegde P, Karibasappa G N. Primary dentition status and treatment needs of children with cleft lip and/or palate. J Indian Soc Pedod Prev Dent 2005;23:80-2

How to cite this URL:
Ankola AV, Nagesh L, Hegde P, Karibasappa G N. Primary dentition status and treatment needs of children with cleft lip and/or palate. J Indian Soc Pedod Prev Dent [serial online] 2005 [cited 2020 Jan 23];23:80-2. Available from: http://www.jisppd.com/text.asp?2005/23/2/80/16447


Cleft lip and palate is one of the most common developmental disturbances of orofacial structures. There is quite a marked racial variation in the prevalence and incidence of cleft lip and palate.[1] It occurs in about one in 800 births among whites, one in 2000 births among blacks and one in 500 Japanese or Indian births.[1] Cleft lip and palate is more frequent in males, however cleft palate alone most frequently affects females.[1]

Children who have cleft lip and palate often experience feeding, swallowing, speech and cosmetic problems as well as poor dental health.[2] A healthy primary dentition is essential for oral function and maintenance of space for future permanent dentition.[3]

Literature reveals that children with congenital malformation in the orofacial region are more susceptible to dental disease than the normal children.

According to studies conducted in Western countries, the children with oral clefts have higher caries prevalence than normal children. The caries experience in the primary dentition is significantly higher. Only sparse data are available from our country on the experience of dental caries in children with oral clefts. Hence an attempt was made to assess the primary dentition status and treatment needs of children with cleft lip and palate.


   Materials and Methods Top


The present study is a descriptive, cross-sectional study done to assess the primary dentition status and treatment needs of cleft affected children visiting K.L.E.S's Medical Hospital and Research Centre, Belgaum, Karnataka.

Permission to conduct the study was obtained from the Head of Department, Department of Plastic Surgery, K.L.E.S's Medical Hospital and Research Centre. Informed consent was obtained from every subject's parents/guardian before examining them. The time limit set for collection of data was 4 months that was from November 2002 to February 2003. A special format was designed exclusively for obtaining required general information of every subject and also for recording the required observations.

The study sample consisted of 83 cleft affected children visiting K.L.E.S's Medical Hospital and Research Centre, Belgaum, from the smile train initiative. Children with mental retardation, serious medical problems, or other congenital malformations were not included in the study sample. The age range was between 2 and 5 years. The study sample was divided into different strata based on age groups, type of clefts involved. Clefts were categorized into one of the following three types.

  1. Cleft of primary palate: lip, lip and alveolar process.
  2. Cleft of secondary palate: soft palate, soft and hard palate.


The examination for dental caries was conducted as advocated by WHO Basic Oral Health Survey Methods.[4] Statistical analysis for the obtained data was done using ' t -test' and 'chi-square test.'


   Results Top


About 46 males and 37 females children constituted the study population. Among 83 children, 21 (25.30%) in 2 years, 19 (22.89%) in 3 years, 21 (25.30%) in 4 years and 22 (26.50%) children were in 5 years age group [Table - 1].

Majority of parents, 56 (67.46%) had just elementary school education, 8 (9.63%) had high school level of education and 19 (22.89%) parents belonging to higher level of education [Table - 2].

[Table - 3] shows that majority of children 49 (59.03%) did not brush their teeth. [Table - 4] shows that majority of children 46 (55.42%) belonging to combination of primary and secondary type of cleft. Minority of children 10 (12.04%) belonged to cleft of primary palate and 27 (32.63%) children belonged to cleft of secondary type of palate [Table - 4].

Mean dmft was 6.57 ± 5.59 among 2 years age group, 3.95 ± 4.36 among 3 years age group, 4.05 ± 5.43 among 4 years age group and among 5 years age group it was 6.27 ± 3.80 ( P > 0.05) [Table - 5].

Mean dmft among breast fed children was 5.11 ± 5.19 and 5.67 ± 4.36 among bottle/spoon fed ( P > 0.05) [Table - 6].

Children who did not brush their teeth experienced mean dmft 5.22 ± 5.12, those who brushed their teeth with tooth brush/toothpaste mean dmft was 7.00 ± 4.83 ( P > 0.05). Mean dmft was 4.50 ± 5.47 among children who used toothbrush/tooth powder to maintain their oral hygiene and mean dmft was 3.50 ± 2.05 who used finger/other aids ( P > 0.05) [Table - 7].

Mean dmft was 2.40 ± 1.24 among children with primary type of cleft and 5.67 ± 4.66 among children with secondary type of cleft ( P < 0.05). Children with combination type had mean dmft 5.63 ± 5.45 ( P > 0.05) [Table - 8].

On an average 17.60 ± 1.74 teeth among children with primary type of cleft did not required any type of treatment and 14.37 ± 4.60 among secondary type of cleft did not required any treatment ( P < 0.05) [Table - 9].


   Discussion Top


There is surprisingly little information on the oral health status of children with oral clefts. The oral health provision in India varies considerably, and the clinical management for orofacial anomalies involves considerable resources. Therefore, the availability of a well-funded program such as the 'Smile Train'0 is to be welcomed. In this study, majority of the children belonged to lower socio-economic families. The level of educational attainment by the parents was used as a proxy measure for socio-economic status.[2]

Majority of the children did not brush their teeth daily. This might be due to the presence of oral cleft which makes tooth brushing difficult. It was observed that parents with higher level of education feed their children more with bottle/spoon than parents with elementary level of education. There was a statistically significant difference in caries experience between children with primary type of oral cleft and children with secondary type of oral cleft ( P < 0.05). This finding is similar to Bian et al.[2]

In this study, it was found that irrespective of the age group, and the type of cleft involved, children experienced dental caries and required various treatments pertaining to dental problems. On an average 17.60 ± 1.24 teeth in primary type and 14.37 ± 4.60 teeth in secondary type of cleft did not require any treatment ( P < 0.05) [Table - 9]. But there was no statistically significant difference ( P > 0.05) between the secondary type and combination of both types (14.6 ± 5.4). This indicates that children with cleft of secondary and combination type are at more risk of developing dental caries. It might be because of the extensive involvement of anatomical structures in secondary and combination type of clefts.


   Conclusions Top


This study shows that

  1. all age groups of cleft affected children were seen to have dental caries;
  2. children with primary type of cleft had less prevalence of dental caries than the children with cleft of secondary or combination type;




 
   References Top

1.Damle SG. Management of handicapped children in 'Text Book of Pediatric Dentistry', 2nd Ed. Arya Publications; p.415, 426.  Back to cited text no. 1    
2.Bian Z, Du M, Bedi R, Holt R, Jin H, Fan M. Caries experience and oral health behaviour in Chinese children with cleft lip and/or palate. Pediatr Dent 2001;23:431-4.  Back to cited text no. 2  [PUBMED]  
3.Bokhout B, Hofman FXWM, Limbeek JV, Kramer GJC, Andersen PB. Incidence of dental caries in the primary dentition in children with a cleft lip and or palate. Caries Res 1997;3:8-12.  Back to cited text no. 3    
4.Oral Health Surveys Basic Method, WHO 1997. 4th Ed. AITBS Publication; p.40-6.  Back to cited text no. 4    


Tables

[Table - 1], [Table - 2], [Table - 3], [Table - 4], [Table - 5], [Table - 6], [Table - 7], [Table - 8], [Table - 9]


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