Dental experience of cleft affected children in the west of Ireland

To investigate caries experience and initial access to dental services in a group of children with cleft lip/palate in the west of Ireland.

Cross sectional study with prospective data capture and matched control. Details of children born with a cleft were obtained from all health professionals likely to be involved in delivering care to these children. Existing databases were cross-referenced to eliminate duplication or missed patients. A matched control sample was recruited from 14 schools in the region.

A sample of 90 cleft affected children (48 male, 42 female) with any category of cleft born between 1980-1996 (i.e. 16 years) was compared with a control group of 100 non cleft children (60 male, 40 female). The DMF index was determined by a trained and calibrated clinician. Twenty-two percent (n=20) of the cleft group were caries free compared to 41% (n=41) in the control group. The combined dmf/DMF for the cleft group was 2.09 compared to 1.50 for the control (P<0.05). Separate analysis of the dmf and DMF between the two groups indicated that the difference lay in the caries found in the deciduous dentition of the cleft group. The first dental visit was at 4 years of age for the cleft group.

Cleft affected children in the region did not receive adequate and regular dental care at the appropriate time. In view of the significantly greater risk of dental disease in clefting, particularly in the deciduous dentition, all cleft affected children should be referred for comprehensive and continued preventive dental care from the first year of life.