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Systematic Review of Clinical Practice Guidelines for Oral Health in Children With Cleft Lip and Palate
Ankita Saikia1, M S Muthu2,3, Omolola O Orenuga4
1Consulting Pediatric Dental Surgeon, Pedo Planet Children Dental Centre, Porur, Chennai, Tamilnadu, India.
Insights
This review found few high-quality clinical practice guidelines (CPGs) for children with cleft lip/palate. Current CPGs lack rigor, hindering optimal oral health care for these patients.
Area of Science:
- Pediatric Dentistry
- Craniofacial Anomalies
- Health Policy
Background:
- Clinical practice guidelines (CPGs) are crucial for optimizing oral health in children and adolescents with cleft lip and/or palate.
- Existing CPGs aim to provide recommendations and policies for this specific patient population.
Purpose of the Study:
- To identify and assess the scope, quality, adequacy, and consistency of CPGs for oral health in children and adolescents with clefts.
- To report differences and shortcomings in existing CPGs.
Main Methods:
- A systematic review of CPGs was conducted following Preferred Reporting Items for Systematic Reviews guidelines.
- The Appraisal of Guidelines for Research & Evaluation II instrument was used to assess the methodological quality of selected CPGs.
Main Results:
- Only 7 CPGs met the inclusion criteria, with most originating from major pediatric and craniofacial associations.
- CPGs scored lowest in "Rigor of Development" (mean 29.58%), indicating methodological weaknesses, but scored highest in "Clarity of Presentation" (mean 73.80%).
Conclusions:
- A significant lack of integrated, high-quality CPGs exists for improving oral health in children with cleft problems.
- Current guidelines are insufficient for universal adoption by multidisciplinary health workers.
Objective:
Clinical practice guidelines (CPGs) exist to present recommendations and policies aimed at optimizing the oral health of children and adolescents born with cleft lip and/or palate. The aim of this review is to identify and assess the scope, quality, adequacy, and consistency of CPGs related to oral health in children and adolescents with clefts, along with reporting any differences and shortcomings.
Methods:
A systematic review of the literature of CPGs following Preferred Reporting Items for Systematic Reviews guidelines was conducted. Assessment of selected CPGs was performed using the Appraisal of Guidelines for Research & Evaluation II methodological quality instrument.
Results:
Only 7 CPGs fulfilled the criteria. Of these, 4 were from the American Cleft Palate-Craniofacial Association, and 1 each from the American Academy of Pediatrics, the Academy of Breastfeeding Medicine, and the American Academy of Pediatric Dentistry. The lowest overall mean scores were in the domain "Rigor of Development" (mean 29.58%, SD 17.11), revealing lower quality in methodology of the guideline. The domain "Clarity of Presentation" (mean 73.80%, SD 7.87) revealed the best score.
Conclusions:
Our review results reveal a lack of integrated high-quality CPGs that can be used as universal guidelines by health workers in a range of disciplines for improving oral health in children and adolescents with cleft problems.
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