Putting 'STOP' to Excess Caries of Cleft Lip and Palate Patients

Cleft lip with/without palate (CL/P) patients require multiple interdisciplinary procedures at different phases of their life. CL/P patients have a high burden of care that has financial repercussion, especially in low- and middle-income countries (LMICs). Lowering preventable diseases such as caries can mitigate this challenge.

To systematically review literature across databases to assess the quantum of caries incidence in CL/P patients in India. Subsequently, to suggest to aim for caries prevention in pilot centres and develop long-term strategies for overcoming the challenges encountered with the implementation of a suitable preventative program such as 'STOP' (Smile Train Oral Health through Prevention).

A comprehensive literature search was conducted from the databases till December 2023 across Medline/PubMed, Scopus, EBSCOhost, and Google Scholar. The studies utilised standardised assessments, employing the DMFT, dmft, or ICDAS index for caries prevalence in cleft individuals in India. Studies meeting predefined eligibility criteria were included and assessed for methodological quality. Data on caries incidence in CL/P patients in India was extracted from included studies.

The current research highlights a trend towards a higher caries incidence in cleft individuals in India. Thus the need for preventative program becomes important.

Caries, which is preventable, is an additional burden both in terms of financial impact as well as chances of failure of clinical procedures.

STOP includes age-appropriate anticipatory guidance, preventive and minimally invasive treatment, and definitive oral health management. The outcomes of the pilot program in 4 centres in India can become the starting point for strategies involving the prevention of caries to limit the burden of care in CL/P patients. STOP can become an indispensable part in the interdisciplinary treatment chart of children born with CL/P.