Advances in the Prevention of Dental Caries in Orofacial Clefts

Dental caries is one of the most common diseases worldwide and tends to more often affect individuals with a cleft lip and/or palate. The reasons for the increased predisposition are multifaceted and varied, and more education and interventions are needed to improve the oral hygiene within this population. The purpose of this article is to highlight the global problem of dental caries, with particular emphasis on its increased prevalence among those born with clefts of the lip and palate, and why this marginalized group is in particular need of good dental and oral health. The authors discuss the Smile Train Oral Health through Prevention (STOP) initiative to improve oral hygiene and prevent dental caries in patients with a cleft lip and palate, while detailing current anticariogenic supplements and future research in caries prevention. Smile Train, the world's largest cleft-focused organization, in collaboration with the World Dental Federation, sought to act and address the increased susceptibility for dental caries within patients with cleft lip and/or palate through the STOP initiative. Through Smile Train's sustainable model of empowering local professionals and health systems to provide care in their own communities, STOP aims to educate cleft providers, patients, and their families using an online resource, while ensuring optimal inclusion for those of all backgrounds. Core pillars within STOP include preventative care delivery, community and caregiver education, professional training and capacity building, awareness and advocacy, and monitoring and evaluation. Fluoride remains a mainstay supplement in dental caries prevention, while others have shown promise in the prevention and/or treatment of cavities using xylitol, nanohydroxyapatite, and silver diamine fluoride. Prevention of dental caries requires continued efforts through evidence-based intervention and ongoing research to provide the best care across the globe.