Cleft and Teeth

Plastic and Maxillofacial Surgery
Cleft and teeth

Cleft and teeth
Many children born with a cleft of the lip and/or palate will have
missing teeth, particularly in the line of the cleft. They may also
have extra teeth, misshapen or malformed teeth (Figure 1). As a result
their teeth can be crowded, tilted or rotated (Figure 2).
Teeth health
It is important that you and your child
look after their teeth to keep them strong
and healthy. Baby teeth are important for
chewing, speaking and for keeping space
in the mouth to help guide adult teeth into
the right place. They are also important
in your child’s appearance and self
confidence. We also know that children
who have decay in their baby teeth are
far more likely to have decay in their adult
Figure 1
teeth. So if you can prevent your child
from getting decay in their baby teeth,
you will be helping them to have healthy
teeth as an adult.
Children with clefts of the lip and/or
palate in Australia generally have good
strong teeth. However sometimes the
teeth that grow in the line of the cleft may
actually be softer than normal which
makes them more likely to decay (Figure 3).
Figure 2
Also, when teeth are very crooked they
are not so easily washed by the natural
action of saliva and the tongue and so can
develop decay more readily.
Figure 3
2 | Cleft lip and palate information — Cleft and teeth

Seeing a dentist
You should start cleaning your child’s Your child should start seeing a dentist
teeth as soon as they come through. soon after their first teeth come through.
Initially this can be done using a clean At The Royal Children’s Hospital Cleft
face washer and wiping it across their Clinic your child will be first seen by a
teeth. As your child gets older you can paediatric dentist at 18–24 months of age.
change to a small toothbrush. Whilst your However if you have any concerns about
child should be encouraged to play with your child’s teeth, an earlier appointment
the toothbrush themselves from a very can be arranged.
early age they will need your help with When your child’s first adult molar teeth
brushing until at least 6 or 7 years of age. start coming through (around 6 years)
Toothpaste containing fluoride helps they can be coated in a protective plastic
to make teeth stronger and less likely coating called a fissure sealant. This is a
to decay. If you and your family live in an very easy thing to have done and can help
area with fluoride in the water supply you to prevent decay in these teeth that have
should use junior or infant toothpaste. to last a lifetime.
If you do not have fluoride in your water
it may be a good idea to start using adult
toothpaste quite early. In the past we have
recommended fluoride supplements,
however we now know that regular use
of small amounts of fluoridated toothpaste
is actually better for your teeth than taking
drops or tablets. You should discuss this
with your child’s dentist.
A diet that is low in sugar is very
important for healthy teeth. Children as
young as 2 years old who have sugary
drinks continuously in contact with their
teeth can get very bad decay. Only milk,
formula or water should be put into baby
bottles and you should encourage your
child to use a feeding cup once they reach
12 months of age.
Cleft lip and palate information — Cleft and teeth

|3
Orthodontic treatment
Children with clefts often require
orthodontic treatment (braces) to
address crowded, misplaced and rotated
teeth. Children affected by cleft palate
may need two lots of orthodontic
treatment. One phase usually involves
wearing a plate glued onto the upper teeth
to expand the upper arch. This is often Figure 4
done just before alveolar bone graft
surgery sometime between 8–12 years of
age, depending upon your child’s dental
development (Figure 4). Full fixed braces on
both upper and lower teeth usually aren’t
started until late adolescence when your
child is coming to the end of their pubertal
growth. Children with clefts of the lip/
palate often have braces put on later and
sometimes for slightly longer than those Figure 5
who do not have a cleft (Figure 5). Sometimes
further surgery to align the jaws may be
needed and is done following careful
The Medicare Cleft Lip
discussion between your child, you, your and Palate Scheme
orthodontist and maxillofacial surgeon. You may be relieved to hear that the
Often the tooth in the line of the cleft Federal Government will help pay for
is missing or is so malformed that is certain aspects of your child’s dental care
not very useful. Once the orthodontic through the Medicare Cleft Lip and Palate
treatment (and if appropriate the jaw Scheme. You should ensure that your child
surgery) is finished, there are several is registered as soon as possible on this
ways of replacing this missing tooth. scheme. Your plastic surgeon, paediatric
The options include a removable plate dentist or orthodontist can register your
or denture, a fixed bridge where a false child. The scheme covers three dental
tooth is stuck onto one of the neighbouring checkups per year, most X-rays and
teeth, or a dental implant where a titanium orthodontic treatment up to the age of 28.
post is surgically placed into the jaw It does not cover the cost of routine dental
ERC 150069 February 2015
bone and crown is fixed to the post. This care such as fillings, fissure sealants etc,
decision is often not made until your child nor does it cover any of the costs of
is entering their early twenties. crowns or bridges.
4 | Cleft lip and palate information — Cleft and teeth

Cleft and Teeth

Uploaded by

Copyright:

Available Formats

Cleft and Teeth

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Cleft and Teeth

Uploaded by

Copyright:

Available Formats

Plastic and Maxillofacial Surgery

Cleft and teeth

2 | Cleft lip and palate information — Cleft and teeth

Cleft lip and palate information — Cleft and teeth

4 | Cleft lip and palate information — Cleft and teeth

You might also like