New research has analyzed the long-term oral health impact that having a cleft lip and palate in youth has. A cleft lip and palate are common facial birth defects. But they are known to impact a range of areas in health, including oral health. Study participants received corrective surgery, with the results finding that surgery had a positive effect on oral health.

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A new study has looked in detail at the long-term impact that having a total unilateral cleft lip and palate has on health. As part of this, the researchers looked into the impact on oral health.

The research involved looking at different types of surgical procedures. As part of this, oral health was examined.

Their findings are useful for those with children that have a cleft lip and palate. They can weigh up the different surgery options and decide if surgery is worthwhile or not.

What is a cleft lip and palate?

A cleft lip and palate are very common facial birth defects. A cleft lip is a gap or split in the upper lip. Moreover, a cleft lip palate is a gap or split in the roof of the mouth [1].

Babies born with this defect will struggle in many elements of day-to-day life. For example, breathing, eating, speaking and hearing can all be affected.

Most people with a cleft lip and palate seek corrective surgery. This can help in many avenues of life. This includes oral health, with those with a cleft lip and palate at a higher risk of poor oral health [2].

The Research

The research took the form of a thesis. It was submitted by Petra Peterson – who works at a Reconstructive Plastic Surgery research group [3].

Corrective surgery for a cleft lip and palate is possible. However, there are multiple surgery types. The research involved analyzing different types. These were one-stage palatal closure Veau-Wardill-Kilner, minimal incision technique (MIT) and MIT with muscle reconstruction [3].

The research involved 2 groups of 19-year-old patients that had been born with a cleft lip and palate being compared. These patients had all had x-rays taken when they were aged 5 [3].

They all received corrective surgery using one of the aforementioned techniques. A control group of other 19-year-olds that were born without a cleft lip and palate were also used [3].

The intention was to see how the 19-year-olds coped following their corrective surgery. This would give the researchers an idea on how their oral health had changed since being aged 5, and the effect that surgery has.

In terms of oral health, the researchers were looking to see if there were signs of gum recession or inflammation [3]. Moreover, the study sought to find if periodontal probing depth was affected [3]. Probing depth refers to the space below the gum tissue next to the tooth. Anything above 3mm can be a sign of Gum Disease.

The results showed that there was “no significant difference” in the probing depth between the teeth in the cleft and non-cleft sites [3]. Furthermore, there was minimal gingival recessions either [3].

However, in the cases that did involve gingival recessions, the inflammation was found to be significantly higher on the side of the cleft. This indicates that the cleft does impact oral health – even if it is just for the side that the cleft is present on.

But in good news, the differences between those with a cleft lip and palate and the control group were minimal [3]. This suggests that surgery can be very effective at improving oral health for those with the defect.

Incidentally, the research concluded that the minimal incision technique was the most successful approach towards surgery. It resulted in improved speech and communication [3].

Author’s Comments

The findings of this study are certainly interesting. While it was known that a cleft lip and palate are associated with inhibited oral health, it wasn’t known that different surgeries can impact outcomes.

Petra Peterson, the author, spoke to the Karolinska Institutet about her findings [4]. She has stated that the findings suggest that there appears to be “a continuous need” for “rigorous oral hygiene” for those with a cleft lip and palate during their youth [4].

Peterson is hoping to conduct further follow-up experiments on participants in the study. This would include further reviews of their progress, including from an oral health perspective.

These findings are important to consider. It can help those looking into surgery options to consider what is best for them. On the oral health front, there are many useful conclusions to take from the study.

Thinking points…

1) Do you have a child with a cleft lip and palate? If so, the research here could be very useful for yourself. It can be difficult to decide firstly whether you want to have corrective surgery for your child, and secondly which type. There are also oral health considerations too. But hopefully the results of this research can be helpful.

2) Those with a cleft lip and palate are at an increased risk of oral health problems. Therefore, it is important for anyone with the defect to take extra care of their teeth. But this can also be a reminder to us all about how we all need to look after our oral health. We should all exhibit excellent oral hygiene and try to avoid sugary and acidic foods and drink where possible. As part of this, ensure that you attend a dental clinic at least twice a year for a check-up, we recommend booking right away!

What we offer at Taradale Dental

Taradale Dental is a Calgary dental clinic that provide its patients with a range of treatment options and advice aimed at improving oral health.

It is crucial to brush your teeth at least twice a day and to floss regularly. Moreover, eating healthily and trying to avoid sugary foods and drink is important.

We advise our patients to attend our Calgary-based dental clinic twice a year for a regular dental check-up. When problems are detected, we have many treatments available. For instance, these include cavity fillings and root canals.

Here at Taradale Dental, we also have some cosmetic treatments available! These include dental implants, tooth whitening and Invisalign™! Many people find that these treatments have a positive impact on their appearance, confidence and self-esteem.

In addition, all of our services at our Calgary dental clinic Taradale Dental are in line with the Alberta Dental Fee Guide.

We would love you to visit our Taradale Dental clinic in Calgary! You can find out more about us by visiting our website https://taradaledental.ca.

References

[1] NHS. (2019). Cleft lip and palate. Available: https://www.nhs.uk/conditions/cleft-lip-and-palate/. Last accessed: 2nd December 2022.

[2] Eslami, N., Majidi, M., Aliakbarian, M., & Hasanzadeh, N. (2013). Oral Health-Related Quality of Life in Children With Cleft Lip and Palate. Journal of Craniofacial Surgery. 24 (4): p340-343. DOI: https://doi.org/10.1097/scs.0b013e31828b743b.

[3] Peterson, P. (2022). A multidisciplinary long-term evaluation of patients born with unilateral cleft lip and palate treated with different surgical protocols. Karolinska Institutet. Available: https://openarchive.ki.se/xmlui/handle/10616/48295?. Last accessed: 2nd December 2022.

[4] Karolinska Institutet. (2022). New thesis on long-term evaluation of patients born with total unilateral cleft lip and palate. Available: https://medicalxpress.com/news/2022-11-thesis-long-term-patients-born-total.html. Last accessed: 2nd December 2022.