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Objective : To compare the caries experience of adolescents and young adults with cleft lip and/or palate (CL/P) with a noncleft control group. Design : Thirty CL/P subjects and 30 controls were clinically examined to obtain the decayed, missing and filled teeth (DMFT) and the decayed, missing and filled surfaces (DMFS) indices, gingival bleeding index, plaque index, and active caries lesions. Data concerning oral hygiene, access to fluoridated water, mother's education level, and family income were also collected. Setting : Pro-Smile Center, a reference center for the treatment of facial deformities, Alfenas, Minas Gerais, Brazil. Subjects : Subjects aged 12 to 21 years with CL/P and without associated syndromes were matched to noncleft controls by sex, age, living habits, and use of orthodontic devices. Null Hypothesis Formulated Prior to Data Collection : Caries experience in CL/P adolescents and young adults is similar to that observed in noncleft controls. Statistical Analysis : Data were analyzed using SPSS 17.0 software for Windows Data Editor. The CL/P and control groups were compared using the McNemar test, paired t test and Wilcoxon test. A significance level of 5% was adopted for all tests. Results : There were no significant differences between the groups for oral hygiene and contact with fluoride. Significant differences were found in per capita income, presence of active caries, decayed surfaces, plaque index, and gingival bleeding. Conclusions : The caries experience of CL/P subjects was higher than that of the noncleft individuals.

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Patients with orofacial clefts present various risk factors for oral infectious diseases, resulting from anatomical and physiological changes and those resulting from rehabilitating therapeutic interventions. The incidence of Candida species in groups of babies and children with orofacial clefts, during pre- and post-operative periods and until return to first consultation, and the profiles for antifungal sensitivity and virulence in vitro were investigated. Oral samples were collected at different times over the surgical procedures and post-surgical clinical consultation and seeded in chromogenic culture media CHROMagar Candida. Candida biotypes were identified by accessing species-specific genomic DNA sequences by PCR techniques and electrophoretic procedures. Antifungal susceptibility testing was performed by the method of microdilution in broth using the antifungals amphotericin B (AP), nystatin (NYS) and fluconazole (FLC). SAP and PL exoenzyme activities were determined by classical microbiological methods. Some orofacial clefts occurred preferentially in male or female. Low incidence (39.1%) of oral colonization by Candida species (C. albicans, C. krusei, C. tropicalis and Candida spp.) was reported in patient admission to surgical ward, with no correlation to orofacial cleft types or surgical history. Significant reduction in frequencies of Candida and changes of species, over sampling periods, showed dynamic patterns of oral colonization: elimination, maintenance or neocolonization of the biotypes. These biotypes showed sensitivity to AP (100%), partial resistance to FLC (<10%) and variable MICs for NYS (0.125-4 μg/mL), in addition to strong exoenzyme activities, especially for SAP. Clinical and therapeutic conducts for surgical rehabilitation, anatomical and physiological characteristics of patients with orofacial clefts, and cultural behavior and regionalism of the patient population served could influence the frequencies and dynamics of oral colonization by Candida species. The data showed Candida biotypes resistant to FLC and sensitive (AP) or clinically compatible (NYS) to polyenes, especially C. albicans, in the oral cavity of patients predisposed to oral colonization and candidiases, contributing to clinical conducts in possible antifungal therapies. These biotypes were considered potentially virulent and able to partially modulate their virulence factors, especially SAP, under the conditions favored by host.