Previous studies on the development of cleft lip, alveolus, palate, and velum and neural tube defects have revealed several shared multifactorial causes. Both anomalies emerge at different times during embryonic development and are not associated with each other unless there is a genetic component to the etiology. Vitamin deficiency disorders are one of several factors contributing to the etiology of these anomalies.Vitamins B6, folic acid and B12 play an essential role in the methylation cycle. A lack of or deficiency in these vitamins thus has severe consequences for the organism, especially the unborn child. Due to its short half-life, vitamin B6 is particularly important for undisturbed embryogenesis and should be taken along with folic acid as a periconceptional supplement to prevent embryonic deformities. This paper is intended to provide the orthodontist (as a member of the interdisciplinary cleft team) with an overview of the issues and etiological significance of vitamin B deficiencies as possible inducers of these embryopathies. This may encourage comprehensive counselling, particularly of parents of children born with deformities who wish to have more children.

Revised regulations in Germany have allowed new curricular concepts to be introduced into the undergraduate dental curriculum. In the first 2 years of the dental curriculum at the University of Greifswald, a new teaching concept which is based on the interactions between Community Medicine and Dentistry has been introduced. It emphasises the importance of early patient contact in providing experience for students. The course consists of three principal elements: student-patient contacts in the patient's home; problem-based learning tutorials to discuss patient cases; and special training in communication skills. The aim of the course is to give students an insight into the patient's view of the illness and treatment, and the effect of their condition on his or her lifestyle. The students also learn about the communal perspective (health survey, intervention planning and implementation in a community). The first four courses were evaluated by questionnaires from the students before and after the 2-year course to assess the concept from the students' perspective. The results indicate that it is possible to provide considerable improvement of the medical/dental education as regards communication skills and understanding of the patients' perceptions, by letting the student establish contact with patients at the very beginning of the curriculum.

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