Dental treatment need and dental general anesthetics among preschool‐age children with cleft lip and palate in northern Finland

Abstract

Cleft lip and palate incidence is high in northern Finland. This study aimed to investigate the proportion of children in need of restorative dental treatment among cleft lip and palate patients in northern Finland, as well as their need for dental treatment under general anesthesia. The records of 183 cleft lip and palate patients, treated in Oulu University Hospital from 1997 to 2013, were reviewed. Data on dental caries were analyzed in association with cleft type, considering also the presence of syndromes. The frequency of dental general anesthetic (DGA) use, and of treatments, were also analyzed. Dental treatment need was most frequently observed, in this rather limited study population, in patients with the most severe deformities, namely bilateral cleft lip and palate, of whom 60% had caries. Among the study population, 11.5% (n = 21) had a syndrome. Of those, 57.1% had dental caries at the age of 3 or 6 yr, and only four could be treated without a DGA. Dental treatment under general anesthesia was performed in 14.8% of cleft patients without a syndrome, but in 38.1% of those with a syndrome. General anaesthesia is required for the provision of dental care more often in cleft (17.5%) than in non-cleft (0.2%) patients, and especially for those with a syndrome.

Characteristics and Dental Treatments of Children under General Anaesthesia

“…Comparable to the results of previous studies (Lehtonen et al, 2015;Solanki et al, 2016), most subjects in the current study had no previous dental history. This finding indicated that the recorded visit was the subject's first dental visit, which is suggestive of the parents' poor understanding of primary teeth function and the importance of maintaining dentition.…”

“…The subjects in the current study had badly broken down and decayed primary molars due to ECC, and they required pulp therapy to allow the teeth to be retained inside the mouth and to function as a space maintainer while awaiting exfoliation. Hence, SSCs were used to ensure that the tooth function could be restored, and to avoid repeated treatment under GA, and to achieve better longterm outcome (Abdul Karim et al, 2008;Lehtonen et al, 2015). Another material of choice to restore primary molars is GIC, which has the advantage of releasing fluoride, calcium, and phosphate ions (Abdul Karim et al, 2008), and a tooth coloured material that provides good aesthetic results.…”

Centre‐level variation in dental treatment and oral health and individual‐ and area‐level predictors of oral health in 5‐year‐old children with non‐syndromic unilateral cleft lip and palate: the Cleft Care UK study. Part 3

“…In our population, this was higher (at 54%) and this may represent an underestimate as children with missing teeth could not be scored. Other studies have reported a higher prevalence of DDE in children with clefts . The aetiology of DDE is not entirely clear, but it has been associated with poor maternal health during pregnancy, pre‐term birth and hospitalization in the first year of life; the majority of these children would have been admitted to hospital in their first year of life for cleft repair operations.…”

Are people with an orofacial cleft at a higher risk of dental caries? A systematic review and meta-analysis

“…31 These findings are supported by other studies. [32][33][34] Just over half of studies in this review reported on cleft type and this potential variable could not be explored further. Only three studies included syndromic children.…”