Epidemiology of Oral Clefts 2012: An International Perspective

Abstract

Classical descriptive epidemiology in the field of cleft lip and palate aims to quantify the problem, and in the higher income countries it is possible to do this with varying degrees of accuracy. This is not however possible in every country in the world, and epidemiology should seek to identify these data gaps with a view to improvement in the situation. Epidemiology must also be investigative and look for trends, associations and inter-population differences, with the aim of supporting aetiological research and advancing the translational agenda. This chapter is set out in three parts and seeks to address all three of the above areas. Birth defects in general and orofacial clefting in particular remain a relatively common and significant problem for not only the individual patients born with these defects in terms of death or disability, but also for their families and for society in general in terms of burden of care and health inequality. In high-income countries, despite very significant advances in treatment, problems in access to care and evidence base for cleft care still exist whereas in the developing world the consequences are lack of access to care and lack of infrastructure to help with quantification of the problem and consequently the ability to address it. The major questions in contemporary cleft lip and palate research surround ways of improving the evidence base for the treatment interventions used to optimise quality of care, and the ultimate scientific and humanitarian objective is primary prevention of those diseases and disorders that are preventable. Descriptive epidemiology underpins research enquiry in both of these major areas.

IRF6, RYK, and PAX9 Expression in Facial Tissue of Children with Cleft Palate

“…CLP is characterized by the incomplete formation of structures separating the nasal and oral cavities including the lip, alveolus, and hard and soft palates, with the most severe clefts extending completely through both soft tissue and bone. To date, little is known of the etiopathogenesis of CLP; however, various genetic and environmental factors have been implicated (Mossey & Modell, 2012).…”

Genome-wide analysis of parent-of-origin effects in non-syndromic orofacial clefts

“…1,2 It may either occur in the context of malformation syndromes, or as an isolated anomaly (ie, non-syndromic OFC, NSOFC). Non-syndromic clefts are divided into two categories on the basis of epidemiological and embryological research findings: (i) cleft lip with or without cleft palate (CL/P) and (ii) cleft palate only (CPO).…”

Cleft Lip and Palate: Etiology, Epidemiology, Preventive and Intervention Strategies

“…The most common risk factors reported were maternal exposure to tobacco products, alcohols, nutritional deficiencies, some viral infections, medications, and teratogens in the workplace or at home in early pregnancy. [29].…”

“…Another dilemma in the reporting of OFCs is that some studies include all births in the rate calculations while others include only live births. Since clefts are more frequent among stillborn and spontaneously aborted infants, their inclusion in the denominator impact the results significantly [29][30][31]. The IPDTOC Working Group, 2011 have summarized the conclusions of all recent epidemiologic data on OFC as follows [32,33]:…”