Experience of maintaining tooth brushing for children born with a cleft lip and/or palate

Abstract

BackgroundChildren with a Cleft Lip and/or Palate (CL/P) have been reported to have poorer oral health than those without the condition. The consequences for these children can be particularly problematic due to implications for future treatments. Tooth brushing is an important behaviour contributing to children’s oral health, but is under researched in the CL/P population. The aim of the study is to explore the experience of maintaining tooth brushing among children in the United Kingdom (UK) with a CL/P and their parents.MethodsSemi-structured interviews were carried out with twenty-two parents and sixteen children with a CL/P (5-11 years), recruited at a cleft centre in the UK. Thematic analysis was used for data analysis.ResultsThree key themes were drawn from the qualitative data: first, parents of children with a CL/P generally had strong motivation to look after their children’s teeth but children’s motivation was inconsistent. Second, parents were primary enablers of children’s tooth brushing behaviour, often employing approaches adapted to their child’s characteristics to encourage tooth brushing. Third, a range of obstacles were encountered by parents and children in maintaining regular tooth brushing behaviours. They reported obstacles such as issues related to CL/P, ‘forgetting’ and childhood illness.ConclusionsThe paper suggests that parents of children with a CL/P need support to enact their intention to maintain regular tooth brushing and prioritise tooth brushing within the context of demanding and dynamic family life.

Are there any solutions for improving the cleft area hygiene in patients with cleft lip and palate? A systematic review

“…14,22 Table 3 includes the articles that addressed oral hygiene based on these two subjects-plaque index and dental caries. Data regarding the brushing habits were present in fourteen studies, 4,5,7,8,11,[14][15][16][21][22][23] and about half of them 4,5,15,21,23,29 reported a frequency ≥2 daily brushings that is higher in CLP patients than in controls. Oral hygiene (plaque index and prevalence of caries) is worse in CLP patients than in controls.…”

“…Just one article showed evidence of differences by gender, that is females had higher caries experience than males, and this was worse in patients with bilateral clefts. 11,12,16,24 Two studies showed that the mother supervision on toothbrushing is higher in CLP patients than that observed in the controls. 26 Many studies also conducted a questionnaire addressing several variables related to oral hygiene.…”

“…26 Many studies also conducted a questionnaire addressing several variables related to oral hygiene. 11 Related to this, some studies stressed the relevance of care and prevention counselling to improve the oral health of CLP children. 16,35 The use of fluoride products was reported in a variety of studies, [4][5][6]8,12,16,21,29,34 and some of them showed that this was higher in CLP patients than in controls.…”

“…This anatomical feature is an additional factor that hampers the maintenance of good local hygiene. 8,9,11,12 In spite of that, epidemiological studies on the oral hygiene of CLP children are scarce, and do not address the hygiene of the cleft area. 2,6,[8][9][10] It is also required for the successful outcome of the surgical corrective procedures.…”

New Instrument for Oral Hygiene of Children with Cleft Lip and Palate

“…The relevance of cleaning the cleft area in order to maintain good oral health is highlighted in a variety of studies [4,8,11,12]. However, a several reasons account for the difficulties of children and parents in performing an appropriate toothbrushing cleaning, mainly fear of soft tissue trauma during brushing, worries about bleeding from inflamed gingiva, and difficult access to the teeth and the deepest area of the cleft [8,13].…”