Hospital admissions for dental treatment among children with cleft lip and/or palate born between 1997 and 2003: an analysis of Hospital Episode Statistics in <scp>E</scp>ngland

Fitzsimons, Kate J; Copley, Lynn P.; Smallridge, J.; Clark, Victoria; Meulen, Jan van der; Deacon, Scott

doi:10.1111/ipd.12062

Cited by 10 publications

(13 citation statements)

References 16 publications

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“…Our results demonstrate that both cleft type and school absence are independently associated with academic attainment in children with a cleft.InterpretationDifferences in annual school absence levels between 7-year-old children with an isolated orofacial cleft and corresponding children in the general population are due to differences in length of absence for illness and medical/dental appointments. This is in line with our previously published observations that children with more complex cleft types require more interventions from multiple specialties, including grommets insertions and dental procedures requiring general anaesthetic [3,7].…”

supporting

confidence: 92%

“…. [1] A cleft can affect hearing, [2,3] language, [4,5] dental health, [6,7] psychosocial health, [8] neurodevelopmental health, [9] and academic outcomes. [9,10] Recently, we have shown that the presence of an isolated cleft (a cleft without additional anomalies or syndromes) negatively affects all areas of learning, especially when the cleft involves the palate (both CPO and CLP).…”

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confidence: 99%

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School absence and achievement in children with isolated orofacial clefts

et al. 2020

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ObjectivesTo examine school absence and academic achievement among 7-year-old children with isolated orofacial clefts in England.DesignAnalysis of educational data linked to national cleft registry and administrative hospital data.SettingEnglish state schools.Patients3523 children with isolated clefts aged 7 years between 2006 and 2014.Main outcome measuresAnnual school absence and reaching the national ‘expected level’ according to teacher-assessed academic achievement.ResultsChildren with isolated clefts had higher mean annual school absence (10.5 days) than their peers in the national population (8.9 days). Total absence was higher in children with a cleft lip and palate (CLP; 11.3 days) or with a cleft palate only (CPO; 10.5 days) than in children with a cleft lip only (CLO; 9.5 days). The percentage reaching the expected academic level decreased with increasing school absence (from 77.4% (923/1192) with annual school absence ≤5 days to 43.4% (193/445) with annual school absence >20 days). However, differences in school absence did not explain that children with CPO (65.9% reaching expected level) or CLP (66.1% reaching expected level) had poorer levels of academic achievement than children with CLO (73.5% reaching expected level). Children with a cleft were twice as often recognised as having special education needs (40.5%) than their peers (21.6%).ConclusionsSchool absence and cleft type are both independently associated with school attainment at 7 years. Children with an isolated cleft, especially when the palate is involved, and those with high levels of school absence may benefit from increased support addressing their educational needs.

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confidence: 92%

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confidence: 99%

School absence and achievement in children with isolated orofacial clefts

et al. 2020

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“…The consequences of caries may be to increase the burden of care through additional treatment visits and increased risk of pain and risk of sepsis. Children with cleft lip and palate are more likely to have a general anaesthetic for dental treatment before the age of seven years than their peers , and this adds further to their number of hospital admissions.…”

Section: Introductionmentioning

confidence: 99%

Functional outcomes in the Cleft Care UK study – Part 3: oral health and audiology

Smallridge

Hall

Chorbachi

et al. 2015

Orthod Craniofacial Res

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Structured AbstractObjectivesTo compare oral health and hearing outcomes from the Clinical Standards Advisory Group (CSAG, 1998) and the Cleft Care UK (CCUK, 2013) studies.Setting and sample populationTwo UK‐based cross‐sectional studies of 5‐year‐olds born with non‐syndromic unilateral cleft lip and palate undertaken 15 years apart. CSAG children were treated in a dispersed model of care with low‐volume operators. CCUK children were treated in a centralized, high volume operator system.Materials and methodsOral health data were collected using a standardized proforma. Hearing was assessed using pure tone audiometry and middle ear status by otoscopy and tympanometry. ENT and hearing history were collected from medical notes and parental report.ResultsOral health was assessed in 264 of 268 children (98.5%). The mean dmft was 2.3, 48% were caries free, and 44.7% had untreated caries. There was no evidence this had changed since the CSAG survey. Oral hygiene was generally good, 96% were enrolled with a dentist. Audiology was assessed in 227 of 268 children (84.7%). Forty‐three per cent of children received at least one set of grommets – a 17.6% reduction compared to CSAG. Abnormal middle ear status was apparent in 50.7% of children. There was no change in hearing levels, but more children with hearing loss were managed with hearing aids.ConclusionsOutcomes for dental caries and hearing were no better in CCUK than in CSAG, although there was reduced use of grommets and increased use of hearing aids. The service specifications and recommendations should be scrutinized and implemented.

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“…52 The remaining 18 studies identified CMs from secondary care data, with most assessing health service delivery, surgical outcomes or disease trends. [53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70] Almost all used HES (n = 16) and the most commonly identified CMs were heart (n = 4) and orofacial defects (n = 4).…”

Section: Resultsmentioning

confidence: 99%

The identification and validity of congenital malformation diagnoses in UK electronic health records: A systematic review

Peppa

Minassian

Mangtani

et al. 2021

Pharmacoepidemiology and Drug

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Purpose: To describe the methods used to identify and validate congenital malformation diagnoses recorded in UK electronic health records, and the results of validation studies.Methods: Medline and Embase were searched for publications between 1987 and 2019 that involved identifying congenital malformations from UK electronic health records using diagnostic codes. The methods and code-lists used to identify congenital malformations, and the methods and results of validations, were examined.Results: We retrieved 54 eligible studies; 36 identified congenital malformations from primary care data and 18 from secondary care data alone or in combination with birth and/or death records. Identification in secondary care data relied on codes from the 'Q' chapter for congenital malformations in ICD-10. In contrast, studies using primary care data frequently used additional codes outside of the 'P' chapter for congenital malformation diagnoses in Read, although the exact codes used were not always clear. Eight studies validated diagnoses identified in primary care data. The positive predictive value was highest (80%-100%) for congenital malformations overall, major malformations, and heart defects although the validity of the reference standard used was often uncertain. It was lowest for neural tube defects (71%) and developmental hip dysplasia (56%).Conclusions: Studies identifying congenital malformations from primary care data provided limited details about the methods used. The few validation studies were limited to diagnoses recorded in primary care. Further assessments of all measures of validity in both data sources and of other malformation subgroups are needed, using robust reference standards and adhering to reporting guidelines.

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Hospital admissions for dental treatment among children with cleft lip and/or palate born between 1997 and 2003: an analysis of Hospital Episode Statistics in England

Abstract: Factors increasing the risk of hospital admission among cleft children should be taken into account when planning services. Efforts to reduce the number of hospital admissions should be focused on disease prevention, particularly among those most at risk of caries.

Cited by 10 publications

References 16 publications

School absence and achievement in children with isolated orofacial clefts

School absence and achievement in children with isolated orofacial clefts

Functional outcomes in the Cleft Care UK study – Part 3: oral health and audiology

The identification and validity of congenital malformation diagnoses in UK electronic health records: A systematic review

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