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Dental Care and Development

Dental decay and gum disease can affect any children, but children with a cleft are particularly vulnerable (especially where the gum is involved) and we start a preventative programme soon after birth. One of our main aims is to ensure all our children have excellent dental health and a pleasing smile in adulthood.

You should receive early advice from our clinical nurse specialists and we encourage you to register your child with a dentist as soon as the first teeth erupt at about 6 months of age. We have tried to answer some of the most commonly asked questions below and hope they help to explain the dental problems associated with a cleft.

What can parents do to help with dental health?

You can help to protect your child from dental decay and gum disease.

Register with a dentist at an early stage and start to brush the teeth with a fluoride-based children's toothpaste as soon as they erupt. Use a small soft toothbrush and try to brush at least once in the morning and once before going to bed.

Try to limit the amounts of sugar your child eats. Look at the labels on products - although sweets, biscuits and fizzy drinks are well known sources of sugar, other products such as ketchup can contain surprisingly high levels. If your child is on long-term medication, ask for the low or sugar free variety.

How does a cleft affect the teeth?

A cleft involving the palate and gum (alveolus) can produce a number of dental problems that vary according to the type of cleft. An isolated cleft of lip or palate is less likely to involve the teeth whilst a cleft of palate involving the gum may lead to missing, misshapen or misplaced teeth around the cleft area, (teeth can be slow to erupt in both the baby and adult dentitions).

How does a cleft affect the jaws?

The upper jaw (maxilla) may be unaffected by the cleft but where the gum is involved the jaw may be slightly small or narrow as a result. This can affect alignment and bite of the teeth requiring braces (orthodontic treatment), a bone graft or in some cases jaw surgery as a teenager.

Will my child have straight teeth?

Misaligned teeth can be corrected with braces in just the same way as any other child. This is typically carried out between 11 - 14 years old but earlier treatment is sometimes necessary (for example, when alveolar bone grafting is required).

Will my child need false teeth?

In the past, almost all children with a cleft in the gum needed one or more plastic teeth to fill spaces in adulthood. Modern dentistry aims to reduce the need for removable or artificial teeth by good orthodontic and restorative care at an early stage.

Who will look after the dental care?

You will need your own family dentist to look after general dental health. If you experience problems finding a dentist we will do our best to register your child with a suitable practitioner in your locality.

You will also be under the care of some specialist dentists during your time with the cleft centre:

  • An orthodontist will monitor dental development as your child grows and initiate treatment with braces when and where it is required
  • A paediatric dentist will be available where specific dental problems arise that cannot be managed by your own dentist
  • A restorative dentist may be needed in the teenage years if implants or complicated bridges are necessary

Does it matter if my child sucks a thumb or a 'dummy'?

Thumb sucking is a normal comfort habit and will cause no long-term problem if it stops before the permanent teeth erupt. A 'dummy' has a similar effect on the teeth as the thumb but needs to stop at an earlier stage. Dummies are not encouraged after surgery

Good dental care is very important