Dental decay and gum disease can affect any children, but children born with a cleft may be more susceptible. We start a preventative programme soon after birth 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.
You can help to protect your child from dental decay and gum disease.
Register with a dentist and start to brush the teeth with a fluoride-based children’s toothpaste as soon as they erupt. Use a small toothbrush and try to brush at least once in the morning and once before going to bed.
Taking your child to the dentist from a young age can help them to feel more comfortable in that environment, which will help them to feel confident about having their teeth examined when they are older. You can even bring them to your own appointments, so that they get used to the sights, sounds and smells of the dental environment.
Try to limit the amounts of sugar your child eats and drinks. 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 to look after your child’s teeth has further information about how to manage your child’s oral hygiene.
A cleft involving the palate and / or gum (alveolus) can produce a number of dental problems that vary according to the type of cleft.
An isolated cleft lip or palate is less likely to involve the teeth, whilst a cleft of the palate involving the gum may lead to missing, misshapen or misplaced teeth around the cleft area. Teeth in the cleft site may be misshapen or discoloured as soon as they erupt. This can look like tooth decay. Also, there may be extra teeth in the cleft site and the permanent tooth may often be absent.
Both baby and adult teeth can be slow to erupt.
The upper jaw (maxilla) may not develop properly where there is a cleft palate involved and the jaw may be slightly smaller 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 young adult.
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 an alveolar bone graft is required).
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 artificial teeth by good orthodontic and restorative care at the end of the orthodontic phase of treatment.
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 signpost you or refer as appropriate.
Your child will also be under the care of some specialist dentists during their time with the Spires Cleft Centre:
- An orthodontist will monitor dental development as your child grows and initiate treatment with braces when and where it is required
- A restorative dentist / paediatric specialist will advise of the more complex issues as they arise.
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 and thumb sucking are not encouraged after surgery, as they can damage the repaired site. Your clinical nurse specialists can advise as to how best to manage this.