DENTAL CARE

As soon as the first primary teeth have erupted, information should be given to parents regarding oral hygiene and proper nutrition for the child in order to maintain the primary and later the permanent teeth in the best possible condition.
The cleaning of the oral cavity should initially be carried out with a wet piece of cloth and after the teeth have erupted with a small, soft nylon toothbrush. Special care is required to clean the teeth in the area of the cleft, because, due to the lack of mobility of the lip in the region of the cleft, removing the bacterial plaque may be difficult. In the area of the cleft, the lip needs to be lifted in order for proper brushing of the teeth to become possible. The interdental spaces should be cleaned with dental floss.
A properly balanced diet and avoidance of sweets will help in the proper development of teeth and in the prevention of dental caries. Fluorination of the teeth, every six months at the pedodontist office, as well as at home in the form of fluorinated toothpaste (after the age of two years) is a valuable adjunct. Children born with clefts of the lip, palate or with a combination both, present a higher rate of dental problems as compared to other children. Their treatment may require help from several dental specialties such as the pediatric dentist, the orthodontist and the prosthetologist. Dental carries is seen more frequently in children with clefts and is mainly due to inadequate oral hygiene but also to the presence of teeth in abnormal locations which favor the retention of food particles, development of dental plaque and consequently carries, which will frequently end up in extensive destruction of teeth in the area of the cleft.
Restoration of malformed teeth or of teeth afflicted by carries during the period of the primary and of the mixed dentition is the main concern of the pedodontist. Restoration of teeth in children with clefts is imperative for conservation of the alveolar bone in the area of the cleft. As stated above, all children with clefts will require orthodontic treatment which becomes difficult or impossible without the ability to secure the orthodontic appliances on healthy teeth. Maintenance of a healthy dentition also greatly contributes to the functional and aesthetics of the mouth which are so important for the child's body image.