Dr. Laila Alkazemi
Pediatric Dentistry
Ministry of Health, Kuwait.
The Role of the General Dentist and the Pediatric Dentist in the Cleft Lip and Palate Team
Cleft Lip and Palate (CLP) management requires a multi-disciplinary treatment approach; as it faces many challenges, which could be initiated at different stages from childbirth to the early adult age. The role of General Dentists towards CLP patients is to have some understanding of the management involved in such cases. They can play a beneficial role in educating the patients and their families and ensuring them of the treatment’s availability, along with providing them the support needed. Moreover, General Dentists are the gateway for referring such patients to the appropriate team that could manage such cases.
What is the role of the Pediatric Dentist in the oral cleft team?
- They provide preventive, restorative and orthodontic treatment starting from the newborns, until permanent teeth fully erupt.
Why is it important to do early dental care for children with cleft lip and palate?
- It is very essential for parents to be aware of the importance of keeping up with the regular dental visits and to provide their child with dental care; as not doing so will lead to dental caries, pain, swelling, and early loss of teeth; thus delaying and complicating the orthodontic treatment
How can you take care of the babies’ (with no teeth) oral health?
- Clean your baby's mouth with wet cloth after every feed.
- As for the children using an appliance, it should be removed after every feed to be cleaned with water; and then returned to the child's mouth to avoid milk accumulation.
How can you take care of the baby’s teeth?
- Children with cleft lip/ palate are more at risk of dental cavities; therefore, dental care and prevention is essential.
- When the teeth starts to emerge, use soft children toothbrush with smear layer of fluoridated toothpaste.
- Brush your child’s teeth in the morning and at bedtime
- Brushing at the site of surgery could be challenging to parents; so the method for brushing the surgical sites must be made clear to the parents; and that is by lifting or stretching the lips using the index finger and brushing the gums and teeth at the surgical site.
What diet advices you should follow to minimize the risk of dental cavities for your child?
- Water and milk are the only liquids to be used inside the nursing bottle.
- Night bottle should stop when the first baby tooth shows.
- Decrease the frequency of sugar intake throughout the day.
- Sugary snacks and juices should be given only following the meal time (lunch).
- If pacifier is used, it should not be sweetened.
- Encourage your child to drink more water.
- Acidic drinks (soft drinks) should be avoided to minimize the risk of dental erosion (surface tooth loss).
At what age do the permanent teeth start to show? And which tooth emerges first?
- The first permanent tooth emerges between the age of six to seven years old, and it is either the lower anterior tooth or the first permanent molar.
What oral health measures should you add at the eruption of the permanent teeth?
- At this period, your children should be encouraged to take the responsibility of their oral health care (brushing their teeth on their own with adult supervision)
- Fluoridated mouth wash is recommended to be added as part of the daily oral hygiene
Will the braces cause dental cavities?
- The patient needs to be made aware of the potential problem of decalcification (white patches) around the orthodontic brackets and other dental caries problems, if she/he does not brush or floss as need, and the frequency and amount of sugar intake is not controlled. For this purpose, it is important for the patient to be aware of the importance of attending both orthodontic and regular dental checkup appointments.
