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Developmental defects of enamel and dental anomalies in five-year-old cleft patients

Children born with cleft lip and/or palate (CLP) have a higher prevalence of developmental defects of enamel and dental anomalies, and are at an increased risk of developing dental caries. The aim of this study was to establish the prevalence of dental anomalies and developmental defects of enamel in children born with CLP, and to assess compliance with dental prevention. Data were collected retrospectively for children who attended the five-year-old dental review clinic at the South Thames cleft service over a four-year period. Records of 162 children were analysed. Unilateral CLP was the most common type of cleft. Two-thirds (65%) of the children in this service evaluation had developmental defects of enamel affecting the upper incisors. A third (32%) had enamel hypomineralisation. Between 90% and 100% of children over the four-year study period were registered with a dentist. Regular fluoride varnish application was received by 64% to 81% of children and toothpaste with an appropriate concentration of fluoride was used by 72% to 91% of children. Improvements in shared care arrangements between primary dental care clinicians and specialist paediatric dentists are needed to ensure that caries risk is reduced in children born with CLP. This allows the specialist dental services to focus on the complex dental issues that are seen more frequently in CLP and often require a multidisciplinary approach.