As nurses, one of the integral part of our patient care is making sure that our patients are well taken care, may it be about their mental health, physical and sometimes about their dental health.
A cleft lip, gum and palate can lead to a variety of dental-health problems. This may include the size, shape, number and position of both the baby and permanent teeth. The teeth in the area of the cleft are most affected as the clefts occur between the cuspid, also known as the eye tooth.
According to the Center for Disease Control (CDC), every year, a cleft lip occurs in more than 4,000 U.S. births. The American Dental Association also warns that children with a unilateral cleft lip have an increased risk of speech, hearing, teeth and ear problems.
A cleft lip is a split in the upper lip that is caused by lip tissue failure that occurs during the 4-7 weeks of pregnancy. While the cause is usually unknown, the combination of genes and other health factors such as nutritional deficiencies, hormonal imbalances, and certain medications.
A cleft palate is a failure of tissue that creates the roof of the mouth that does not join during the 6-9th week of pregnancy. The cleft palate is more serious than the cleft lip. Risk factors include diabetes, smoking, and the use epilepsy medication.
Surgery is highly recommended by dentists to help treat the cleft condition for children between 1-2 years old as additional required surgeries may improve the overall health and appearance.
Dental nurses, make sure you share these best oral hygiene practices to patients with cleft lip/palate:
Early Dental Care
Patients with a cleft lip are more likely to experience tooth decay as the teeth closest to the left can have defective enamel. This makes it highly important to limit the intake of refined sugar to help avoid tooth decay.
While cutting sugar may decrease the risk of tooth decay, there a number of unhealthy habits to break to help decrease the risk. Patients must make sure to properly brush and floss the area consistently.
Find a Qualified Dentist
Before any more dental health problems may occur, make an appointment with an experienced dentist. Patients with a cleft lip have a higher risk of additional orthodontic health problems, such as crowding, overbite, sideways or missing teeth. The dentist will typically refer the patient to an orthodontist to assess the bone and jaw growth and help determine the ideal course of treatment.
Orthodontic Care
The orthodontic evaluation is used to assess the facial growth, especially in children. This will determine the proper plan for the short and long-term oral health needs. If the upper teeth do not match well together with the lower set of teeth, the orthodontist may suggest an early treatment to help correct the placement of the upper and lower jaw. The orthodontist will continuously monitor the facial and dental development.
Dental Prosthetics
A Prosthodonist is a dental specialist who makes dental appliances and artificial teeth in order to help improve the appearance of patients with cleft and meet their daily functional requirements for speaking and eating. This dental specialist may create a dental bridge to replace the missing teeth due to the cleft. Palatal lifts or speech bulbs may also help close the nose away from the mouth to improve speech.
Maintain Constant Oral Care
Proper oral hygiene is very important, especially after intensive procedures and surgeries. Be sure to follow the dentist’s and oral specialist’s care plans in order to avoid any form of infection. Aside from brushing and flossing, use a proper mouthwash to maintain continued dental health. Brush after meals, floss, use fluoride-based products and avoid sugary foods.
Preventive Management
Managing proper oral hygiene is relatively simple as positive reinforcement should encourage the patient to improve or maintain their motivation. Patients must be well-aware of the potential and common health problems that may occur, including decalcification. Aside from sugar, also be sure to avoid acidic foods to lower the possibility of erosion.
Regular monitoring or oral hygiene is necessary, especially for fixed appliances. A small-headed toothbrush is highly recommended along with an interspace brush as valuable oral hygiene aids. When appliances are not worn, dental floss is highly recommended. Daily brushing may be difficult, especially during the early stages of fixed appliance therapy, as unrestored teeth may cause potential plaque accumulation.
Patients with a cleft must be monitored closely as regular oral care should be properly maintained.
While receiving a diagnosis like a cleft lip is never easy, living with it doesn’t have to be. With the latest advances in oral care, along with practicing good oral hygiene, following with daily care will help create a good foundation for a happy, healthy and full dental life.
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