Prevalence and Care
Etiology
General Physical Characteristics
Oral Characteristics
Treatment/Dental Hygiene Care
100

What classification does cleft lip and/or palate fall into?

Congenital craniofacial anomalies

100

What time period is most significant due to influences from a wide variety of environmental factors?

Early first trimester

100

What common infections are patients with cleft lip and/or palate predisposed to?

Upper respiratory and middle ear infections

100

What common incidences are associated with the cleft lip and/or palate?

Higher incidence of missing and supernumerary teeth, and abnormalities of tooth form

100

When does surgical union of the cleft lip typically take place? When does primary surgery to close the palate typically take place?

  • 2-3 months of age
  • 18 months of age or earlier
200

What factors impact the prevalence of cleft lip and/or palate?

Geographic and ethnic distribution

200

When are cleft lip and cleft palate evident?

  • Cleft lip: End of the second month in utero
  • Cleft palate: End of the third month
200

With regards to airway and breathing, why is early treatment intervention necessary? 

To cope with feeding problems

200

What are the functions and risks associated with an open palate?

  • An open palate provides direct communication with the nasal cavity
  • A cleft palate may cause formula or breast mild to pass into the naval cavity
200

What are the purposes of early treatment for cleft lip?

  • Aid in feeding
  • Encourage development of the premaxilla 
  • Help partial closure of the palatal cleft 
  • Assist families in adjusting to the birth of a child with cleft lip and/or palate
300

What is used to prevent dental dysfunction, starting from birth?

Extensive habilitative care and supervision from an interdisciplinary team of medical and dental specialists

300

What does cleft lip and/or palate represent?

A failure of normal fusion of the embryonic process during the first trimester of pregnancy

300

What speech problems are associated with a cleft lip and/or palate?

Difficulty making certain sounds that may potentially produce nasal tones

300

What areas are primarily affected by lack of muscle coordination?

Lack of coordinated movements of lips, tongue, cheek, floor of the mouth and throat

300

What are the goals for treatment of the cleft palate? What are the objectives of secondary surgical procedures?

  • Produce anatomic closure, maximize maxillary growth and development, achieve normal function and normal speech, relieve problems of airway and breathing, establish good dental aesthetics and functional occlusion
  • Improve function for coherent communication, improve appearance, or both
400

What are the primary factors considered for long-range treatment, and what is the primary objective of treatment?

  • Speaking ability and appearance
  • To help the patient lead a normal life
400

Where does fusion occur?

Fusion begins in the premaxillary region and continues backward to toward the uvula

400

What factors contribute to speech problems?

Anatomic structure, airway and breathing problems, and hearing difficulties

400

Why is there an increased risk for dental caries?

Due to risk factors relating to mispositioned teeth, problems of mastication, diet selection, and dental biofilm retention

400

Describe factors related to post-surgery personal oral care.

  • After each feeding (liquid diet for several days, soft diet for the next week), the mouth is rinsed carefully
  • Oral care is needed and accomplished with great care, usually by the parent or caregiver, to avoid damage to the healing suture lines
  • A toothbrush with suction attachments may be useful in some cases
498

List three of the seven stages of classification for clefts. 

*Any 4 from the following list

  • Class 1: Cleft of the tip of the uvula
  • Class 2: Cleft of the uvula (bifid uvula)
  • Class 3: Cleft of the soft palate 
  • Class 4: Cleft of the soft and hard palates
  • Class 5: Cleft of the soft and hard palates that continues through the alveolar ridge on one side of the premaxilla 
  • Class 6: Cleft of the soft and hard palates that continues through the alveolar ridge on both sides, leaving a free premaxilla 
  • Class 7: Submucous cleft in which the muscle union is imperfect across the soft palate
498

List 4 environmental risk factors. 

*Any 4 from the following list

  • Tobacco use
  • Alcohol consumption
  • Teratogenic agents: phenytoin, vitamin A, corticosteroids, drugs of abuse
  • Maternal age > 40
  • Diabetes diagnosis prior to pregnancy
  • Inadequate diet: vitamins especially folic acid deficiency
  • Lack of adequate prenatal care  
498

What facial deformities are associated with cleft lip and/or palate? 

* Must state all three: 

  • Depression of the nostril on the side with the cleft lip
  • Deficiency of upper lip which may be short or retroposed
  • Over-prominent lower lip
498

What factors influence dental biofilm accumulation?

  • Irregularly positioned teeth 
  • Inability to keep lips closed
  • Mouth breathing 
  • Difficulties in accomplishing adequate personal oral care especially around the cleft area
498

What aspects are included in documentation of care provided?

  • Description of location, classification, and extent of cleft
  • History and status of surgical interventions
  • Missing teeth and related recommendations for self-care regimens
  • Descriptions of prosthetic appliances and recommendations for daily care regimens
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