Teeth for unilateral cleft lip and palate
Development of the teeth
Dental care
Orthodontic treatment
Development of the teeth
Milk teeth
On average the first milk teeth come through from the sixth month after birth. A full set of milk teeth is in place around the age of 2½ or 3 years. Children with a unilateral or bilateral cleft in the upper jaw usually have dental abnormalities.
These abnormalities vary considerably:
there may be too many or too few teeth - the shape of the teeth may be abnormal: too small or too big
- the teeth may sometimes be blocked and may therefore not come through by themselves.
- the teeth may also be rotated or may come through crooked.
- the shape of the dental arch is often abnormal in these children. The dental arch may be interrupted in the area of the cleft and usually has a peaked shape
- often the upper jaw (maxilla) is relatively underdeveloped in comparison with the lower jaw (mandible). These children therefore often have a reversed relationship between their jaws.
Mixed dentition
From the child’s sixth birthday, permanent teeth begin to come through. The milk teeth are replaced and the permanent teeth come through. When the new teeth come through the same dental abnormalities may occur as with the milk teeth. The permanent teeth seem more abnormal because they are larger. The transition is not as smooth as usual. The abnormal relationship between the jaws may become more pronounced as the children grow: both sideways and front to back.
Permanent teeth
On average all permanent teeth have come through by the age of about 12 to 14 years. From then on, abnormalities in the positioning of the jaws and teeth can be finally assessed.
Dental care
Children with a unilateral cleft lip and palate usually have a number of dental abnormalities:
- there may be too many or too few teeth
- they may come through in an abnormal position
- they may have an abnormal shape
Since these children will need orthodontic treatment later, it is very important to keep their teeth and gums healthy. This applies to both milk teeth and permanent teeth.
What can you do as a parent?
- As soon as the first milk teeth come through, you must care for them well.
- Brush daily using a small toothbrush (“baby toothbrush”) with a little infant toothpaste
- Do not allow your child to get used to sweet things, do not give sweet drinks or soft drinks in the feeding bottle and definitely do not let your child go to sleep with a bottle. A dummy with a sweet taste on it (such as honey) is definitely bad for their teeth!
- Fluoride reduces the likelihood of dental caries. In the past it was often given in the form of fluoride tablets. Now it is known that applying small amounts of fluoride on a regular basis is most effective. You should therefore brush using a toothpaste that suits the child’s age.
- Allow your child to get to know your own dentist from the age of 3 so that they can develop a good relationship. It is recommended to have a check-up every six months. Your dentist will advise you on the best ways to clean teeth in difficult positions. He will also clean the teeth professionally.
- Particularly when wearing a brace or brackets the dentist will monitor your child's oral hygiene. Otherwise there is a very high risk of dental caries and serious gum disease.
- The dentist can also apply preventative sealing if there are abnormal shapes or deep grooves. He will treat any cavities if necessary. In this way premature tooth loss can be prevented. The dentist will correct permanent teeth that have enamel defects or abnormal shapes. Usually this treatment will be provided in consultation with the dentist from the cleft lip and palate team.
- If dental care or extractions cannot be carried out by your own dentist, the dentist from the cleft lip and palate team will talk to your dentist and the other members of the team to find the best treatment option. This may be combined with another operation under general anaesthetic or light sedation.
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