INCIDENCE OF MUTANS STREPTOCOCCI AND LACTOBACILLI IN ORAL CLEFT CHILDREN WEARING ACRYLIC PLATES FROM SHORTLY AFTER BIRTH

Children with a palatal cleft can be treated with preoperative infant orthopedics including an acrylic plate that is applied shortly after b irth to obturate the cleft. It is advised to wear these plates until t he 18th month of age. Such a plate, being a hard non-shedding surface, may be expected to facilitate early colonization of mutans streptococ ci. The first aim of the present investigation was to assess the incid ence of mutans streptococci and lactobacilli in children with cleft li p and/ or palate during the first 2 years of life. The second aim was to study whether preoperative orthopedics, that is, the wearing of an acrylic plate, had facilitated the establishment of mutans streptococc i and lactobacilli. The third aim was to determine other factors assoc iated with colonization of these organisms in these children. Sixty-tw o Caucasian Dutch children with cleft lip and/or palate participated i n this study. Twenty-four of these children were treated with preopera tive infant orthopedics and had been wearing an acrylic plate from wit hin a few days after birth. At regular control visits plaque and saliv a samples and samples from the surface of the acrylic plate were taken , while a dental examination was performed to document the emergence o f the primary teeth, caries status, gingival condition and oral hygien e procedures. Saliva samples were also taken from the accompanying par ents. At the visit at the age of 18 months, the parents were interview ed using a structured questionnaire. At this age, the prevalence of mu tans streptococci and lactobacilli was compared to that in a control g roup of non-cleft children. The oral cleft children wearing an acrylic plate from shortly after birth were colonized earlier with mutans str eptococci and lactobacilli than the non-plate oral cleft children. In the children wearing acrylic plates, the prevalence of lactobacilli de creased with age, while the prevalence of mutans streptococci increase d. At the age of 18 months the prevalence of mutans streptococci was c omparable in both groups of oral cleft children and in the control chi ldren. There was no relation between the numbers of mutans streptococc i in the saliva of the mothers and their children. The presence of mut ans streptococci in the saliva of the oral cleft children was signific antly associated with between-meal snacking and with the presence of l actobacilli.