Dental experience of cleft affected children in the west of Ireland

Aim: To investigate caries experience and initial access to dental services in a group of children with cleft lip/palate in the west of Ireland. Desig n and method: Cross sectional study with prospective data capture and match ed control. Details of children born with a cleft were obtained from all he alth professionals likely to be involved in delivering care to these childr en. Existing databases were cross-referenced to eliminate duplication or mi ssed patients. A matched control sample was recruited from 14 schools in th e region. Results: A sample of 90 cleft affected children (48 male, 42 fema le) with any category of cleft born between 1980-1996 (i.e. 16 years) was c ompared with a control group of 100 non cleft children (60 male, 40 female) . The DMF index was determined by a trained and calibrated clinician. Twent y-two percent (n = 20) of the cleft group were caries free compared to 41% (n = 41) in the control group. The combined dmf/DMF for the cleft group was 2.09 compared to 1.50 for the control (P < 0.05). Separate analysis of the dmf and DMF between the two groups indicated that the difference lay in th e caries found in the deciduous dentition of the cleft group. The first den tal visit was at 4 years of age for the cleft group. Conclusions: Cleft aff ected children in the region did not receive adequate and regular dental ca re at the appropriate time. In view of the significantly greater risk of de ntal disease in clefting, particularly in the deciduous dentition, all clef t affected children should be referred for comprehensive and continued prev entive dental care from the first year of life.