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Oral Health Fact Sheet for Medical Professionals
Children with Cleft Lip and Palate
Cleft lip is a congenital defect in the upper lip where the maxillary prominence fails to merge with
the merged medial nasal prominence; thought to be caused by faulty migration of the mesoderm in the
head region. It can include cleft palate that is a congenital fissure of the soft and/or hard palate,
due to faulty fusion (ICD 9 code 749)
Oral Manifestations and Considerations
• Congenitally missing teeth
• Supernumerary teeth
• Malformed teeth
• Fistulas may be obturated
• Ectopic eruption of primary maxillary anterior dentition
Other Potential Disorders/Concerns
• Many conditions may have an associated cleft
• Understanding the condition is critical to dental management of the patient
Oral Side Effects of Commonly Prescribed Medications
• Persons with clefts may have other conditions for which they need medication, but typically no special
medications are taken.
Parent/Caregiver Support and Guidance
• Surgical scarring may limit mobility of maxillary lip and vestibule. Advise caution when manipulating
this area.
• Discourage consumption of cariogenic foods and beverages.
• Prescribe sugar-free medications, if available.
• Recommend preventive measures such as topical fluoride and sealants.
• Advise the use of fluoridated toothpaste twice daily and support the family in following dental care
• Instruct caregiver on appropriate protocol following dental trauma (locate/preserve missing tooth and put
in cold milk; seek immediate professional care).
• Review safety issues appropriate to the age of the child, such as mouth guards to prevent oral-facial trauma.
• Recommend rinsing with water thoroughly after taking each dose of sugar containing medication and
frequent water intake for patients taking xerostomic medication.
• Discuss habits that may harm the child’s teeth such as propping baby bottles, putting child to bed with bottle.
Additional information: Special Needs Fact Sheets for Providers and Caregivers
Children with Cleft Lip and Palate continued
• Policy on management of patients cleft lip/palate and other craniofacial anomalies. Pediatr Dent. 20082009;30(7 Suppl):238-9. American Academy on Pediatric Dentistry Clinical Affairs Committee; American
Academy on Pediatric Dentistry Council on Clinical Affairs.
• Reisberg, D.J, Dental and Prosthodontic Care for Patients With Cleft or Craniofacial Conditions, Cleft
PalateCraniofac J:2000Nov; 37 (6): 534–537. Review.javascript:PopUpMenu2_Set(Menu19216429);
• Precious, D.S, Goodday, R.H, Morrison, A.D,. Davis, B.R. Cleft lip and palate: a review for dentists. J Can
Dent Assoc. 2001 Dec;67(11):668-73. Review
• Rivkin, C.J, Keith, O, Crawford, P.J, Hathorn, I.S. Dental care for the patient with a cleft lip and palate. Part 1:
From birth to the mixed dentition stage. Br Dent J. 2000 Jan 22;188(2):78-83. Review.
• Rivkin, C.J, Keith, O,, Crawford, PJ, ,Hathorn, I.S. Dental care for the patient with a cleft lip and palate. Part 2:
The mixed dentition stage through to adolescence and young adulthood. Br Dent J. 2000 Feb 12;188(3):131-4.
Additional Resources
• NIH Institute for Cleft Lip and Palate
• Special Care: an Oral Health Professionals Guide to Serving Young Children with Special Health Care Needs
• Bright Futures Oral Health Pocket Guide
• American Academy of Pediatrics Oral Health Initiative
• American Academy of Pediatric Dentistry: 2011–2012 Definitions, Oral Health Policies and Clinical
• MCH Resource Center
• ASTDD-Special Needs
• Block Oral Disease, MA
• NOHIC-NIDCR publications
DOH 160-047 March 2012
Permission is given to reproduce this fact sheet.
Oral Health Fact Sheets for Patients with Special
Needs © 2010 by University of Washington and
Washington State Oral Health Program
Fact sheets developed by the University of Washington DECOD
(Dental Education in the Care of Persons with Disabilities) Program
through funding provided to the Washington State Department of
Health Oral Health Program by HRSA grant #H47MC08598).
For persons with disabilities, this document
is available on request in other formats.
To submit a request, please call
1-800-525-0127 (TTY/TDD 1-800-833-6388).