Dental Caries, Oral Hygiene, and Oral Clearance in Children with Craniofacial Disorders

The reason that children with cleft palates tend to have a greater prevalence of tooth decay than normal children is unclear. We hypothesized that children with cleft palates would have increased oral clearance times for foods and, consequently, higher levels of caries and caries-associated micro-organisms than control children. Children aged 6–16 yrs, with (n = 81) or without (n = 61) cleft palates, were studied. Children with cleft palates had DMFT and dmft scores greater (p < 0.01) than those of the control group. The number of caries-associated organisms was greater in the saliva of the cleft palate children (all p < 0.001). The oral hygiene, plaque and gingival index scores were greater (p < 0.0001), oral clearance was longer (p < 0.01), and levels of sucrose and starch-derived saccharides higher (p < 0.01) in the cleft palate group. However, salivary concentrations of organic acids were lower in the children with craniofacial disorders, probably reflecting the altered physiology of the more mature dental biofilm. The longer oral clearance times of foods and the consequent generation of fermentable sugars from starches may contribute to the higher caries prevalence observed in children with cleft palates.

[1]  D. Birkhed,et al.  Oral sugar clearance and root caries prevalence in rheumatic patients with dry mouth symptoms. , 1992, Caries research.

[2]  L. Birkenfeld,et al.  Clearance and Metabolism of Starch Foods in the Oral Cavity , 1999, Annals of Nutrition and Metabolism.

[3]  J. van Limbeek,et al.  Incidence of dental caries in the primary dentition in children with a cleft lip and/or palate. , 1997, Caries research.

[4]  J. van Limbeek,et al.  Increased caries prevalence in 2.5-year-old children with cleft lip and/or palate. , 1996, European journal of oral sciences.

[5]  J. van Limbeek,et al.  Prevalence of Streptococcus mutans and Lactobacilli in 18-Month-Old Children with Cleft Lip and/or Palate , 1996, The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association.

[6]  J. W. Jones,et al.  Epidemiology of facial clefting. , 1985, Archives of disease in childhood.

[7]  S. Socransky,et al.  Dental biofilms: difficult therapeutic targets. , 2002, Periodontology 2000.

[8]  L. Zoitopoulos,et al.  Dental caries and caries-associated micro-organisms in the saliva and plaque of 3- and 4-year-old Afro-Caribbean and Caucasian children in south London. , 1996, Archives of oral biology.

[9]  R. Bedi,et al.  Caries experience and oral health behavior in Chinese children with cleft lip and/or palate. , 2001, Pediatric dentistry.

[10]  W. Edgar,et al.  Acid production in plaques after eating snacks: modifying factors in foods. , 1975, Journal of the American Dental Association.

[11]  D. Birkhed,et al.  Oral glucose clearance in nonagenarians in relation to functional capacity, medication and oral variables. , 1997, Gerodontology.

[12]  N. Lang,et al.  Periodontal conditions in adolescents with cleft lip, alveolus and palate following treatment in a co-ordinated team approach. , 1985, Journal of clinical periodontology.

[13]  C. Tsai,et al.  Caries prevalence and bottle-feeding practices in 2-year-old children with cleft lip, cleft palate, or both in Taiwan. , 1999, The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association.

[14]  D. Birkhed,et al.  Oral sugar clearance and other caries-related factors in patients with myotonic dystrophy. , 1997, Acta odontologica Scandinavica.

[15]  H Löe,et al.  The Gingival Index, the Plaque Index and the Retention Index Systems. , 1967, Journal of periodontology.

[16]  V. Singhal,et al.  The effects of lactation education and a prosthetic obturator appliance on feeding efficiency in infants with cleft lip and palate. , 2001, The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association.

[17]  S. Kashket,et al.  Accumulation of Fermentable Sugars and Metabolic Acids in Food Particles that Become Entrapped on the Dentition , 1996, Journal of dental research.

[18]  T. Grenby,et al.  Properties of maltodextrins and glucose syrups in experiments in vitro and in the diets of laboratory animals, relating to dental health , 2000, British Journal of Nutrition.

[19]  T. Modéer,et al.  Caries, gingivitis, and dental abnormalities in preschool children with cleft lip and/or palate. , 1989, The Cleft palate journal.

[20]  V. Clerehugh.  Oral health surveys: Basic methods, 3rd edition , 1989 .

[21]  J. Sandy,et al.  Dental experience of cleft affected children in the west of Ireland. , 2001, International dental journal.

[22]  G. Luke,et al.  Human Salivary Sugar Clearance after Sugar Rinses and Intake of Foodstuffs , 1999, Caries Research.

[23]  G. Roberts,et al.  Dental Health Indices and Caries Associated Microflora in Children with Unilateral Cleft Lip and Palate , 2000 .

[24]  G. Svensäter,et al.  Dental plaque mass and acid production activity of the microbiota on teeth. , 2000, European journal of oral sciences.