Caring for children with cleft lip and palate is a long-term task that requires specialized attention from a pediatric dentist. The first step in providing care for these children is to establish a “dental home” where medical records can be reviewed on a regular basis and an interdisciplinary approach can be administered. The pediatric dentist should assess the child's risk of tooth decay, provide preventive dental care, and offer nutritional counseling. Depending on team protocols, orthodontists and pediatric dentists may coordinate care with the plastic surgeon to use maxillary devices, active or passive, extraoral or intraoral.
These devices are designed to provide force that alters the relationships between hard and soft tissues. The pediatric dentist may also use a stone molded from an impression of the cleft of the upper jaw to construct palatine appliances. This is done to help stabilize the posterior maxillary alveolar segments and allow the segments of the anterior cleft to rotate or “mold” around an acrylic structure. Additionally, the pediatric dentist should provide parents with guidance on dental care and answer any questions they may have.
Dr. Pratibha Kukreja Pandit, a board-certified pediatric dentist who focuses especially on children with special needs, points out that difficulties in brushing their teeth often arise when the upper permanent incisors come out due to the lack of depth of the groove and the stiffness of the repaired lip. The best pediatric dentist will guide your child's oral health, care and development over the years. The coordination of periodic check-ups by the pediatric dentist and the adjustment of orthopedic appliances by the orthodontist can minimize trips to urban centers and reduce overall care time.
It is important for parents to understand that all their questions and concerns are prioritized in team care.