Preoperative dental treatment for children with cleft lip and palate

Abstract

Introduction: Children with cleft lip and palate present diverse risk factors to dental caries and some differentiated needs concerning the dental treatment. This paper will describe the stages of definitive dental treatment before cheiloplasty, aiming at oral health adequacy for a child with cleft lip and palate. Material and methods: The paper will present a literature review with emphasis on the dental particularities and risk factors, including a case report to illustrate the preoperative dental treatment required before primary repair surgeries. Results and discussion: The male boy of African descent first attended HRAC-USP at the age of eight years, without previous treatment, presenting complete right cleft lip and palate. The intraoral clinical examination revealed presence of seveal carious lesions and need of extractions. The dental treatment planning comprised several sessions and was initiated by pediatric dental management, followed by anmalgam and glass ionomer restorations and tooth extractions, beginning by regions with smaller lesions and where local anesthetics causes less discomfort. The anterior teeth close to the cleft area were extracted under general anesthesia immediately before cheiloplasty. Conclusion: The definitive preoperative dental treatment with complete removal of carious tissue is fundamental for patients with cleft lip and palate, because dental caries is an infectious disease and, if present, it may contaminate the primary surgery and even compromise its outcomes.