ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Non-Syndromic Patients With Cleft Lip And/Or Palate (CLP) Tend To Have Higher Caries Prevalence Than Non-CLP Patients
Clinical Question In patients with non-syndromic cleft lip/cleft palate, is there greater predisposition to caries than in non-CL/P patients?
Clinical Bottom Line Non-syndromic patients with cleft lip and/or palate tend to have higher caries prevalence than non-CLP patients. This is supported by a meta-analysis of several cross-sectional trials in which the decayed, missing, and filled (DMF) index was significantly higher for CLP patients than non-CLP patients. This would suggest that dentists should factor in CLP while determining caries risk status for patients.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 23652859Antonarakis/2013474 CLP patients aged 1.5-29 years and matched non-CLP controls in 7 included studiesMeta-Analysis
Key resultsIn the permanent dentition, patients with CLP displayed a higher DMF index than non-CLP patients (mean difference 1.83, p=0.003). Deciduous dentition also displayed a higher DMF index in patients with CLP than in non-CLP patients (mean difference 1.51, p=0.03).
Evidence Search ("Dental Caries"[Mesh] AND "Cleft Lip"[Mesh]) AND "Cleft Palate"[Mesh]
Comments on
The Evidence
The evidence is a meta-analysis of several cross-sectional studies after an extensive literature search. There was a large patient pool in the included studies (n=474), and the initial individual studies were pared down (from 592 to 7 articles) based on eligibility criteria to include the best possible evidence. Four of the studies were assessed to be of good quality, two of medium, and one of poor quality. Overall, the evidence is sound in suggesting the caries risk of patients with non-syndromic CLP is higher than the risk in controls without CLP.
Applicability The evidence is very valuable to general and pediatric dentists as well as orthodontists in assessing the caries risk status of their patients. Focus should be placed on oral hygiene instructions given to the cleft lip/palate patient and parent in order to increase caries prevention. More frequent recall should be in place to ensure proper oral health.
Specialty/Discipline (Public Health) (General Dentistry) (Orthodontics) (Pediatric Dentistry)
Keywords Dental caries, cleft lip, cleft palate, CLP, non-syndromic
ID# 2989
Date of submission: 03/09/2016spacer
E-mail kellypj@livemail.uthscsa.edu
Author Patrick J. Kelly
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Kevin Gureckis, DMD
Faculty mentor/Co-author e-mail gureckis@uthscsa.edu
Basic Science Rationale
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