Clefts of the lip and palate (CLP) are amongst the commonest craniofacial anomalies
encountered by clinicians. Compared to many other anomalies, CLP is easily diagnosed
and described. Due to this, it has been one of the most intensively studied congenital
malformation worldwide. Anomalies of the face give rise to considerable morbidity
which is psychologically traumatic to the parents. Thus the need to study the oral health
status of children with cleft lip/palate (CLP) in a section of a Kenyan population.
Type of study: A descriptive comparative cross-sectional study.
Methods: A total of 89 children were clinically examined, 49 formed the study group
(children with clefts) and 40 were the control group (children without clefts) ; age range,
2 to 15 years. Factors such as plaque, gingivitis, caries, missing teeth and stage of the
dentition were recorded.
Setting: Nairobi, Kenya.
Results: Out of the 49 children in the study group, 55% had CLP and 33% had CLA
while 6%had isolated CL. The prevalence of plaque was 96.27% in the 'study group while
among the control group this was lower at 89.5% (p<0.05). This was reflected by the
significant difference observed in the frequency of tooth brushing (x211.564 l df
p=O.OOI). Children with clefts had a significantly increased number of units with
gingivitis ranging from 79.2% for tooth 16 (p=0.04) to 51.6% for tooth 52 (p =0.264),
although not statistically significant in the latter.
The prevalence of caries in the study group was 11.8% (95% CI; 9.8%-13.8%) and the
control group was 8% (95% CI; 6.2%-9.8%). This difference was significant (p<0.05).
These children also showed an increased number of carious teeth in the posterior
segments ranging from 16.7% for tooth 16 (p>O.05) to 41.2% for tooth 46 (p>O.05),
while in the deciduous dentition it ranged from 22.6% for tooth 61 (p>O.05) to 36.7% for
tooth75 ( p>O.05)and was not significant. The children with clefts also showed generally
delayed eruption in both the permanent and the deciduous dentitions. This was significant
for the lateral incisors in the deciduous dentition (pO.05).
Conclusions: Children with clefts had generally poor oral hygiene and gingival health
with an increased number of carious teeth compared to children without clefts. These
children should be considered to have an increased risk of developing dental diseases and
therefore,will require stringent oral hygiene instructions and regular reviews by dental
professionals. Their treatment should involve preventive and curative services in order to
maintain healthy primary and permanent dentitions.