Cleft Care India Study: A National Audit on Patients with Non-Syndromic Unilateral Cleft Lip and Palate Patients. Part 2: Oral Health Outcomes.

Background

Oral health is a critical yet often neglected component of cleft care. Individuals with cleft lip and palate (CLP) are predisposed to a higher risk of dental caries and poor oral hygiene due to anatomical, functional, and behavioral challenges. Despite national public health efforts, limited data exist from India on the oral health status of this vulnerable group.

Objective

To evaluate the oral health status of 5, 12, and 20 year olds, non-syndromic unilateral cleft lip and palate (UCLP) patients regarding history of dental care and present dental status.

Methods

This multicentric cross-sectional study, conducted as part of the Cleft Care India Study (CCIS), evaluated oral health parameters in individuals with non-syndromic UCLP across 14 cleft centers in India. Patients were assessed for various parameters of oral hygiene practices through a standardized data collection form. Descriptive statistics were used to report the results across the 3 age groups.

Results

Of the 296 UCLP patients, 36% of 5 year olds, 41% of 12 year olds, and 29% of 20 year olds had never visited a dentist. Mean dmft/DMFT for 5 year olds was 5.6, for 12 year olds was 3.4 and for 20 year olds was 3.0. Data on active caries showed 53% of 5 year olds, 34% of 12 year olds, and 14% of 20 year olds had untreated caries. Data on plaque levels showed 47%, 60%, and 76% of 5, 12 and 20 year olds had visible deposits. The prevalence of enamel hypoplasia was highest in 5 year olds (32%), and hypodontia was most common in 20 year olds (52%). Around 70% of 5 year olds, 75% of 12 year olds, and 80% of 20 year olds had never visited a pediatric dentist.

Conclusion

The findings highlight a substantial unmet need for dental care among Indian patients with UCLP. Channelized referral systems and service centralization could reduce this care burden. Integrating pediatric dental services within cleft care teams is essential for improving oral health outcomes in this high-risk population.