Helping Those With Orofacial Clefts

I’m often asked how I think of topics for my Editor’s Note. Sometimes, the topics seem to flow freely, while others require more time to think of something interesting. As I recently sat down to write, I received a notice that my monthly donation to a charity supporting the treatment of orofacial clefts had been posted. Wow, talk about a sign!

July is National Cleft and Craniofacial Awareness and Prevention Month. The American Cleft Palate-Craniofacial Association (ACPA) estimates that one in six newborns is affected by cleft lip and/​or cleft palate at birth. This makes cleft lip and/or palate one of the most common birth defects in the United States.¹ A specific cause is not known, but the majority of cleft lip and/or palate anomalies appear to be due to genetic or environmental conditions. The US Centers for Disease Control and Prevention has identified the following as risk factors for developing an orofacial cleft:²

• Smoking―Smoking during pregnancy raises the risk for delivering a baby with cleft lip and/​or palate.
• Diabetes―Pregnant women with diabetes are more likely to have a baby with cleft lip and/​or palate than those without diabetes.
• Use of epilepsy medication―The use of some medications to treat epilepsy during the first trimester of pregnancy increases the risk of having an infant with cleft lip and/​or palate.

While the oral ramifications of cleft lip and/or palate are obvious to any oral health professional, there are additional impacts, such as malnutrition, which can lead to starvation; ear infections, which can lead to hearing loss; and impaired speech and language development. Feeling isolated and experiencing bullying are also concerns. Surgery can treat these conditions quite effectively if performed at optimum times. For cleft lip, that period is prior to 12 months. For cleft palate, surgery should be performed between the ages of 12 months and 18 months.

As with many health conditions that have varied and numerous underlying factors, a team approach to treatment is recommended. The ACPA website lists a care coordinator, speech-language pathologist, orthodontist, and surgeon as important team members. Additional key health care professionals are audiologists, nurses, social workers, and pediatricians. Dental hygienists would be vital additions to the team as well! With ACPA-approved teams in nearly every state and around the globe, the opportunities for dental hygienists to participate in the care and education of patients with orofacial clefts are enormous. As we see expanding scopes of practice for dental hygienists in the medical community, serving on orofacial cleft treatment teams seems like a perfect addition to our role in improving the health of the public.

Jill Rethman, RDH, BA
Editor in Chief
jrethman@belmontpublications.com

REFERENCES

1. American Cleft Palate-Craniofacial Association. Introduction to Cleft and Other Craniofacial Injuries. Available at: cleftline.org/family-resources/introduction-to-cleft-craniofacial-conditions/​. Accessed June 1, 2019.
2. United States Centers for Disease Control and Prevention. Facts About Cleft Lip and Cleft Palate. Available at: cdc.gov/ncbddd/birthdefects/cleftlip.html. Accessed June 1, 2019.

From Dimensions of Dental Hygiene. July/August 2019;17(7):6.