Pediatric dental management in patients with orofacial clefts

Pediatric dentistry is a specialty that provides comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health-care needs. For patients with orofacial clefts, it is important to integrate the role of pediatric dentist with health-care providers on the cleft team. Dental caries is the most common preventable disease. Aberrations of dental development in children with CL/P can include hypoplastic teeth, missing teeth, supernumerary teeth, peg laterals, microdonts, delayed dental development, malpositioned teeth, ectopic eruption, and malocclusion. Some of these anomalies will require pediatric dental management during a patient's life. The goals of the minimally invasive dentistry philosophy are to preserve natural tooth tissue for as long as possible by not removing enamel and dentin tissue unnecessarily and by supporting remineralization of demineralized enamel and dentin. Communication and coordination with the cleft and craniofacial team will allow an understanding of comprehensive cleft/craniofacial needs, especially surgical and orthodontic timing.