The prospects of children born with cleft lips and/or palates have improved tremendously over the last few decades. What was once a disfiguring and lifelong deformity, associated with a raft of medical problems and complications, can now be treated and repaired to the point where the child can live a normal life—the most modern surgical techniques can repair the palate and lip to the point where no sign of initial deformity is detectable. However, this kind of corrective surgery can not be undertaken straight away. Every child's case is different, with its own set of symptoms and restrictions on treatment; combine this with the ever-present waiting lists for non-emergency surgery, and it could be months or years before a child's series of corrective surgeries starts.

Until that time comes, caring for the dental health of a child with a cleft palate is a priority. Naturally, the unusual formation of the gums and teeth present some specific problems, unique to every child's individual case, but there are also less obvious concerns. If your child has a cleft palate deformity, or you are in any way involved in caring for the child, you will probably already be consulting with a range of doctors and specialists (such as Hopkins Street Dental) on proper care and treatment, but here are a few basic guidelines to dental care in the early stages of a child's development.

The Pre-Teething Stage

• At this stage, your primary concern is with proper feeding - babies with cleft lip and/or palate naturally have some difficulty learning to breastfeed and eventually eat solid food properly, and you should be offered help and advice on how to feed a child safely at a very early stage. When feeding with baby food or other soft solids, pay close attention to make sure no food enters an exposed nasal passage, where it can cause choking, or other cavities in the palate where it can rot and cause serious infection.
• Most dentists recommend an paediatric appointment be scheduled around the child's first birthday (earlier if there are immediate signs of dental malformation) and even if your child has not started teething by this point, a dentist can make a detailed evaluation of how the child's teeth will come in, and steps that might need to be taken to correct them.

The Teething Stage

• At the aforementioned dental evaluation, the dentist may detect one of a number of problems that children with cleft palates are susceptible to, such as abnormal positioning, missing teeth, overlapping or crowded teeth, or even 'twinning' of teeth around the cleft palate. Your child may have to undergo extractions or fillings at this early stage, so make sure to provide proper aftercare according to the dentist's instructions.
• Besides this, you should conduct all the same procedures you would to look after the teeth of an unaffected child, using a small, soft-bristled brush to clean teeth as soon as they erupt from the gum line. Be careful not to let the child inhale or swallow toothpaste foam.
• Children with cleft palates are statistically more vulnerable to dental cavities. You can help prevent this by not feeding the child excessive amounts of sweet, sugary foods, and cleaning after meals. Do not over-clean or brush too hard, as this may cause gum damage or recession.

Regarding Post-operative Care

• You may be concerned about helping a child clean their teeth soon after corrective surgery, but dentists and nurses can provide you with guidelines on how to avoid aggravating post-operative scarring. Do not neglect everyday dental hygiene for fear of causing damage, as it may result in infection.
• If the child has had artificial teeth implanted to replace removed or missing ones, they should be cared for in the same way as natural teeth. However, you should also check for signs of unusual swelling, discolouration or pain around the gum and jaw line of the new teeth, as this may be a sign of infection, rejection or incorrect surgical insertion.