EC Paediatrics

Introduction: Cleft lip and palate being most common in congenital deformity and also present with many syndrome conditions. Child with CL/P face difficulty in early breast feeding due to improper lip seal and nasal regurgitation, thus compromising nutrition of new born. Oral cleft patients with a palatal fistula showed a significantly higher incidence of poor oral hygiene. This could be due to the tenacious nature of the nasal fluid, which drains into the oral cavity and consequently promotes the adherence of plaque to the teeth. Obturators given before cleft palate surgery can act as a barrier for nasal contamination entering to oral cavity apart from its use for feeding.

Materials and methods: 15 cleft lip and palate children were selected and obturator was given one week prior to saliva collection. saliva was collected using sterile wooden spatula before and after the obturator placement after performing hygiene by immersion in commercially available mouthwash (Belleric Myrobalan, Betel, Meswak). Optical Density (OD) measured using spectrophotometric method.

Results: The mean Optical Density of saliva before obturator placement was 0.138 ± 0.031 and after the placement was 0.070 ± 0.033. There was a significant difference in mean optical density values before and after obturator placement (p-value < 0.001).

Conclusion: The findings of the study shows that the OD due to the bacterial load after obturator placement and practice of obturator hygiene is significantly lower and hence obturator can act not only as a feeding plate but it also helps in preventing the passage of nasal and pharyngeal contamination to oral cavity.

 Keywords: Cleft Lip and Palate; Obturators; Oral Hygiene; Oral Feeding Appliances

1. Takemura Hiroshi., et al. "Correlation of cleft type with incidence of perioperative respiratory complications in infants with cleft lip and palate”. Pediatric Anesthesia7 (2002): 585-588.
2. Cheng Lam L., et al. "Predisposing factors to dental caries in children with cleft lip and palate: a review and strategies for early prevention”. The Cleft Palate-Craniofacial Journal1 (2007): 67-72.
3. Turner S Rumsey., et al. "Psychological aspects of cleft lip and palate”. The European Journal of Orthodontics4 (1998): 407-415.
4. Park Joon Soo., et al. "Oral health-related quality of life changes in children following dental treatment under general anaesthesia: a meta-analysis”. Clinical Oral Investigations8 (2018): 2809-2818.
5. Rathee M., et al. "Role of feeding plate in cleft palate: Case report and review of literature”. Internet Journal of Otorhinolaryngology 1 (2010): 1.
6. Paradise Jack L., et al. "The universality of otitis media in 50 infants with cleft palate”. Pediatrics 1 (1969): 35-42.
7. Kuijpers-Jagtman., et al. "History of neonatal maxillary orthopedics: past to present”. Cleft Lip and Palate. Berlin, Heidelberg: Springer Berlin Heidelberg (2006): 395-407.
8. Naik Amit Vinayak and Ranjana C Pai. "A study of factors contributing to denture stomatitis in a north Indian community”. International Journal of Dentistry (2011): 589064.
9. Felton David., et al. "Evidence‐based guidelines for the care and maintenance of complete dentures: A publication of the American College of Prosthodontists”. Journal of Prosthodontics: Implant, Esthetic and Reconstructive Dentistry1 (2011): S1-S12.