Early childhood caries prevalence among children with cleft lip and palate at padjadjaran university dental hospital

Julia Thrisna Silvyani    -  Padjadjaran University, Indonesia
Asty Samiaty Setiawan*  -  Padjadjaran University, Indonesia
Fidya Meditia Putri  -  Padjadjaran University, Indonesia

(*) Corresponding Author

Background: Cleft lip and/or palate (CL/P) is a congenital abnormality that can be a risk factor for Early Childhood Caries (ECC). ECC is caries that occur in children aged 0-71 months. Poor oral hygiene often found in CL/P patients due to anatomic defects, treatment devices, and surgical scars that can facilitate the colonization of Streptococcus mutans and Lactobacilli as caries-causing bacteria. This study aims to determine the prevalence of ECC in children with CL/P aged 2-6 years at Padjadjaran Univeristy Dental Hospital from 2018 - June of 2021.
Method: The study used a descriptive observational method with a cross-sectional approach. The data used is secondary data which is CL/P patients aged 2-6 years medical records at Padjadjaran University Dental Hospital from 2018 until June 2021. The sample obtained using total sampling is 102.
Result: The prevalence of ECC in children with CL/P was 46.08%. Unilateral complete palatognatoschizis was the most found CL/P cases (49.02%), including patients with ECC (21.57%). Male is the most common gender in this study (62.75%) also the gender with the most ECC (28.43%). Most children aged 13-24 months (66,67%), while 25-60 months (22,55%) had the highest ECC cases. Most of the CL/P patients came from West Java (95.10%), including patients with ECC (43.14%)
Conclusion: Children with CLP have a high risk of caries, regardless in this study, the prevalence was not that high. Although, there are still a hefty amount of children who experience ECC. Oral hygiene must be a concern of parents from an early age to prevent ECC.

Keywords: Prevalence; ECC; cleft lip; cleft palate; oral cleft

  1. McGuire E. Cleft lip and palates and breastfeeding. Breastfeeding Review. 2017;25(1):25–30.
  2. Crockett DJ, Goudy SL. Cleft lip and palate. Facial Plast Surg Clin North Am. 2014;22(4):573–84.
  3. Prabhu S, Krishnapillai R, Jose M, Prabhu V. Etiopathogenesis of orofacial clefting revisited. J Oral Maxillofac Pathol. 2012;16(2):228–32.
  4. Kemenkes RI. InfoDATIN: Kelainan bawaan. Pusat Data dan Informasi Kemeterian Kesehatan RI. 2018;1–6.
  5. Badan Penelitian dan Pengembangan Kesehatan RI. Laporan nasional riset kesehatan dasar 2018. Badan Penelitian dan Pengembangan Kesehatan. Jakarta; 2018. 433–440 p.
  6. Weraarchakul, Wilawan WW. Dental Caries in Children with Cleft Lip and Palate. Journal Medical Association Thai. 2017;100(6):131–5.
  7. Tinanoff N, Baez RJ, Diaz Guillory C, Donly KJ, Feldens CA, McGrath C, et al. Early childhood caries epidemiology, aetiology, risk assessment, societal burden, management, education, and policy: Global perspective. Int J Paediatr Dent. 2019;29(3):238–48.
  8. Cheng LL, Moor SL, Ho CTC. Predisposing factors to dental caries in children with cleft lip and palate: A review and strategies for early prevention. The Cleft Palate-Craniofacial Journal. 2007;44(1):67–72.
  9. Worth V, Perry R, Ireland T, Wills AK, Sandy J, Ness A. Are people with an orofacial cleft at a higher risk of dental caries? A systematic review and meta-analysis. Br Dent J. 2017;223(1):37–47.
  10. American Academy of Pediatric Dentistry. Policy on Early Childhood Caries (ECC): Classifications, Consequences, and Preventive Strategies, AAPD Reference Manual. 2011;34:12–13.
  11. World Health Organisation. WHO expert consultation on public health intervention against early childhood caries: report of a meeting, Bangkok, Thailand, 26-28 January 2016. REPORT OF A MEETING – Bangkok, Thailand, 26–28 January 2016. 2016;15–20.
  12. Anil S, Anand PS. Early childhood caries: prevalence, risk factors, and prevention. Front Pediatr. 2017;5:1–7.
  13. Congiu G, Campus G, Lugliè PF. Early childhood caries (ECC) prevalence and background factors: A review. Oral Health Prev Dent. 2014;12(1):71–6.
  14. Britton KFM, Welbury RR. Dental caries prevalence in children with cleft lip/palate aged between 6 months and 6 years in the West of Scotland. European Archives of Paediatric Dentistry. 2010;11(5):236–41.
  15. Li MY, Zhi QH, Zhou Y, Qiu RM, Lin HC. Impact of early childhood caries on oral health-related quality of life of preschool children. Eur J Paediatr Dent. 2015;16(1):65–72.
  16. Damiano PC, Tyler MC, Romitti PA, Momany ET, Jones MP, Canady JW, et al. Health-related quality of life among preadolescent children with oral clefts: The mother’s perspective. Pediatrics. 2007;120(2):283–90.
  17. Martins-Júnior PA, Vieira-Andrade RG, Corrêa-Faria P, Oliveira-Ferreira F, Marques LS, Ramos-Jorge ML. Impact of early childhood caries on the oral health-related quality of life of preschool children and their parents. Caries Res. 2013;47.
  18. Yusuf M, Setiawan S, Kusuma ARP. Gambaran Kelengkapan dan Keseragaman Penulisan Odontogram Oleh Dokter Gigi di Kota Semarang. Odonto Journal. 2019;6(1):40–4.
  19. ICD10data.com. Congenital malformations, deformations and chromosomal abnormalities Q00-Q99. 2021.
  20. Williams K, Thomson D, Seto I, Contopoulos-Ioannidis DG, Ioannidis JPA, Curtis S, et al. Standard 6: Age groups for pediatric trials. In: Pediatrics. 2012.
  21. Pimenta L. Management of patients with orofacial clefts. Craniofacial and Dental Developmental Defects: Diagnosis and Management. 2015;1–129.
  22. Khamila N, Nurwiadh A, Putri FA, Sadikin H. Characteristic of cleft lip and palate at cleft center of Padjadjaran University Dental Hospital: 2 Years retrospective study. Jurnal Pendidikan Tambusai. 2022;6(1):1058–64.
  23. de Moura AM, André M, Lopez MT, Dias RB. Prevalence of caries in Brazilian children with cleft lip and/or palate, aged 6 to 36 months. Braz Oral Res. 2013;27(4):336–41.
  24. Freitas ABDA, de Barros LM, Fiorini JE, Boriollo MFG, Moreira AN, Magalhães CS. Caries experience in a sample of adolescents and young adults with cleft lip and palate in Brazil. The Cleft Palate-Craniofacial Journal. 2013;50(2):187–91.
  25. Peterka M, Tvrdek M, Müllerová Ž. Tooth Eruption in Patients with Cleft Lip and Palate. Acta Chir Plast. 1993;35(3–4):154–8.
  26. Tandon S. Textbook of Pedodontics. Manipal: College of Dental Surgery MAHE, a deemed University; 2019. 758–760 p.
  27. Durhan MA, Topcuoglu N, Kulekci G, Ozgentas E, Tanboga I. Microbial Profile and Dental Caries in Cleft Lip and Palate Babies Between 0 and 3 Years Old. The Cleft Palate-Craniofacial Journal. 2018;56(3):349–56.
  28. Kirchberg A, Makuch A, Hemprich A, Hirsch C. Dental Caries in the Primary Dentition of German Children with Cleft Lip, Alveolus, and Palate. The Cleft Palate-Craniofacial Journal. 2014;51(3):308–13.
  29. Ismail M, Abdallha AE. Caries assessment in preschool children in relation to some socioeconomic factors. Advanced Dental Journal. 2022;4(1):61–73.
  30. Xiao W-L, Zhang D-Z, Xu Y-X. The caries prevalence of oral clefts in eastern China. Int J Clin Exp Med. 2015;8(9):16322–7.
  31. Alazmah A. Early childhood caries: A review. Journal of Contemporary Dental Practice. 2017;18(8):732–7.
  32. Berkowitz RJ. Causes, treatment and prevention of early childhood caries: a microbiologic perspective. Journal-Canadian Dental Association. 2003;69(5):304–7.
  33. Correa-Faria P, Martins-Junior PA, Vieira-Andrade RG, Marques LS, Ramos-Jorge ML. Factors associated with the development of early childhood caries among Brazilian preschoolers. Braz Oral Res. 2013;27:356–62.
  34. Bian Z, Holt R, Du M, Jin H, Bedi R, Fan M. Caries experience and oral health behavior in Chinese children with cleft lip and/or palate. American Academy of Pediatric Dentistry. 2001;23(5):431–4.
  35. Johnsen DC, Morris Dixon MD. Dental caries of primary incisors in children with cleft lip and palate. Children. 1984;5(5):5–10.
  36. Mutarai T, Ritthagol W, Hunsrisakhun J. Factors influencing early childhood caries of cleft lip and/or palate children aged 18 to 36 months in southern Thailand. The Cleft palate-craniofacial journal. 2008;45(5):468–72.
  37. Ann Mani S, John J, Yen Ping W, Mastura Ismail N. Early Childhood Caries: Parent’s Knowledge, Attitude and Practice Towards Its Prevention in Malaysia Melaka Manipal Medical College Malaysia. 2012.
  38. Hassani H, Chen J-W, Zhang W, Hamra W. Comparison of Microbial Activity Among Infants With or Without Using Presurgical Nasoalveolar Molding Appliance. The Cleft Palate-Craniofacial Journal. 2020;57(6):762–9.
  39. Chopra A, Lakhanpal M, Rao NC, Gupta N, Vashisth S. Oral health in 4-6 years children with cleft lip/palate: a case control study. N Am J Med Sci. 2014;6(6):266–9.
  40. Cameron; Angus C., Widmer; Richard P. Handbook of Pediatric Dentistry. Fourth. Toronto: MOSBY ELSEVIER; 2013. 396–397 p.
  41. Nagappan, John J. Oral hygiene and dental caries status among patients with cleft lip, cleft palate and cleft lip, alveolus and palate in Chennai, India. J Cleft Lip Palate Craniofacial Anomalies. 2015;2(1):49–52.
  42. Parapanisiou V, Gizani S, Makou M, Papagiannoulis L. Oral health status and behaviour of Greek patients with cleft lip and palate. Eur Arch Paediatr Dent. 2009;10:85–9.
  43. Loi NH, Thai N van. Oral health status of patients with repaired cleft lip and palate: A prospective study. Journal of Clinical Medicine- Hue Central Hospital. 2021;(69):33–40.
  44. Sjamsudin E, Maifara D. Epidemiology and characteristics of cleft lip and palate and the influence of consanguinity and socioeconomic in West Java, Indonesia: a five-year retrospective study. Int J Oral Maxillofac Surg. 2017;46:46–9.
  45. Noorollahian M, Nematy M, Dolatian A, Ghesmati H, Akhlaghi S, Khademi GR. Cleft lip and palate and related factors: A 10 years study in university hospitalised patients at Mashhad--Iran. Afr J Paediatr Surg. 2015;12(4):286–90.
  46. Rittler M, López-Camelo J, Castilla EE. Sex Ratio and Associated Risk Factors for 50 Congenital Anomaly Types: Clues for Causal Heterogeneity. Birth Defects Res A Clin Mol Teratol. 2004;70(1):13–9.
  47. Kuriakose S, Prasannan M, Remya KC, Kurian J, Sreejith KR. Prevalence of early childhood caries among preschool children in Trivandrum and its association with various risk factors. Contemp Clin Dent. 2015;6(1):69–73.
  48. Meyer F, Enax J. Early Childhood Caries: Epidemiology, Aetiology, and Prevention. Abdalla AI, editor. Int J Dent. 2018;2018:14–7.
  49. Ningsih DS. Hubungan Jenis Kelamin Terhadap Kebersihan Rongga Mulut Anak Panti Asuhan. ODONTO Dental Journal. 2015;2:14–9.
  50. Nur Rahman AP, Nugraha Prabamurti P, Riyanti E, Fakultas Kesehatan M. Faktor-faktor yang berhubungan dengan perilaku pencarian Pelayanan kesehatan (Health Seeking Behavior) pada Santri di Pondok Pesantren Al Bisyri Tinjomoyo Semarang. 2016;4:346–56.
  51. Widayanti AW, Green JA, Heydon S, Norris P. Health-seeking behavior of people in Indonesia: A narrative review. J Epidemiol Glob Health. 2020;10(1):6–15.
  52. Handayani L, Siswanto, Ma’ruf NA, Hapsari D. Pola pencarian pengobatan di Indonesia. Bulan Penelitian Kesehatan. 2003;31(1):33–47.
  53. Indonesia Cleft Center: Yayasan Pembina Penderita Celah Bibir dan Langit-Langit. SmileTrain. 2021.
  54. Puteri N, Indah T, Bramanti I. Perbedaan pengaruh perilaku pemeliharaan kesehatan gigi dan mulut antara ibu bekerja dan tidak bekerja terhadap akumulasi plak pada anak prasekolah 5-6 tahun (Kajian di TK Annur III Maguwoharjo Selam Yogyakarta) [minor thesis]. 2017;32–6.
  55. Christiono S, Rama Putranto R. CARIES STATUS EARLY CHILDHOOD CARIES IN INDONESIAN CHILDREN WITH SPECIAL NEEDS : Study In SDLB Central Java. ODONTO Dental Journal. 2015;2(2):1–7.
  56. Notoatmodjo S. Pendidikan dan Perilaku Kesehatan. Edisi 1. Jakarta: PT Rineka Cipta; 2003. 34–50 p.
  57. Rosalina DJ. Perbedaan prevalensi karies gigi dan tingkat keparahan karies gigi pada anak usia 3-5 tahun yang ibunya bekerja dan tidak bekerja. Jurnal Kedokteran Gigi Terpadu. 2021;3(1):63–9.
  58. Lauterstein AM, Mendelsohn DDSM, Chicago DDS. An Analysis of the Caries Experience of 285 Cleft Palate Children. Cleft Palate J. 1964;29:314–90.
  59. Paul T, Brandt RS. Oral and Dental Health Status of Children with Cleft Lip and/or Palate. The Cleft Palate-Craniofacial Journal. 1998;35(4):329–32.
  60. Turner C, Asiya Zagirova D, Larisa Frolova D, Courts FJ, Williams WN. Oral health status of Russian children with unilateral cleft lip and palate. The Cleft Palate-Craniofacial Journal. 1998;35(6):489–94.
  61. Ankola A v., Nagesh L, Hegde P, Karibasappa GN. Primary dentition status and treatment needs of children with cleft lip and/ or palate. J Indian Soc Pedod Prev Dent. 2005;80–2.
  62. Chapple JR, Nunn MFDSJH. The Oral Health of Children With Clefts of the Lip, Palate, or Both. Cleft Palate Craniofac Journal. 2001;38(5):525–8.

Lisensi Creative Commons
This work is licensed under a Lisensi Creative Commons Atribusi-BerbagiSerupa 4.0 Internasional.
Contact us: Odonto Dental Journal: Jl. Raya Kaligawe Km.4, PO BOX 1054/SM Semarang, Central Java, Indonesia, 50112. Email: odontodentaljournal@unissula.ac.id
apps