Is a child with a cleft more prone to cavities?

My son was born with bilateral cleft lip and palate. Although his teeth were brushed regularly, when he was about two years old he began to get cavities, especially on his front teeth. At this time his palate had been closed but he still had a separation of his gums bilaterally. Is a child with a cleft more likely to have cavities?

Question:

Children born with cleft palates generally tend to have more differentiation in their teeth than those without cleft palate. These differences can include missing teeth, supernumerary (extra) teeth, malpositioned teeth, fused teeth, delayed eruption of teeth, and malformed teeth. The malformations may include problems with enamel formation. Enamel, which is the hardest layer of the tooth, covers the outer surface of the tooth. If the enamel is extremely thin or missing, the tooth becomes more susceptible to decay. In addition, because of the malpositioning of the teeth, it can be more difficult for the natural cleansing ability of the mouth (through chewing and salivary action) and your hygiene efforts to decrease the amount of decay. In short, it is possible the clefting played a role in the formation of cavities on your son's teeth.

Cleft lip and cleft palate occur when the lip and palate do not completely close together during formation of these structures. The formation of cleft lip, with or without cleft palate, occurs in about 1 in 1,000 births, and it is believed to be genetic, although no simple pattern has been determined. The treatment for cleft lip and palate can be extensive and take many years to complete. Treatment requires involvement of a team of diverse health sciences personnel. The good news is that treatment over the years has improved, thereby improving the quality of life for people born with this defect.

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