Dental Findings and Management of Paediatric Patient with Unilateral Cleft Lip: A Case Report

Background: Cleft lip, with or without Cleft Palate (CLP), is the most common congenital defect, occurring in approximately 1 in 500 to 1 in 2,500 live births, depending on geographic and ethnic factors. Genetic and/or environmental influences cause it during the fourth to eighth weeks of embryonic development. Children with CLP frequently experience dental anomalies involving tooth position, number, morphology, structure, and eruption patterns, which can affect the primary and permanent dentition. Importantly, dental issues are associated with CLP defects, whether unilateral or bilateral cleft lip with or without palate.

Case report: An eight-year-old girl from Saudi Arabia, who has a history of left-sided cleft lip repair, bronchial asthma, social anxiety, and Periventricular Leukomalacia with mild brain atrophy due to hypoxia at birth, presented to the pediatric dental clinic with her father. They were concerned about multiple carious teeth. Upon clinical and radiographic examination, she had numerous interproximal caries, supernumerary teeth, congenitally missing upper permanent first molars, and a unilateral right posterior crossbite. Dental rehabilitation under general anaesthesia was performed, including the restoration of all carious primary molars and the surgical extraction of supernumerary teeth in collaboration with oral and maxillofacial surgery. Subsequently, interceptive orthodontic treatment was initiated.

Conclusion: The pediatric dentist should discuss with the parents the common dental issues related to clefts and maintain close communication with the cleft team to ensure consistent care throughout the patient's long-term treatment.