Cleft Paediatric Dentistry

The Paediatric Dental team

Your child will initially be seen by the cleft team paediatric dentist Dr Collard at 12 months of age.

In Cardiff Dental Hospital you will meet Dr Collard and Rachel Yemm (cleft team nurse-Cardiff) and in Morriston Hospital you will meet Dr Collard and Sian Tucker (cleft team nurse- Swansea)

Dr Collard will monitor your child’s teeth, liaise with your local dentist and provide treatment for your child when required.

If your child was born with a cleft palate they will also meet Rachel or Sian at babble therapy at 9-12 months of age.


Looking after your child’s teeth

When your child was born, the primary (baby) teeth and permanent (adult) teeth were already beginning to form under the gum. The first teeth will start to appear from about six months. It will take a further two years for all the primary teeth to come through.

The first permanent teeth usually appear at about six years. Over the next five years each of the primary teeth will be replaced in turn, by permanent teeth.

There is much variation in the times at which teeth appear, and there is no need to worry if your child’s teeth take a little longer than normal to come through.

If your child has a cleft involving the bone there may be teeth missing, extra teeth or teeth which look unusual or come through in unusual positions, if you are concerned about this you should contact the cleft team for an appointment with Dr Collard.

Giving your child’s teeth a healthy start in life is important. To prevent tooth decay and gum disease there are several things you can do from an early age:


Take care with diet

Feeding bottles should only contain water or milk to ensure the best healthy start for your child's teeth. The best advice is to keep the amount of sugar in the diet as low as possible. Try to limit the number of times that your child has sugar-containing food or drinks. A good guide is to give any sugar-containing foods or drinks at meal times only.

Encourage your baby to drink from a free-flow feeding cup rather than a bottle as soon as possible. A night-time bottle should be stopped when your baby is 12 months old as this can cause tooth decay (even if filled with milk).



Clean the teeth regularly  

Once your child’s teeth come through the gums (erupt) brush twice a day with a toothpaste containing fluoride.  A family toothpaste is fine, but because little children tend to swallow toothpaste, use only a smear on their brush.


Take your child to visit the dentist

It is a good idea if you take your baby with you to your own dental check-up visits initially, to get them used to visiting a dentist. You will also be sent an appointment once your child is 12 months old to meet the cleft team’s paediatric dentist. We will be able to give you more advice about tooth eruption, brushing and diet in relation to the cleft.

If you have any questions or concerns about your baby's teeth, please contact the cleft dental team for advice.


How does a cleft affect the teeth?

A cleft that includes the bone can produce several dental problems, the teeth most commonly affected are those in the cleft site

  • There can be missing teeth or extra teeth, especially in the cleft area.
  • Teeth can be abnormal in shape or in position.

Your child will be seen regularly by the cleft team paediatric dentist to ensure that they get the right treatment if there are any problems.


How does this affect dental care?

Because children born with clefts may have special problems related to missing, misshapen or poorly positioned teeth, all the teeth present are very precious. Keeping your child’s teeth and gums healthy is important from a very early age and will continue to be so.


Why are baby teeth so important for your child?

  • Baby teeth guide the adult teeth in to a good position
  • If a very young child has tooth decay because of their age the only treatment option may be extraction, and this will most likely involve another operation
  • Removing baby teeth at the front of the mouth can affect a child’s speech


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