Clinical and psychosocial outcomes among patients with clefts in Norhern Finland

Thesis event information

Date and time of the thesis defence

Place of the thesis defence

Oulu University, Dentopolis. Markku Larmas-auditorium (H1091)

Topic of the dissertation

Clinical and psychosocial outcomes among patients with clefts in Norhern Finland

Doctoral candidate

Doctor of dental surgery Mirjami Corcoran

Faculty and unit

University of Oulu Graduate School, Faculty of Medicine, Research unit of oral health sciences

Subject of study

Oral development and orthodontics

Opponent

Professor Timo Peltomäki, The University of Eastern Finland and the University of Tampere

Custos

Docent Virpi Harila, The University of Oulu, Oulu University of Hospital

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Patients with clefts experience physical and psychological challenges

The results of the thesis show that patients with clefts experience lower oral health related quality of life, dental fear, and limited growth of the upper jaw.
Cleft lip and/or palate are the most common congenital craniofacial anomalies. In Finland about 120 children are born with a cleft yearly. The prevalence of cleft palate is exceptionally high in Finland, especially in Northern Finland. Children with clefts have a vast treatment need. They often face numerous physical and psychological cleft-related challenges during their life. The burden of care is significant for the child, the parents, and the society.

The aim of this thesis was to evaluate the oral health-related quality of life and dental fear among 18-year-old cleft patients. The purpose was also to study cleft patients’ motivation to attend complex treatments. Another aim was to examine the dimensions of the upper jaw and the connection of those and the initial cleft size. The oral health-related quality of life and dental fear was studied using a questionnaire (n=63). The upper jaw of the 6-year-olds were examined with a 3D-technique using scanned plaster casts (n=89). The initial cleft size was compared to the dimensions of the upper jaw in cleft palate patients. The subjects were all patients of the Oulu University Hospital.

Over half of the 18-year-olds reported impact on oral health related quality of life. Physical pain and psychological discomfort were the most reported domains. Almost 40% of the subjects reported moderate dental fear. Those with a cleft involving the lip experienced lower quality of life and more dental fear. Those with dental fear often reported feelings of uncontrollability and unpredictability during dental treatment. Good outcome, support from others, and dental care being a routine were the motivating factors to attend treatments. Larger clefts resulted in shorter upper jaws at 6 years of age. The growth of the upper jaw was reduced among patients with a cleft involving the palate. Cleft lip alone affected the growth of the upper jaw the least.

The results of this thesis show that patients with clefts are at higher risk to experience low oral health-related quality of life and dental fear. Clinicians should take this into consideration when treating patients with clefts. The clinicians should avoid causing the feelings of uncontrollability and unpredictability during a dental procedure which could reduce the experienced dental fear. Larger clefts of the palate cause the smallness of the upper jaw which can be clinically significant in terms of the occlusion.
Last updated: 2.1.2023