147 - Cleft Lip and Palate Infants: Caries Risk Reduction

Primary

Objective: 1) Utilize a questionnaire that will assess the dental knowledge of caregivers with infants who have cleft lip and palate, at initiation and completion of NAM therapy. 2) Determine the effectiveness of at-home care by measuring bacterial activity via rapid adenosine triphosphate (ATP)-driven bioluminescence assay from the infant’s palate and NAM appliance.

Methods: The intervention group received an in-depth oral hygiene education program every NAM therapy visit, and the comparison group included caregivers who only received the standard oral hygiene education every visit. Each group consisted of 15 parent-child dyads. The initial and final visit required parents to complete a pre-therapy and post-therapy questionnaire assessing their dental knowledge. Appliance adjustments occurred every week for a total of 3 months therapy duration. Plaque was collected from the infant’s palate and appliance and tested for level of bacterial activity via (ATP)-driven bioluminescence assay (CariScreen Caries Susceptibility Monitor, CariFree of OralBiotech, Albany, OR). In addition, the palate, tongue and appliance were visually evaluated and graded for degree of cleanliness using the following plaque index: 0” = no plaque, “1” = minimal plaque, “2” = moderate plaque, “3” = gross plaque buildup. Those infants that established a dental home at the same clinic were evaluated for dental caries in the primary dentition.

Results: Questionnaires and bacterial activity were completed from 11 and 12 of the intervention and control parent-child dyads respectively. By completion of NAM therapy, the dental IQ of caregivers in the intervention group increased on average by 13 points compared to the control group that increased an average of 1 point. The intervention group had significantly lower bacterial activity on the NAM across the 12 weeks. In both groups, the CariScreen scores of the NAM increased with time, however, this was not significant. In contrast, the CariScreen scores of the palate slightly decreased with time, however this finding was not significant. Both groups had similar bacterial activity on the palate throughout the duration of the NAM appliance with a slightly lower CariScreen scores in the experimental group.

Conclusion: Implementation of anticipatory guidance topics during NAM appointments increased parent's dental IQ and led to improved cleanliness of NAM appliances.