Orthodontic burden of care for patients with a cleft lip and/or palate

Background: Patients with a cleft lip and/or palate may require multiple episodes of orthodontic treatment, e.g. before alveolar bone grafting, upper arch alignment, orthodontic camouflage and in combination with orthognathic surgery. There is little published regarding the overall orthodontic burden of care for these patients. Aim: To assess the orthodontic burden of care for patients with a cleft lip and/or palate. Method: Data were collected retrospectively from all consecutive cleft patients who had completed orthodontic treatment between January 2014 and December 2015 at Great Ormond Street Hospital, London, United Kingdom. Results: Forty-two patients were included in the study: Twenty-three patients with a cleft lip and palate; nine with an isolated cleft palate; eight with cleft lip and alveolus; and two with cleft lip. The mean age of orthodontic treatment commencement was 13.4 years (range = 8.9-18.2 years) with a mean duration of 3.4 years (range = 1.3-8.3 years). An average of 44 appointments were required with an orthodontist (range = 18-98 appointments). Conclusion: The orthodontic burden of care for patients with cleft lip and/or palate must not be underestimated. The duration of treatment varies depending on the type of cleft diagnosis and whether orthognathic surgery will be required. From this study, a patient with cleft lip and/or palate required an average of 44 orthodontic appointments and a mean duration of treatment of 3.4 years in order to complete their treatment. This is a considerable burden to patients and their guardians, which they must be informed of before commencement of orthodontic treatment.