title: Comparing caries risk profiles between 5- and 10- year-old children with cleft lip and/or palate and non-cleft controls.
abstract: BACKGROUND
  Previous studies have suggested that children with oral clefts may have higher caries prevalence in comparison with non-cleft controls but the relative importance of the potential risk factors is not clear. The aim of this study was to compare the caries risk profiles in a group of cleft lip and/or palate (CL(P)) children with non-cleft controls in the same age using a computerized caries risk assessment model.
  
  
  METHODS
  The study group consisted of 133 children with CL(P) (77 subjects aged 5 years and 56 aged 10 years) and 297 non-cleft controls (133 aged 5 years and 164 aged 10 years). A questionnaire was used to collect data concerning the child's oral hygiene routines, dietary habits and fluoride exposure. Oral hygiene was assessed using Quigley-Hein plaque Index and the caries prevalence and frequency was scored according to the International Caries Detection and Assessment System. Whole saliva samples were analyzed for mutans streptococci, lactobacilli, buffering capacity and secretion rate. The risk factors and risk profiles were compared between the groups with aid of Cariogram and the estimated risk for future caries was categorized as "high" or "low".
  
  
  RESULTS
  Children with CL(P) (the entire study group) had significantly higher counts of salivary lactobacilli (p < 0.05) and displayed less good oral hygiene (p < 0.05). More 10-year-old children in the CL(P) group had low secretion rate but this difference was not significant. The average chance to avoid caries ranged from 59 to 67% but there were no significant differences between the groups. The odds of being categorized with high caries risk in the CL(P) group was significantly elevated (OR = 1.89; 95% CI = 1.25-2.86). In both groups, children in the high risk category had a higher caries experience than those with low risk.
  
  
  CONCLUSIONS
  Children with CL(P) displayed increased odds of being categorized at high caries risk with impaired oral hygiene and elevated salivary lactobacilli counts as most influential factors. The results suggest that a caries risk assessment model should be applied in the routine CL(P) care as a basis for the clinical decision-making and implementation of primary and secondary caries prevention.
authors.affiliation: Department of Pediatric Dentistry, Institute for Postgraduate Dental Education, Box 1030, SE, 551 11, Jönköping, Sweden. annalena.sundell@rjl.se.
authors.forename: Anna Lena
authors.initials: AL
authors.lastname: Sundell
authors.affiliation: Institute for Clinical Dentistry, UiT The Arctic University of Norway, Tromsø, Norway. christer.ullbro@uit.no.
authors.forename: Christer
authors.initials: C
authors.lastname: Ullbro
authors.affiliation: Department of Dentofacial Orthopedics, Maxillofacial Unit, Linköping University Hospital, Linköping, Sweden. Agneta.Marcusson@regionostergotland.se.
authors.forename: Agneta
authors.initials: A
authors.lastname: Marcusson
authors.affiliation: Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. stwe@sund.ku.dk.
authors.forename: Svante
authors.initials: S
authors.lastname: Twetman
mesh_terms: D002021:Buffers; D002327:Cariostatic Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000150:complications*; D002972:Cleft Palate / Q000150:complications*; D004245:DMF Index; D003731:Dental Caries / Q000209:etiology*; D003733:Dental Caries Susceptibility; D003774:Dental Plaque Index; D005247:Feeding Behavior; D005459:Fluorides / Q000627:therapeutic use; D006801:Humans; D007778:Lactobacillus / Q000302:isolation & purification; D009910:Oral Hygiene; D018570:Risk Assessment; D012463:Saliva / Q000378:metabolism / Q000382:microbiology / Q000502:physiology; D012636:Secretory Rate / Q000502:physiology; D013295:Streptococcus mutans / Q000302:isolation & purification
chemical_list: D002021:Buffers; D002327:Cariostatic Agents; D005459:Fluorides