title: Functional outcomes in the Cleft Care UK study--Part 3: oral health and audiology.
abstract: OBJECTIVE
  To compare oral health and hearing outcomes from the Clinical Standards Advisory Group (CSAG, 1998) and the Cleft Care UK (CCUK, 2013) studies.
  
  
  METHODS
  Two UK-based cross-sectional studies of 5-year-olds born with non-syndromic unilateral cleft lip and palate undertaken 15 years apart. CSAG children were treated in a dispersed model of care with low-volume operators. CCUK children were treated in a centralized, high volume operator system.
  
  
  METHODS
  Oral health data were collected using a standardized proforma. Hearing was assessed using pure tone audiometry and middle ear status by otoscopy and tympanometry. ENT and hearing history were collected from medical notes and parental report.
  
  
  RESULTS
  Oral health was assessed in 264 of 268 children (98.5%). The mean dmft was 2.3, 48% were caries free, and 44.7% had untreated caries. There was no evidence this had changed since the CSAG survey. Oral hygiene was generally good, 96% were enrolled with a dentist. Audiology was assessed in 227 of 268 children (84.7%). Forty-three per cent of children received at least one set of grommets--a 17.6% reduction compared to CSAG. Abnormal middle ear status was apparent in 50.7% of children. There was no change in hearing levels, but more children with hearing loss were managed with hearing aids.
  
  
  CONCLUSIONS
  Outcomes for dental caries and hearing were no better in CCUK than in CSAG, although there was reduced use of grommets and increased use of hearing aids. The service specifications and recommendations should be scrutinized and implemented.
authors.affiliation: South Thames' Cleft Unit, Guy's and St Thomas Hospital, London, UK.|Cleft Net East Cleft Network, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: J
authors.initials: J
authors.lastname: Smallridge
authors.affiliation: Children's Hearing Centre, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.|School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: A J
authors.initials: AJ
authors.lastname: Hall
authors.affiliation: North Thames Cleft Centre, Great Ormond Street Hospital for Children and Broomfield Hospital, London, UK.
authors.forename: R
authors.initials: R
authors.lastname: Chorbachi
authors.affiliation: East of England Cleft Network, Audiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
authors.forename: V
authors.initials: V
authors.lastname: Parfect
authors.affiliation: Centre for Appearance Research, University of the West of England, Bristol, UK.
authors.forename: M
authors.initials: M
authors.lastname: Persson
authors.affiliation: School of Oral and Dental Sciences, University of Bristol, Bristol, UK.
authors.forename: A J
authors.initials: AJ
authors.lastname: Ireland
authors.affiliation: School of Oral and Dental Sciences, University of Bristol, Bristol, UK.
authors.forename: A K
authors.initials: AK
authors.lastname: Wills
authors.affiliation: School of Oral and Dental Sciences, University of Bristol, Bristol, UK.|National Institute for Health Research (NIHR) Biomedical Research Unit in Nutrition, Diet and Lifestyle at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK.
authors.forename: A R
authors.initials: AR
authors.lastname: Ness
authors.affiliation: School of Oral and Dental Sciences, University of Bristol, Bristol, UK.
authors.forename: J R
authors.initials: JR
authors.lastname: Sandy
mesh_terms: D001298:Audiology; D002675:Child, Preschool; D002971:Cleft Lip / Q000150:complications*; D002972:Cleft Palate / Q000150:complications*; D003430:Cross-Sectional Studies; D003731:Dental Caries; D005260:Female; D006801:Humans; D008297:Male; D009909:Oral Health
keywords: audiology; cleft Lip; cleft palate; oral health; treatment outcome