Incidence of mutans streptococci and lactobacilli in oral cleft children wearing acrylic plates from shortly after birth.

Children with a palatal cleft can be treated with preoperative infant orthopedics including an acrylic plate that is applied shortly after birth to obturate the cleft. It is advised to wear these plates until the 18th month of age. Such a plate, being a hard non-shedding surface, may be expected to facilitate early colonization of mutans streptococci. The first aim of the present investigation was to assess the incidence of mutans streptococci and lactobacilli in children with cleft lip and/or palate during the first 2 years of life. The second aim was to study whether preoperative orthopedics, that is, the wearing of an acrylic plate, had facilitated the establishment of mutans streptococci and lactobacilli. The third aim was to determine other factors associated with colonization of these organisms in these children. Sixty-two Caucasian Dutch children with cleft lip and/or palate participated in this study. Twenty-four of these children were treated with preoperative infant orthopedics and had been wearing an acrylic plate from within a few days after birth. At regular control visits plaque and saliva samples and samples from the surface of the acrylic plate were taken, while a dental examination was performed to document the emergence of the primary teeth, caries status, gingival condition and oral hygiene procedures. Saliva samples were also taken from the accompanying parents. At the visit at the age of 18 months, the parents were interviewed using a structured questionnaire. At this age, the prevalence of mutans streptococci and lactobacilli was compared to that in a control group of non-cleft children. The oral cleft children wearing an acrylic plate from shortly after birth were colonized earlier with mutans streptococci and lactobacilli than the non-plate oral cleft children. In the children wearing acrylic plates, the prevalence of lactobacilli decreased with age, while the prevalence of mutans streptococci increased. At the age of 18 months the prevalence of mutans streptococci was comparable in both groups of oral cleft children and in the control children. There was no relation between the numbers of mutans streptococci in the saliva of the mothers and their children. The presence of mutans streptococci in the saliva of the oral cleft children was significantly associated with between-meal snacking and with the presence of lactobacilli.