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Davies AJV, Humphries K, Lewis SJ, Ho K, Sandy JR, Wren Y. The Cleft Collective: protocol for a longitudinal prospective cohort study. BMJ Open 2024; 14:e084737. [PMID: 38969383 PMCID: PMC11227803 DOI: 10.1136/bmjopen-2024-084737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 06/07/2024] [Indexed: 07/07/2024] Open
Abstract
INTRODUCTION Cleft lip and/or palate (CL/P) affects 1 in 700 live births globally. Children born with CL/P and their families face various challenges throughout the child's development. Extant research is often limited by small numbers and single-centre data. The Cleft Collective, a national cohort study in the UK, aims to build a resource, available to collaborators across the globe, to understand causes, best treatments and long-term outcomes for those born with CL/P, ultimately seeking to enhance their quality of life through improved understanding and care. METHODS AND ANALYSIS A longitudinal prospective cohort study of children born with CL/P and their families. Recruitment occurs across the UK and started in November 2013. Recruitment will continue until September 2027 with an estimated final sample of 4822 children born with CL/P (1157 cleft lip including/excluding the alveolus; 2112 cleft palate only; 1042 unilateral cleft lip and palate and 511 bilateral cleft lip and palate). Biological samples are collected from all recruited members of the family. Parental and child questionnaires are collected at key time points throughout the child's development. Surgical data are collected at the time of surgical repair of the child's cleft. Consent is obtained to link to external data sources. Nested substudies can be hosted within the cohort. Regular engagement with participants takes place through birthday cards for the children, social media posts and newsletters. Patient and Public Involvement is conducted through the Cleft Lip And Palate Association and Cleft Collective Patient Consultation Group who provide insightful and essential guidance to the Cleft Collective throughout planning and conducting research. ETHICS AND DISSEMINATION The Cleft Collective was ethically approved by the National Research Ethics Service committee South West-Central Bristol (REC13/SW/0064). Parental informed consent is required for participation. Findings from the Cleft Collective are disseminated through peer-reviewed publications, conference presentations, newsletters and social media.
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Affiliation(s)
- Amy J V Davies
- Bristol Dental School, The Cleft Collective, University of Bristol Faculty of Health Sciences, Bristol, UK
| | - Kerry Humphries
- Bristol Dental School, The Cleft Collective, University of Bristol Faculty of Health Sciences, Bristol, UK
| | - Sarah J Lewis
- Bristol Medical School, University of Bristol Faculty of Health Sciences, Bristol, UK
| | - Karen Ho
- Bristol Bioresource Laboratories, University of Bristol Faculty of Health Sciences, Bristol, UK
| | - Jonathan R Sandy
- Bristol Dental School, The Cleft Collective, University of Bristol Faculty of Health Sciences, Bristol, UK
| | - Yvonne Wren
- Bristol Dental School, The Cleft Collective, University of Bristol Faculty of Health Sciences, Bristol, UK
- Bristol Speech and Language Therapy Research Unit, North Bristol NHS Trust, Westbury on Trym, Bristol, UK
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Stock NM, Costa B, Bannister W, Ashby C, Matthews N, Hebden L, Melles L, Hilton-Webb Z, Smith S, Kane K, Carter L, Kearney A, Piggott K, Russell C, Wilkinson-Bell K. "When I was Younger, My Story Belonged to Everyone Else": Co-production of Resources for Adults Living with Craniosynostosis. Cleft Palate Craniofac J 2024:10556656241236580. [PMID: 38500357 DOI: 10.1177/10556656241236580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024] Open
Abstract
OBJECTIVE Despite growing recognition that congenital craniofacial conditions have lifelong implications, psychological support for adults is currently lacking. The aim of this project was to produce a series of short films about living with craniosynostosis in adulthood, alongside a psychoeducational booklet. DESIGN The resources were developed using multiple focus groups and meetings attended by researchers, patient representatives, a leading charitable organisation, an award-winning film production company, clinicians, and other experts in the field. RESULTS An online mixed-methods survey was developed based on prior work to request feedback on the acceptability and utility of the resources from the craniosynostosis community. While data collection to evaluate the resources is ongoing, preliminary results (n = 36) highlight an acceptability rating of 100%. CONCLUSIONS The resources developed represent a step forward in addressing the unmet information and support needs of adults with craniosynostosis and highlight the benefits of co-production in research.
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Affiliation(s)
- Nicola M Stock
- Centre for Appearance Research, University of the West of England, Bristol, UK
| | - Bruna Costa
- Centre for Appearance Research, University of the West of England, Bristol, UK
| | | | | | | | | | | | | | | | | | | | - Anna Kearney
- Alder Hey Craniofacial Unit, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Katie Piggott
- Alder Hey Craniofacial Unit, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Charlotte Russell
- Centre for Appearance Research, University of the West of England, Bristol, UK
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Kalantar-Hormozi A, Chitsazan M, Davai NR, Eghbali Zarch A, Manafi A, Mozafari N, Saberi Ghouchani A, Azhdari K, Shahverdiani R, Ashabyamin M, Tarahomi M, Shams Hojjati Y, Sheikhi A, Kalantar-Hormozi H, Manafi N, Poudineh M. The Road Less Traveled: The Marham National Health Institute's Journey on Cleft Lip and Palate Surgery Missions. World J Plast Surg 2024; 13:3-15. [PMID: 38742029 PMCID: PMC11088737 DOI: 10.61186/wjps.13.1.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 11/26/2023] [Indexed: 05/16/2024] Open
Abstract
Congenital cleft lip and palate represent the prevailing craniofacial birth anomalies on a global scale. Notably, a substantial proportion of patients within remote regions of Iran defer corrective surgery until later stages of life, often in childhood or adulthood, primarily due to intricate financial and cultural constraints. In response to this pressing healthcare challenge, a dedicated collective of volunteer plastic surgeons was established in 2009 with the explicit aim of providing medical care to these underserved patients. Over the subsequent years, this compassionate team embarked on 31 meticulously planned missions to underprivileged areas scattered across the country. Through these organized endeavors, a remarkable total of 20,579 medical visits were conducted, coupled with the performance of 2,303 essential surgeries, thus offering a lifeline of healthcare to these disadvantaged individuals.
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Affiliation(s)
- Abdoljalil Kalantar-Hormozi
- Department of Plastic and Craniofacial Surgery, 15 Khordad Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | - Ahmad Eghbali Zarch
- Anesthesiology Research Center, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Manafi
- Department of Plastic and Craniofacial Surgery, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Naser Mozafari
- Department of Plastic and Craniofacial Surgery, 15 Khordad Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Kamyar Azhdari
- Department of plastic surgery, Imam Reza Hospital, AJA University of Medical Sciences, Tehran, Iran
| | - Reza Shahverdiani
- Department of Tissue Engineering and Stem Cell, Georgetown Medical University, Washington DC, USA
| | - Mahmoudreza Ashabyamin
- Department of Plastic and Craniofacial Surgery, Kerman University of Medical Sciences, Kerman, Iran
| | | | | | - Abdolreza Sheikhi
- Department of Plastic Surgery, Taleqhani Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Navid Manafi
- David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
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Moshtaghi Fard Z, Aghadoost S, Moradi N, Sarmadi S, Mohammadi F, Bahrami N. Quality of Life in Adolescents and Young Adults with Cleft Lip and Palate with and Without Speech Therapy During COVID-19. Cleft Palate Craniofac J 2023:10556656231219413. [PMID: 38115690 DOI: 10.1177/10556656231219413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023] Open
Abstract
OBJECTIVE Cleft-related speech concerns can affect the quality of life (QOL) in patients with cleft lip and palate (CLP). During the coronavirus disease 2019 (COVID-19), in-person speech therapy (ST) was restricted due to fear of getting infected. This study aimed to compare QOL in patients with CLP with and without ST during the pandemic. DESIGN Cross-sectional Study. SETTING CLP team at Tehran University of Medical Sciences (TUMS). PATIENTS/PARTICIPANTS Thirty-six CLP subjects with a mean age of 17.33 ± 4 years participated in two groups, including with and without ST. Fifteen subjects had cleft palate only (CPO) and others had CLP. INTERVENTIONS ST group received at least 10 ST sessions, and group without ST didn't receive ST during COVID-19. MAIN OUTCOME MEASURE(S) A virtual link of demographic and QOL adolescent cleft (QoLAdoCleft) questionnaires were sent to fill out. Results were extracted and transferred to SPSS. RESULTS Total and subscales' scores of QoLAdoCleft were lower in ST group than without ST but differences between them weren't statistically significant (P > .05). Furthermore, according to cleft type, there weren't any statistically significant differences in total, physical, and social subscales of QoLAdoCleft (P > .05); however, psychological subscale in CLP had a higher significant score than CPO (P < .05). CONCLUSIONS QOL was weak in all patients with CLP, and receiving/not receiving ST couldn't make noticeable differences between them. It seems; COVID-19 pandemic can have an adverse effect on these results. Also, subjects with CLP had weaker psychological than CPO due to negative psychosocial feedback related to Orofacial deformities received from society.
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Affiliation(s)
| | - Samira Aghadoost
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Negin Moradi
- Department of Communication Sciences and Disorders, University of Wisconsin-River Falls, USA
| | - Sarvin Sarmadi
- Department of Orthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnoosh Mohammadi
- Craniomaxillofacial Research Center, Oral and Maxillofacial Surgery Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Naghmeh Bahrami
- Craniomaxillofacial Research Center, Department of Tissue Engineering and Applied Cellular Sciences, Tehran University of Medical Sciences, Tehran, Iran
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Gee S, Ezzeldin M, Curtis J, Clark VJ, Smallridge J, Collard M. Associated medical conditions among 10-year-old children with oral clefts - a retrospective review across three cleft centres: Part 2. Br Dent J 2023; 234:931-936. [PMID: 37349449 PMCID: PMC10287554 DOI: 10.1038/s41415-023-5975-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 04/07/2023] [Accepted: 04/15/2023] [Indexed: 06/24/2023]
Abstract
Introduction In many cases, children with oral clefts present with accompanying medical conditions. These associated conditions can add complexity to the patient's dental management, both in terms of their treatment need and risk. Recognition and careful consideration of associated medical conditions is therefore crucial in providing safe and effective care for these patients.Aim This paper is the second in a two-part three-centre series. It investigates the prevalence of medical conditions affecting cleft lip and/or palate patients attending three cleft units within the UK.Method Retrospective review was undertaken within three cleft units: South Wales (SW), Cleft NET East (CNE) and West Midlands (WM). This was completed via assessment of the 10-year audit record appointment clinical notes for the year 2016/2017.Results In total, 144 cases were reviewed (SW = 42; CNE = 52; WM = 50). Of these, 38.9% of patients (n = 56) had associated medical conditions recorded.Discussion The review highlights the variety and impact of medical conditions affecting UK cleft patients providing insight into the consequent complexity of their dental care.Conclusion An awareness of cleft lip and/or palate patients' associated medical conditions is important for all health care professionals involved in their care. Indeed, understanding of the patient's medical needs by multidisciplinary cleft teams is essential for effective planning and completion of holistic care. Involvement of specialists in paediatric dentistry sharing care with general dental practitioners is vital in providing appropriate oral health care and preventive support.
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Affiliation(s)
- Samantha Gee
- Specialty Registrar and Honorary Clinical Teacher in Paediatric Dentistry, University Dental Hospital and School, Cardiff, United Kingdom.
| | - Maryam Ezzeldin
- Specialist and Honorary Clinical Teacher in Paediatric Dentistry, University Dental Hospital and School, Cardiff, United Kingdom
| | - Jacob Curtis
- Post Certificate of Completion of Training in Orthodontics, Morriston Hospital, Swansea, United Kingdom
| | - Victoria J Clark
- Consultant in Paediatric Dentistry, Birmingham Children´s Hospital, United Kingdom
| | - Jacqueline Smallridge
- Consultant in Paediatric Dentistry, CleftNetEast, Cambridge University Hospitals, United Kingdom
| | - Mechelle Collard
- Consultant in Paediatric Dentistry, Morriston Hospital, Swansea, UK; Consultant and Honorary Senior Lecturer in Paediatric Dentistry, University Dental Hospital and School, Cardiff, United Kingdom
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Hotton M, Cropper J, Rundle J, Crawford R. The role of the clinical psychologist within a cleft service. Br Dent J 2023; 234:887-891. [PMID: 37349436 DOI: 10.1038/s41415-023-5952-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 06/24/2023]
Abstract
Clinical psychologists are core members of UK cleft services. This paper outlines the variety of ways in which clinical psychologists work across the lifespan to promote the psychological wellbeing of those born with a cleft and their families. In the context of dental or orthodontic treatment, this involves a combination of early intervention and advice, psychological assessment or specialist psychological therapy for individuals experiencing dental anxiety or anxiety regarding the appearance of their teeth. This paper therefore aims to highlight the varying roles which clinical psychologists play in the provision of cleft-related dental care, often alongside multidisciplinary colleagues.
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Affiliation(s)
| | - Jenny Cropper
- Clinical Psychologist, Spires Cleft Centre, Oxford, UK
| | - Jen Rundle
- Clinical Psychologist, Evelina London Cleft Service, UK
| | - Rebecca Crawford
- Clinical Psychologist, National Cleft Surgical Service for Scotland, UK
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Kadi H, Jacobs R, Shujaat S, Lemberger M, Benchimol D, Karsten A, Pegelow M. A CBCT Based Assessment of Canine Eruption and Development Following Alveolar Bone Grafting in Patients Born With Unilateral Cleft lip and/or Palate. Cleft Palate Craniofac J 2023; 60:386-394. [PMID: 34873962 DOI: 10.1177/10556656211064477] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
To three-dimensionally assess and visualize the eruption path and development of the maxillary canine following alveolar bone grafting in patients born with cleft lip and palate. A further objective of this analysis was to assess how the presence of the lateral incisor impacts the eruption path of the canine. Observational follow-up study. Stockholm Craniofacial Team, Karolinska University Hospital, Sweden. Thirty children born with non-syndromic unilateral cleft lip with or without palate were consecutively included. CBCT scans of the maxilla were taken six months before and six months after the alveolar bone-grafting surgery for each patient. Canine eruption (angulation and vertical movement) and canine development (length and volume). There was a significant difference pre- and post-operatively of the canine angulation between the cleft and non-cleft sides. The mean angulation on the cleft side was 14.7° (SD = 11.1°) while on the non-cleft side, it was 4.9° (SD = 9.2°). No significant differences were noted between cleft-side and non-cleft side canines in terms of amount of vertical eruption and volumetric development. Absence of the lateral incisor did not significantly contribute to either canine angulation or its vertical eruption on the cleft-side. Higher angulation of the canine on the cleft side indicates a higher risk of future canine impaction. Presence or absence of the lateral incisor did not significantly affect canine angulation or its vertical eruption. Increased age and children born with total cleft lip and palate imply a higher risk of angulated canines on the cleft side.
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Affiliation(s)
- Hasan Kadi
- Division of Orthodontic and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.,Orthodontic Division, Preventative Dentistry Department, College of Dentistry, 48058Umm Al-Qura University, Makkah, Saudi Arabia
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Sohaib Shujaat
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Mathias Lemberger
- Division of Orthodontic and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Daniel Benchimol
- Division of Oral Diagnostics and rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Agneta Karsten
- Division of Orthodontic and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Marie Pegelow
- Division of Orthodontic and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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8
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Stock NM, Costa B, Wilkinson-Bell K, Culshaw L, Kearney A, Edwards W. Psychological and Physical Health Outcomes in Adults With Craniosynostosis. Cleft Palate Craniofac J 2023; 60:257-267. [PMID: 34866454 PMCID: PMC9900192 DOI: 10.1177/10556656211059966] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES Within current research, little is known about the long-term outcomes of craniosynostosis. A priority-setting exercise by UK charity Headlines Craniofacial Support identified 2 key questions in this area: (1) What are the long-term physical and psychological effects for individuals with syndromic and non-syndromic craniosynostosis? and (2) Are individuals with craniosynostosis likely to suffer from mental health difficulties, or are they more resilient? The aim of the current study was to conduct an initial investigation of these priority questions. METHODS A comprehensive UK-wide survey consisting of 9 standardized psychological outcome measures and open-ended questions was distributed online. Thirty-six eligible adults (69.4% female) with a mean age of 30.8 years responded to the survey. Participants reported having single suture craniosynostosis (27.8%) or syndromic craniosynostosis (52.8%), with 19.4% being unsure of their diagnosis. Sample means were compared to published norms using independent samples t tests. Qualitative responses were analysed using inductive content analysis. RESULTS Compared to the general population, participants reported significantly less favorable scores related to appearance concerns, attachment in adult relationships, anxiety, optimism, and resilience. Self-worth, depression, and social anxiety scores were similar to norms. Qualitative responses provided additional insight into participants' satisfaction with appearance, physical health, medical treatment, employment, relationships, and recurrence risks. Few participants had accessed psychological support. DISCUSSION This preliminary study illustrates the potential long-term implications for individuals with craniosynostosis. Improved treatment protocols are needed to address physical health concerns in adulthood, while dedicated psychological resources are necessary to promote emotional well-being, social confidence, and resilience.
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Affiliation(s)
- Nicola Marie Stock
- Centre for Appearance Research, University of the West of England,
Coldharbour Lane, Bristol, United Kingdom
- Nicola Marie Stock, Centre for Appearance
Research, University of the West of England, Bristol BS16 1QY, United Kingdom.
| | - Bruna Costa
- Centre for Appearance Research, University of the West of England,
Coldharbour Lane, Bristol, United Kingdom
| | | | - Laura Culshaw
- Alder Hey Craniofacial Unit, Alder Hey Children's NHS Foundation
Trust, Liverpool, United Kingdom
| | - Anna Kearney
- Alder Hey Craniofacial Unit, Alder Hey Children's NHS Foundation
Trust, Liverpool, United Kingdom
| | - Wendy Edwards
- Headlines Craniofacial Support, St Albans, Hertfordshire, United
Kingdom
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Grewcock RE, Innes NP, Mossey PA, Robertson MD. Caries in children with and without orofacial clefting; Systematic Review and Meta-Analysis. Oral Dis 2022; 28:1400-1411. [PMID: 35263806 PMCID: PMC9314085 DOI: 10.1111/odi.14183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/24/2022] [Accepted: 03/04/2022] [Indexed: 11/28/2022]
Abstract
This systematic review compared children's primary dentition caries experience for those with cleft lip and/or palate (CL/P) and without. Four databases were searched without date restriction for; cross‐sectional studies comparing caries experience for children with CL/P to those without. Screening, data extraction and risk assessment were carried out independently (in duplicate). Meta‐analyses used a random‐effects model. Twenty studies (21 reports) fitting the inclusion criteria comprised 4647 children in primary dentition from 12 countries. For dmft (n = 3016 children; 15 groups), CL/P mean = 3.2; standard deviation = 2.22 and no CL/P mean dmft = 2.5; sd 1.53. For dmfs (n = 1095 children; 6 groups), CL/P mean = 4; sd = 3.5 and no CL/P mean = 3; sd = 2.8. For % caries experience (n = 1094 children; 7 groups), CL/P mean = 65%; sd = 20.8 and no CL/P mean = 52%; sd = 28.1. Meta‐analysis showed higher caries experience in children with CL/P, standardised mean difference = 0.46; 95% CI = 0.15, 0.77. Studies' risk of bias was high (n = 7), medium (n−10) and low (n = 3). Children with CL/P had higher caries experience compared to those without CLP.
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Affiliation(s)
- R E Grewcock
- Dental Hospital and School, University of Dundee, Park Place, Dundee, DD1 4HN, UK
| | - N P Innes
- School of Dentistry, Cardiff University, Heath Park, Cardiff, CF14 4XY, UK
| | - P A Mossey
- Dental Hospital and School, University of Dundee, Park Place, Dundee, DD1 4HN, UK
| | - M D Robertson
- Dental Hospital and School, University of Dundee, Park Place, Dundee, DD1 4HN, UK
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Jensen ED, Poirier BF, Oliver KJ, Roberts R, Anderson PJ, Jamieson LM. Childhood Experiences and Perspectives of Individuals With Orofacial Clefts: A Qualitative Systematic Review. Cleft Palate Craniofac J 2022:10556656221084542. [PMID: 35254151 DOI: 10.1177/10556656221084542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Children and adolescents with orofacial clefts may experience ongoing psychosocial impacts due to the continuous nature of cleft treatments, facial and dental differences, and speech and hearing difficulties. The aim of this qualitative systematic review was to better understand the experiences of children and adolescents with orofacial clefts. DESIGN A systematic search strategy using PubMed, Embase, Emcare, Scopus, and Web of Science databases was performed to identify relevant qualitative studies evaluating the lived experience of children and adolescents with orofacial clefts from inception through to June 2021. Eligible studies were critically appraised using the Joanna Briggs methodology and a meta-aggregative approach. RESULTS The search identified 2466 studies, with 13 found to meet the inclusion criteria. Extraction of 155 findings resulted in 27 categories, which were meta-aggregated into 7 overarching synthesized findings. These 7 core findings included aspects of child experience and findings that enhanced or impeded child experience at the individual, family, and community levels. CONCLUSIONS Factors that impeded child experience at the individual, family, and community levels were more pronounced than factors that enhanced their experience among children and adolescents with orofacial clefts. Further initiatives are needed to provide support to individuals, families, and school communities to enhance children's experience of orofacial cleft during the formative childhood and adolescent years.
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Affiliation(s)
- Emilija D Jensen
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia.,Department of Paediatric Dentistry, Women's and Children's Hospital, North Adelaide, Australia
| | - Brianna F Poirier
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - Kelly J Oliver
- Department of Paediatric Dentistry, Women's and Children's Hospital, North Adelaide, Australia
| | - Rachel Roberts
- School of Psychology, The University of Adelaide, Adelaide, Australia
| | - Peter J Anderson
- Cleft and Craniofacial South Australia, Women's and Children's Hospital, North Adelaide, Australia.,Discipline of Paediatrics, Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Lisa M Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
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11
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Costa B, Ardouin K, Stock NM. Factors Associated With Psychological Adjustment in Adults With Cleft Lip and/or Palate: Findings From a National Survey in the United Kingdom. Cleft Palate Craniofac J 2021; 59:S7-S17. [PMID: 34235990 DOI: 10.1177/10556656211028494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Research has identified adults born with cleft lip and/or palate (CL/P) to be at risk of poorer psychological outcomes compared to the general population. This study investigated factors that may contribute to positive and negative adjustment in adults born with CL/P. DESIGN A survey was designed and distributed by the Cleft Lip and Palate Association in collaboration with the Centre for Appearance Research CAR at the University of the West of England (UWE). There were 207 eligible responses (95% completed online) received between July and October 2018. Dependent variables included the Body Esteem Scale for Adolescents and Adults, Harter's Self Perception Profile for Adults (Global Self-Worth, Social Competence, and Intimacy subscales), the Fear of Negative Appearance Evaluation Scale, and the Revised Adult Attachment Scale. Independent variables were the Revised Life Orientation Test, biodemographic data, and self-reported single-item questions. RESULTS Factors associated with positive adjustment included reports of a happy childhood, talking about CL/P with family, close friendships, comfort in public spaces, satisfaction with appearance, and a positive life orientation. Psychological distress was associated with a desire for further surgery to improve appearance and/or function. CONCLUSIONS Several factors were identified that may influence psychological adjustment in adults with CL/P. Throughout childhood, family-centered practice to support family cohesion and an open dialogue about CL/P is indicated, as is support for young people to develop social confidence. For adults returning to the cleft service, treatment options for appearance and/or functional concerns should be explored, with access to psychological support when indicated. Interventions to increase optimism, resilience, and self-acceptance may also be warranted throughout the life span.
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Affiliation(s)
- Bruna Costa
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
| | - Kenny Ardouin
- Cleft Lip and Palate Association, London, United Kingdom
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12
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Ardouin K, Davis N, Stock NM. Expanding Support Services for Adults Born With Cleft Lip and/or Palate in the United Kingdom: An Exploratory Evaluation of the Cleft Lip and Palate Association Adult Services Programme. Cleft Palate Craniofac J 2021; 59:S48-S56. [PMID: 34184577 DOI: 10.1177/10556656211025415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The largest group of people living with repaired cleft lip and/or palate (CL/P) are adults. Previous research has identified unmet treatment and psychosocial needs, yet few interventions exist. This article outlines 3 interventions developed by the Cleft Lip and Palate Association as part of its 3-year community-based Adult Services Programme; an Adults Conference, a series of panel discussions ("Cleft Talk") streamed in podcast/video format, and a Leaver's Pack of resources for adults wishing to return to cleft care. METHODS Feedback from attendees of the Adults Conferences (2018-2019) was collected using specifically developed evaluation forms. Streaming metrics and social media interactions were extracted for Cleft Talk panel discussions (2019-2020). The Leaver's Pack was piloted in 2020, using an online evaluation form. Specialist health professionals were invited to provide feedback or participate in a one-to-one interview regarding their perceived impact of the program. RESULTS All 3 interventions across the different modalities received support from participating adults, demonstrating potential to meet adults' needs across the life span. Health professionals also offered support for the program, viewing the interventions as a valuable adjunct to formal medical CL/P services. CONCLUSIONS This exploratory evaluation indicates that peer- and community-led interventions, in combination with ongoing access to specialist medical care, can have a range of positive impacts for adults with CL/P. There is scope for similar initiatives to be developed internationally and for individuals with other craniofacial conditions. Not-for-profit organizations are encouraged to routinely evaluate their interventions to create a stronger evidence base for their valuable work.
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Affiliation(s)
- Kenny Ardouin
- Cleft Lip and Palate Association, The Green House, London, United Kingdom
| | - Nicky Davis
- Cleft Lip and Palate Association, The Green House, London, United Kingdom
| | - Nicola Marie Stock
- Centre for Appearance Research, University of the West of England, Bristol, United Kingdom
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