Caries in children with and without orofacial clefting: A systematic review and meta-analysis

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 4,647 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.