185 - Oral Health Determinants and Access in Cleft Lip and Palate

Abstract:

Purpose: To describe oral health status, sociodemographic factors, dental general anesthesia (DGA) utilization, and evaluate associations between dental home proximity and oral health outcomes among patients with cleft lip and/or palate at the University of North Carolina Craniofacial Center.

Methods: This cross-sectional study included 452 patients from birth to 19-year-olds seen between August 2023 and October 2025. Data were collected through questionnaires, dental examinations, and chart reviews. Dental home and patient addresses were geocoded using ArcGIS Pro to calculate Euclidean distance. Multivariable logistic regression examined associations between distance-to-dental-home quartiles and DGA use and tested for linear trends.

Results: Sixty-five patients (14%) presented with cleft lip, 166 (37%) with cleft palate, and 221 (49%) with cleft lip and palate. Eighty-seven patients (19%) had an associated syndrome; Pierre Robin sequence (n=29) was most common. Most patients were male (66%), White (46%), and Medicaid insured (58%). The prevalence of dental caries, restorations, gingivitis, and dental trauma was 26%, 46%, 42%, and 11%, respectively. Most patients (83%) had a dental home, and 21% had undergone DGA. DGA prevalence increased across distance quartiles (16% to 30%), with a positive linear trend. Each quartile increase in distance was associated with higher odds of DGA use (OR=1.35; 95% CI:1.06–1.70; P=0.014) after adjusting for sex, age, ethnicity, and rural/urban residence.

Conclusion: Greater distance to dental home was associated with increased DGA use, underscoring the importance of improving access to coordinated dental care for patients with cleft conditions.

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