Dental treatment need and dental general anesthetics among preschool- age children with cleft lip and palate in northern Finland Lehtonen V, S andor GK, Ylikontiola LP, Koskinen S, Pesonen P, Harila V, Anttonen V. Dental treatment need and dental general anesthetics among preschool-age children with cleft lip and palate in northern Finland. Eur J Oral Sci 2015; 00: 00–00. © 2015 Eur J Oral Sci Cleft lip and palate incidence is high in northern Finland. This study aimed to investigate the proportion of children in need of restorative dental treatment among cleft lip and palate patients in northern Finland, as well as their need for dental treatment under general anesthesia. The records of 183 cleft lip and palate patients, treated in Oulu University Hospital from 1997 to 2013, were reviewed. Data on dental caries were analyzed in association with cleft type, considering also the pres- ence of syndromes. The frequency of dental general anesthetic (DGA) use, and of treatments, were also analyzed. Dental treatment need was most frequently observed, in this rather limited study population, in patients with the most severe deformities, namely bilateral cleft lip and palate, of whom 60% had caries. Among the study population, 11.5% (n = 21) had a syndrome. Of those, 57.1% had dental caries at the age of 3 or 6 yr, and only four could be treated without a DGA. Den- tal treatment under general anesthesia was performed in 14.8% of cleft patients without a syndrome, but in 38.1% of those with a syndrome. General anaesthesia is required for the provision of dental care more often in cleft (17.5%) than in non- cleft (0.2%) patients, and especially for those with a syndrome. Ville Lehtonen 1 , George K. S  andor 2,3 , Leena P. Ylikontiola 2,3 , Sari Koskinen 4 , Paula Pesonen 5 , Virpi Harila 3,6 , Vuokko Anttonen 1,3 1 Department of Cariology, Paedodontics and Endodontology, Institute of Dentistry, University of Oulu, Oulu; 2 Department of Oral and Maxillofacial Surgery, Institute of Dentistry, University of Oulu, Oulu; 3 Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu; 4 Oulu University Hospital, Oulu; 5 Institute of Dentistry, University of Oulu, Oulu; 6 Department of Oral Development and Orthodontics, Institute of Dentistry, University of Oulu, Oulu, Finland Vuokko Anttonen, DDS, PhD, Assistant Professor, Institute of Dentistry, University of Oulu, POB 5281, 90014 Oulu, Finland E-mail: vuokko.anttonen@oulu.fi Key words: cleft; dental caries; dental general anaesthesia; dental treatment Accepted for publication April 2015 Cleft lip and/or palate is the most frequent congenital anomaly occurring in the craniofacial region (1). Clefts are divided into three groups: cleft lip (CL); cleft lip and palate (CLP); or isolated cleft palate (CP). Cleft lip can be unilateral or bilateral. The incidence of clefts varies between countries and racial or ethnic groups (2). The incidence of clefts is estimated to be between 1 and 2.21/1,000 live births (3). In England, the incidence of clefts is 1.42/1,000 infants (4). A recent study in Tai- wan found a birth rate of 3.2/1,000 facial cleft deformi- ties in newborns (5). The overall incidence of clefts in Finland is 2.56/1,000 live births and abortions. The incidence of isolated cleft palate in Finland is amongst the highest on the globe, at 1.36/1,000 (6). The respec- tive figure is about 1/2,000 births among Black people, 1/800 births among White people, and 1/500 births in Indian or Japanese people. Cleft lip and palate is more frequent in male infants, but CP most frequently affects female infants (7, 8). Patients with CLP may experience feeding, swallow- ing, speech, hearing, and cosmetic problems, as well as poor dental health (9). The successful treatment of a cleft patient consists of multidisciplinary surgical and nonsur- gical care that is performed from birth to adulthood (4). The goal of the cleft-related surgical treatments is to ensure normal development, facial growth, and appear- ance for the patient, as well as normal hearing and speech and a normal upper respiratory tract (10). In Finland, dental treatments involving cleft patients are funded by the government. Surgical treatment starts before the child reaches 1 yr of age. A cleft lip is normally repaired at the age of 3–6 months, and a cleft palate at the age of approximately 9 months. However, the exact timing of surgical treatments varies with each case (11). In Finland, all children are entitled to free dental care up to the age of 18 yr, inclusive. Yet, about one- third of 5-yr-old children and one-half of 12-yr-old chil- dren have dental caries-related tooth damage with approximately 0.5 caries lesions/individual (or 500 car- ies lesions/1,000 individuals) (12, 13). The proportion of children with cleft lip and/or palate, 6–36 months of age with dental caries lesions, was recently reported to be 18.9% in an article assessing Brazilian children (14). A study in West Scotland found that the prevalence of dental caries was more common in children with clefts than in healthy children (15). Eur J Oral Sci 2015; 1–6 DOI: 10.1111/eos.12195 Printed in Singapore. All rights reserved Ó 2015 Eur J Oral Sci European Journal of Oral Sciences