Counselling for adults
CLAPA offers a dedicated counselling service for adults born with a cleft to help you cope with these challenges and feel better.
A cleft can make it harder to keep teeth clean and can also cause issues with teeth placement or missing teeth.
This page answers common questions adults born with a cleft may have about accessing dental treatment, both through local dentists and the NHS Cleft Teams.
We also have a page about dental health and hygiene which is aimed at parents and carers of children born with a cleft.
Campaign: End the Cleft Dental Crisis
Cleft is a lifelong condition where good dental health is vital. But born with cleft are disproportionately unable to access vital dental treatment, with some even being denied care outright.
Learn more about CLAPA's campaign to end the cleft dental crisis in the UK.
Maintaining good dental health
Generally, you should see your General Dental Practitioner (family dentist) up to twice a year for check-ups and cleaning.
Your family dentist will tell you if they
need to see you more often. They should check if you are keeping your mouth clean enough, consider your gum health, and look closely at your teeth to check if any are developing cavities. Your dentist should also provide any cleaning and most of the dental treatment you need.
For some treatments, your dentist will ask for specialist advice and support from a consultant in restorative dentistry, who usually works as part of the Cleft Team.
Treatment related to your cleft, delivered by an NHS Cleft Team, is free of charge.
For services from your General Dental Practitioner, there is usually a charge. You will need to see them for routine dental care, including during and after any treatment you may have through the Cleft Team. The charge depends on where in the UK you live and if you are registered with an NHS or private dentist.
Search ‘NHS dental treatment
costs’ and the country or region
you live in to find up-to-date
information.
If your dentist says a type of treatment is necessary, you should not be asked to pay for it privately. These should always be available at the usual NHS rates, and they should be of the same high standards as private treatments. This includes treatment that is usually considered cosmetic (such as implants), as long as it is for problems caused by your cleft.
If you are worried about seeing a dentist or having treatment, go with a trusted friend or family member for support, and talk to your dentist beforehand. They will be ready to help and calm you if you’re feeling nervous.
Some dentists advertise that they welcome nervous patients. Speak to your Cleft Clinical Psychology Team if you are
particularly worried about visiting the dentist, especially if fear is preventing you from visiting the dentist as often as you should.
The Oral Health Foundation provides confidential help and advice with dental issues. They have information on dental phobias available here.
You should visit your General Dental Practitioner (family dentist) for the same reasons somebody without a cleft would.
This would be for check-ups, cleanings, to check for decay, caries and cavities, or
because you are experiencing sensitivity and pain not related to cleft (e.g. an abscess in one of your lower teeth).
You should see the Cleft Team’s specialist restorative dentist for anything you believe has happened due to being born
with a cleft, e.g. missing or extra upper teeth, differences in the shape of the upper teeth, pain or sensitivity in teeth near the cleft site. The restorative dentist can then advise you on the best course of treatment and who can provide this.
If you’re unsure, contact your Cleft Team for advice on who to see.
The NHS website is the best place to start when looking for a local dentist taking on NHS patients.
Some adults with a cleft can have problems finding a dentist that understands their particular issues and can provide appropriate treatment. If you’re having trouble finding a dentist that can help you, talk to your Cleft Team, as there will be a specialist dentist and/or orthodontist who may be able to advise you going forward. There is some inconsistency across the UK when it comes to where and how any dental care for patients with a cleft will be carried out, and you may be sent out of your local area to get complex care on the NHS.
CLAPA cannot give recommendations or referrals to General Dental Practitioners.
If you are having trouble finding a local General Dental Practitioner to register with, it may be helpful to present them with a template letter explaining how vital dental care is for people born with a cleft.
What dental treatment may be available to me as an adult through the Cleft Team?
Adults born with a cleft which affects their teeth can have their dental and orthodontic needs assessed (and sometimes treated) by cleft specialists in the NHS Cleft Teams.
If you are referred to see the Cleft Team, the team will work together to look for a solution to your problems, including any dental issues. Even if you think there may not be any options for your teeth, or you were told many years ago no further treatment is available for you, it’s worth checking with the Cleft Team’s restorative dentist and/or orthodontist.
The restorative dentist can restore teeth and replace missing teeth, as well as help you achieve better dental health. The treatments include fillings, dentures, crowns, braces, bridges, veneers, and, in some cases, dental implants.
- A denture is a removable plate or frame holding one or more artificial teeth. They are made of acrylic, or acrylic with a metal alloy of cobalt and chromium.
- A crown is a type of fixed dental restoration that completely covers a tooth. A crown may be needed when a large dental cavity cannot be restored with a filling.
- A bridge is a fixed dental restoration that’s used to replace one or more missing teeth by joining an artificial tooth to one or more of the adjacent teeth.
- A veneer is a fixed dental restoration that is bonded to the tooth surface, to change the surface, shape or shade of a tooth. They are usually thin layers of porcelain or composite resin.
- A dental implant is a titanium metal screw which can be surgically placed into the socket bone from where a tooth is missing. The implant can then be restored with a crown, a bridge, or a denture.
If you haven’t had an alveolar bone graft or jaw surgery, these could be starting points for your treatment, depending on your needs.
Specialist care (orthodontics, oral and maxillofacial surgery and sometimes restorative care) will usually be carried out by your Cleft Team free of charge, but the provision of restorative dental care (bridges, implants and veneers) varies from area to area, so you should talk to your Cleft Team for more information.
Find support
Need to talk it through? Check out CLAPA's support services for adults born with a cleft.
Peer Support Service
Our Peer Support service is a quick and simple way to talk to a trained volunteer adult one-on-one about whatever’s on your mind.
Adults’ Facebook Group
CLAPA’s Adult Support Group on Facebook has over 2.5k UK members swapping stories, sharing photos, celebrating successes, and supporting each other through the toughest parts of their cleft journeys.