Managing cleft patients in primary care (SW26-06-10-01)

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We will be joined by Julia Wheatley and Dr Danielle McWilliams from Cleft Lip and Palate Action (CLAPA)

Julia Wheatley was born with a bilateral cleft lip and palate and underwent multiple corrective surgeries throughout childhood and adolescence, including major reconstructive surgery in the 1980s. Despite extensive treatment, she has lived into adulthood with a persistent palatal fistula and complex dental needs, relying on a dental plate to manage the impact on speech and eating. In recent years, progressive tooth loss has placed this at risk, creating significant functional, psychological, and employment-related concerns.

Like many adults born with a cleft, Julia has experienced long-standing difficulties accessing appropriate dental care, often relying on private treatment and encountering limited understanding of cleft-related needs within general dentistry. In 2024, following a period of acute difficulty, she re-entered specialist adult cleft care and is now supported by a multidisciplinary cleft team, receiving restorative dental treatment alongside psychological support. Julia’s experience highlights the lifelong nature of cleft and the cumulative impact of gaps in adult dental provision, as well as the importance of respectful, specialist, and psychologically informed care throughout adulthood.

Dr Danielle McWilliams is a Clinical Psychologist, working within secondary mental health services with a special interest in long-term health challenges, particularly in cleft and craniofacial conditions. She has 8 years of research experience in this field, and has published several qualitative studies, most recently focussing on adult patient experience narratives. Danielle also was born with a bilateral cleft lip and palate, and has had upwards of 25 cleft-related surgeries. Her lived experience brings a different, carefully balanced lens to her work, and she is looking to write more on the unique Insider Researcher position and responsibility within cleft and craniofacial work. Like many adults with a cleft, she has a story to tell of her dental treatment throughout her life and is personally and professionally invested in advocating for the CLAPA dental campaign. Danielle’s clinical training allows and encourages her to think systemically about the challenges faced both by services and by patients, in a way that hopefully is helpful in developing a proactive, trauma-informed view of the possibilities for cleft treatment in the future.

Recommended to all

To increase the confidence of the general dental team to provide routine, preventive and ongoing oral health care for people born with a cleft lip and/or palate, improving patient experience through evidence-based practice and inclusive professional behaviour.

By the end of this session, delegates will be able to:

• Understand the oral health needs of people with cleft across the life course, including common dental, periodontal and restorative considerations.
• Challenge myths and misconceptions that contribute to inappropriate refusal or avoidance of care for patients with cleft.
• Recognise the role of the general dental team in providing routine care alongside specialist cleft services.
• Apply practical guidance and resources, including the FDI–Smile Train materials, to everyday clinical practice.
• Identify when and how to refer appropriately, while maintaining responsibility for ongoing preventive and routine care.

Following this session, delegates will feel more confident and empowered to provide routine dental care for patients with cleft, understand their role within the wider cleft care pathway, and be better equipped to deliver inclusive, patient-centred care without unnecessary referral.