Considerations in dental local anaesthesia for the patient with cleft lip and palate

Patients who have had a history of surgical repair of cleft lip and palate can often develop scar tissue post-operatively that can make it more difficult for dentists to achieve sufficient local anaesthesia. In addition, the presence of a cleft can result in anatomical variation of nerve supply to the maxillary region, which can result in further complications for achieving sufficient anaesthesia. This article reviews the anatomical variations that can occur, and posits a technique to allow for more predictable and successful local anaesthesia in this cohort of patients. CPD/Clinical Relevance: GDPs may have difficulty in achieving sufficient local anaesthesia for patients with a cleft lip and palate.