Life-Course Patterns of Medical and Dental Care in Patients with Cleft Lip and/or Palate: A Nationwide Claims-Based Study

Objective To characterize diagnosis-specific structures and temporal trajectories of medical and dental healthcare utilization for cleft-related conditions using a nationwide claims database in Japan. Design Nationwide retrospective cross-sectional observational study. Setting Analysis of Japan's National Database of Health Insurance Claims and Specific Health Checkups for 2019. Patients, Participants We analyzed 52,326 patients with cleft palate (CP), cleft lip and palate (CLAP), cleft lip and alveolus (CLA), and cleft lip (CL) who generated insurance claims during the study period. Interventions None. Main Outcome Measure(s) We compared distributions of medical and dental visits by diagnosis and calculated diagnosis-specific dental-to-medical visit ratios. Differences were assessed using chi-square tests with effect size estimated by Cramér's V. Temporal differences in utilization were evaluated by calculating weighted mean age based on age group-specific visits for medical and dental care. Results A significant association was observed between diagnosis and type of care (chi-square test, P < 0.001; effect size by Cramér's V). Dental visits predominated among patients with CLAP and CLA, whereas medical visits were relatively more frequent among those with CP and CL. The dental-to-medical visit ratio exceeded 1.0 in CLAP and CLA but remained below 1.0 in CP and CL. Across all diagnoses, weighted mean age for dental visits was higher than that for medical visits, indicating a shift from early medical care to sustained dental care; this shift was most pronounced in CLAP. Conclusions Diagnosis-specific differences exist in the structure and temporal dynamics of medical and dental care among patients with cleft-related conditions.