In a developed society with good healthcare, the occurrence of a cleft lip or cleft palate is relatively rare. While it is true that good diet, pre-natal healthcare, and proactive pregnancy can make significant differences in baby development prior to birth, the occurrence of a lip or palate defect is actually far more common elsewhere in the world. Fortunately, it’s also a situation that can be remedied effectively, preventing a child from a lifetime of difficulty both in physical facial function as well as social acceptance.

Background

The conditions of a cleft lip or a cleft palate fall into a group of birth situations known as congenital deformities. They are not automatically genetic, i.e. passed down from a parent. Instead, as the baby is developing in utero, something goes off track and the baby’s mouth and nasal area do not completely close prior to birth. The result is a lip that seems to be split or the nose/mouth area remains open instead of closed in a typical facial appearance. 

Treatment and Surgical Correction

If the child can feed and develops properly, there’s no need for any additional steps medically. However, once the child reaches approximately 10 months and 10 pounds, he or she is ready for a surgical correction of a cleft lip. If a cleft palate is involved, more involved surgical intervention may be necessary and may require multiple surgeries.

Typically, the child involved will go through a series of surgeries close the soft tissue defect, repairs the underlie bony deficits, and ultimately the position of the jaws. In doing so, the child then regains a functional lip, palate or both, which also helps with proper speech and swelling functions as well as social development. Children affected may also suffer from sinus problems, hearing issues and social stigmas compared to other children.

Specialized Help is Necessary

A cleft lip or cleft palate surgical treatment is not handled by a regular dentist. Both procedures fall into the category of complex craniofacial surgery and require the expertise of well trained facial surgeons.

A formal craniofacial surgical team involving oral and maxillofacial surgeons, plastic surgeons, ear, nose, and throat surgeons, speech pathologists, and general dentists are typically available to provide initial care in major metropolitan areas.  Secondary reconstructive surgeries such as repair of naso-alveolar clefts and orthognathic surgery (or reconstruction of the jaw) are often completed in your local community.  

Naso-alveolar clefts occur when the bone that supports the eye teeth of the upper jaws doesn’t develop appropriately due to a cleft palate defect.  Reconstruction of the bony deficit is completed with bone and sometimes soft tissue grafting.  This surgery typically occurs around the age of 9 or 10 years old.  

With the multiple surgeries often required to repair a cleft lip and/or palate, growth of the jaws may be restricted due to scar tissue formation.  This condition can be corrected with orthognathic surgery, or surgical repositioning of the jaws. This surgery is typically completed once skeletal growth is finished in the mid to late teens.

That said, the same expertise can also help treat similar conditions in older children and adults who may not have had surgical intervention on the typical timeline. Northwest Oral and Maxillofacial Surgery would be to provide more information and schedule a consultation as appropriate.