Cleft Lip and Palate Cleft Information

Cleft Lip and Palate Cleft 

Parents who have children or babies with Cleft Lip and Palate Cleft condition have options in what they can do. Now with modern dental and health care advances, both parents and young adults have options if they like to treat this condition. It is estimated that less than .1 percent of children are born with cleft lip and palate cleft conditions.

Cleft Lip

In the US, it is estimated about 1 or 2 children out of every 1000 or so, are born with this condition. Children with Cleft Palate and Palate Cleft are just as smart as other children, though they do have this cosmetic condition that can be fixed - if you and they choose to. 

Local Dentists, Pediatric Dentists or Oral Surgeons who have worked with babies with cleft lip and palate cleft have a lot of experience in how to handle this condition. Over time, these dentists have developed wisdom in dealing with this medical and dental issue. 

There are several important things for a family with a new diagnosis of cleft lip and/or cleft palate to understand. 

Some clefts are related to specific medications, smoking or excess alcohol consumption, but a majority are new genetic issues. This means the parents did not do anything wrong, and they should not look back with any regrets about the pregnancy. Sometimes things just happen and there is no explainable reason why they happen.

Watching new parents beat themselves up about things that they could have done differently which may have prevented the cleft does not make the situation better. Childbirth is both the most scary and most exciting time of a young couple's life. Emotionally as parents, it can for some be somewhat overwhelming. There are extra medical and dental visits to get this condition treated, if you choose to. Expect to have some down days, and let yourself experience the full range of emotions. Do not be afraid to ask for help. Know that, there are many great dental and health care options to take care of this. Your child is 

most importantly smart and can use many great health care resources to help with this condition. 

A child with a cleft lip and or cleft palate is a healthy child with a cosmetic issue that can be fixed. These issues are not like neurological, cardiac, liver, or lung issues that often have no cure. Cleft lip and palate issues are treatable with cosmetic surgery, speech therapy, cosmetic dentistry and orthodontics. As a pediatric dentist, I like to remind parents that they are speaking with the dentist and not a neurosurgeon or oncologist. These are good issues to have as they can be resolved. 

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When children are born with a cleft, they are not going to be able to nurse from the breast of the mother. Dentists that have been involved with the treatment of thousands of cleft kids, rarely see breastfeeding. Out of a thousand, will only hear one or 2 stories of a child with a cleft lip being able to nurse directly from the breast of their mother. 

The Parents need to select a center for Craniofacial disorders before birth or as soon after birth as possible. An experienced occupational and feeding therapist can help with any feeding issues that arise. The child may need a specialized type of bottle. Many times the birth hospital will not have the necessary resources. The child may have to be transferred to a Children’s Hospital. Feeding issues need to be addressed immediately so corrective surgery is not delayed. 

What is happening when children have Cleft Lip and/or Palate Cleft? 

People with Cleft Lip have a physical separation between the lip - that is, they have a separation of the two sides of their lip. Palate Cleft has a separation of the two sides of the roof of the mouth or the palate. 

People with Palate Cleft have a split or opening in the palate area of their mouth. 

When the baby is young, it is important to keep the tissue in the area of the cleft clean. Each time you change the diaper of the baby, cleft lip and palate cleft care should be done. After changing the diaper, wash your hands before going to the other end. Use a long handle cotton swab and a water based lubricant like ky jelly to clean the cleft tissues. Do not let scabs or buggers build up on the lip. The better quality of the tissue and the more healthy the tissue the surgeon has to work with, the better the result of the repair. Learn to roll the cotton swab with ky jelly over the lip and alveolar ridge. This will keep the tissue clean and make sure it is in ideal shape for surgery. 

Orthodontic Appliance 

Depending on what cleft centers you have access to, you may be offered or pushed toward a pre-surgical appliance. Two different kinds of appliances are currently used. Significant controversy exists in the literature about which one is better, and many experienced dentists' opinions feel that one size does not fit all. There are specific times and circumstances when different appliances help with different problems.

The goal of all of these appliances is to normalize anatomy before surgery. Orthodontic appliances are used to reposition the lips, bones, and nose tissues. Restoring the anatomy to a more normal position makes the surgery easier and often gets superior esthetic results. Many times if possible to do earlier in life, your dentist or doctor will use some sort of functional non-invasive appliance to help in the development of the midface and the growth of the upper jaw of kids with cleft lip and palate cleft. 

Cleft care is definitely a marathon and not a sprint. Different issues need to be treated at different times. We cannot program surgery to grow a specific way so revisions and touch up surgeries will have to be done. Dental and Orthodontic treatment will be more involved than care for the average child. Speech therapy will have to be done. If you 

have a choice, choose the providers with the most experience at a center with high volume. Once adult teeth start erupting, kids with cleft lip and palate cleft can possibly use orthodontic treatment such as braces or other appliances to align their teeth better. 

With modern dental health care advances, children born with cleft lip and palate cleft can be treated successfully. For parents, it is important to get a good dental treatment plan, proper dental imaging x-rays and understand what it entails. 

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