Cleft lip, cleft palate, and dental care

This is an acquired or congenital defect of the upper lip and, much less frequently, of the lower lip. It appears as a narrow opening or cleft in the front of the upper lip, which may extend to the base of the nose. This usually occurs when the soft tissues fail to join together in the womb.

The causes are not fully understood, but are thought to be genetic or acquired (medication taken during pregnancy or severe psychological, emotional, or traumatic situations, viruses). It is much more common in boys than in girls.

In this article, we will examine two problems—cleft lip and cleft palate—which in many cases occur in combination.

These children may suffer from frequent ear infections (they are more prone to fluid buildup in the middle ear, which can lead to hearing loss), difficulty eating (because food can pass from the mouth to the nose), difficulty speaking (sound is lost to the nose and they are difficult to understand), and many dental problems. These include crooked teeth, missing lateral incisors, and defects of the alveolar ridge (which can twist the position of the permanent teeth or cause them to be missing).

For babies with this problem, there are special pacifiers that allow food to go into the stomach instead of the nose.

Which specialists treat cleft lip?

It is mandatory to consult with a dentist and orthodontist about the alignment of the teeth, who will explain in detail how and what hygiene should be observed. The dentist will plan the treatment and, if necessary, correct the relationship between the upper and lower jaw at an early stage. It is important to consult and work together with a dental surgeon and orthodontist.

Surgical correction can be performed by a dental surgeon (maxillofacial prosthetics) under anesthesia, using bone grafting. After the correction, artificial partial dentures can be made to facilitate speaking and eating.

Consultation with an otolaryngologist (ear, nose, and throat specialist) to discuss and assess hearing problems.

A pathologist to assess speech and eating problems.

Speech therapist – to work with the child to improve speech.

The first surgery is performed when the baby is 3 months old (in cases of cleft palate). Other surgeries follow over time—at age 8, a bone graft to the palate and other surgeries to improve speech. Treatment usually begins in early childhood and often continues into adolescence.

The role and assistance of parents and their full support for the mental and social development of the child are also important.

Oral hygiene begins with the appearance of the first teeth using a soft children’s toothbrush.
What are the prospects for children with cleft lip?

Treatment takes several years and several operations, but normal appearance, eating, and speech can be achieved in children affected by this condition.