When experienced, qualified oral and maxillofacial surgeons, such as the physicians of COFSC, do the surgery, the results can be quite positive.

Clefts In The Lip, Gum And Palate

During early pregnancy, separate areas of the face develop individually and then join together, including the left and right sides of the roof of the mouth and lips. However, if some parts do not join properly, sections don’t meet and the result is a cleft. If the separation occurs in the upper lip, the child is said to have a cleft lip.

A completely formed lip is important not only for a normal facial appearance, but also for sucking and to form certain sounds made during speech. A cleft lip has opening in the upper lip between the mouth and nose that looks as though there is a split in the lip. It can range from a slight notch in the colored portion of the lip to complete separation in one or both sides of the lip extending up and into the nose. A cleft can be unilateral (on one side) or bilateral (on both sides.)

A cleft in the gum may also occur in association with a cleft lip. This may range from a small notch in the gum to a complete division of the gum into separate parts. A similar defect in the roof of the mouth is called a cleft palate.

Understanding a Cleft Palate

The palate is the roof of your mouth—the part you feel when you run your tongue over the top of your mouth. Made of bone and muscle, it is covered by a thin, wet skin that forms the red covering separating the nose from the mouth. The back portion is called the soft palate and the front is known as the hard palate.

As in cleft lip, a cleft palate occurs in early pregnancy when separate areas of the face, which have developed individually, do not join together properly. A cleft palate can range from just an opening at the back of the soft palate to a nearly complete separation of the roof of the mouth (soft and hard palate).

The palate has an extremely important role during speech because it prevents air from blowing out of the nose instead of the mouth when talking. It is also crucial for eating because it prevents food and liquids from going up into the nose.

Some babies born with a cleft palate have a small chin. Babies who have this combination of symptoms, known as Pierre Robin sequence, may have breathing difficulties. Since the lip and palate develop separately, it is possible for a child to be born with a cleft lip, palate or both. Cleft defects occur in about one out of every 800 babies.

Children born with either or both of these conditions usually need the skills of several professionals to manage the problems associated with the defect, such as feeding, speech, hearing and psychological development. In most cases, surgery is recommended. When experienced, qualified oral and maxillofacial surgeons, such as the physicians of COFSC, do the surgery, the results can be quite positive.

Cleft Lip Treatment

Cleft lip surgery is usually performed when the child is about 10 years old. The goal of surgery is to close the separation, restore muscle function and provide a normal shape to the mouth. The nostril deformity may be improved as a result of the procedure or may require a subsequent surgery.

Cleft Palate Treatment

A cleft soft palate is usually safely treated with surgery when the child is 7-18 months old, but it depends upon each individual’s situation. For example, if the child has other associated health problems, it is likely that the surgery will be delayed.

The cleft hard palate is generally repaired between the ages of 8 and 12 when the cuspid teeth begin to develop. The procedure involves placement of bone from the hip into the bony defect, and closure from the nose to the gum tissue in three layers. The corrective surgery may also be performed in teenagers and adults as an individual procedure or combined with corrective jaw surgery.

The major goals of surgery are to:

• Close the gap or hole between the roof of the mouth and the nose.
• Reconnect the muscles that make the palate work.
• Make the repaired palate long enough so that the palate can perform its function properly.