What is cleft lip and cleft palate?
Cleft lip and cleft palate are facial or oral deformities that occur during early pregnancy when the fetus is developing in the womb. The reason for clefting is insufficient tissue in the lip and mouth area and the available tissue is incapable of joining together properly.
A cleft lip is a physical split or separation of the two sides of the upper lip and appears as a narrow opening in the skin of the upper lip. This opening generally extends beyond the base of the nose and involves the upper gum and the bones of the upper jaw.
A cleft palate is a physical split or opening in the roof of the mouth. It involves the hard palate and/or soft palate.
Cleft lip and cleft palate can occur on one or both sides of the mouth and since the lip and palate develop separately they can appear either together or anyone without the presence of the other.
What causes cleft lip and cleft palate?
In most cases the etiology of both these conditions is not known but generally it is believed to be caused by
- Environmental factors
Clefting is more common in an individual wherein either the siblings or parents or a relative has had a similar condition.
Another attributing factor may be certain medications that the mother might have taken during pregnancy such as anti convulsant drugs, anti-cancer drugs, drugs for arthritis and psoriasis.
Sometimes cleft lip and cleft palate may be a condition of some other medical problem. It can also happen if the fetus during development has been exposed to certain viruses or chemicals.
How can a cleft lip or cleft palate be diagnosed?
Usually since the physical deformity is so obvious, a prenatal ultrasound can detect this condition in an unborn child. If this has gone unnoticed in the prenatal ultrasound, then a physical examination confirms this condition after the birth of the child. And at this time certain other diagnostic procedures are also carried out to evaluate if there is any other medical condition in association with cleft lip and palate.
What are the difficulties associated with cleft lip/palate?
- Eating difficulties: With an opening in the palate, foods and liquids may pass through the nose and enter back into the mouth. But nowadays certain specially designed bottles are available which help in the downward flow of the fluid into the stomach. Until surgical intervention is possible, a cleft palate patient may require using a man-made palate to help eat properly and ensure adequate nutrition.
- Ear infections: In cleft lip and palate there is always a probability of fluid buildup in the middle ear which causes ear infection and if left untreated can even lead to hearing loss. Hence such kids may need to use special tubes in the ear drum to help in fluid drainage.
- Speech problems: The voices of such children take a nasal sound and speech may be difficult to understand. Surgery generally can fix this issue entirely.
- Dental problems: Cleft lip and palate patients are more prone to dental caries and also often have missing, extra or malformed teeth which require dental and orthodontic treatments.
Treatment of cleft lip and cleft palate
Surgeries and bone graft are often necessary to treat both these conditions. Additional surgeries may be required to improve the appearance of the lips and the nose, close opening between the nose and mouth and to realign the jaw.
Dental care for cleft lip and cleft palate patients
- Early dental care: Such patients need special cleaning and fluoride application for healthy teeth. And healthy teeth are important for chewing and good nutrition. Regular dental checkups are mandatory since the initial eruption of teeth. Routine care at home such as regular brushing is also very important.
- Orthodontic care: The first orthodontic appointment should be scheduled even before any teeth eruption so that the orthodontist can evaluate the facial growth and jaw development.After teeth eruption to understand the short and long term dental needs. After the permanent teeth erupt orthodontic treatment can be done to align the teeth.
- An oral surgeon along with a prosthodontist and speech pathologist may be required to manage the associated problems like formation of dental bridges and improvement of speech.
What is the treatment for Cleft lip and Palate?
Surgeries and bone graft are often necessary to treat both these conditions. Additional surgeries may be required to improve the appearance of the lips and the nose, close opening between the nose and mouth and to realign the jaw