Cleft lip and/or palate are among the most common birth defects worldwide. In the United States alone, more than 4000 babies are born with cleft lip every year, while as much as 3000 have cleft palate. These developmental defects occur when the structures that form the lip and/or roof of the mouth fail to fuse properly during embryonic development.
Risk Factors for Cleft Lip and Palate:
Risk factors that could lead to the development of cleft lip and palate include diabetes, smoking, alcohol abuse, and anti-seizure medications to name a few. Not taking enough folic acid may also be contributing factor.
Genetics and race may also play a role, as it has been found that babies of Asian, Native American, and Latin American descent are more likely to develop cleft lip and/or palate than everyone else.
Diagnosis of Cleft and Lip Palate:
Cleft lip can easily be diagnosed during pregnancy via routine ultrasound, while cleft palate may only be diagnosed after the baby is born. Some forms of cleft palate are diagnosed later in life.
Types of Cleft Lip and Palate:
There are two major types of cleft – cleft lip and cleft palate. Some babies are born with either cleft lip or cleft palate, but there are also those who have both.
A cleft lip appears like an opening on the edge of the upper lip, but in severe cases, it may extend up to the nose. It may be a partial or complete, unilateral (one-sided) or bilateral (both sides) cleft.
On the other hand, a cleft palate pertains to the split in the floor of the mouth, which results to communication between the nasal and oral cavity. The cleft usually involves the soft palate, or it may also extend into the bony hard palate.
Complications of Cleft Lip and Palate:
The most common problems associated with clefts are feeding difficulties, especially in the case of a cleft palate. The gap in the roof of the mouth prevents proper suction, and thus necessitates the use of special feeders that aid parents in feeding their babies.
Other complications that may arise include speech difficulties, ear infections and possible hearing loss, and dental problems such as misshapen, missing, or misaligned teeth. There may also be increased risk for tooth decay since the enamel of the teeth tends to be weaker, and the salivary flow is often decreased and less effective.
Treatment for Cleft Lip and Palate:
Cleft lip and palate is a complicated problem that requires team effort to manage. Treatment depends on the severity of the cleft. Some patients may only need orthodontic treatment, but surgery is required most of the time. Surgical treatment is often planned and executed by a team of specialists which usually include an orthodontist, an oral surgeon, a pediatrician, an otorhinolaryngologist (ENT specialist), and a speech therapist. The initial surgery will take place in as early as eight weeks.
Successful treatment shall help the patient achieve normal appearance and function.