What is Cleft Lip / Cleft Palate?

A cleft palate occurs when there is a direct opening between the palate, or roof of the mouth, and the floor of the nose. During pregnancy, the baby's upper jaw fails to close as it should, leaving a gap. A cleft palate is a more serious condition than a cleft lip, although both require surgery in order to be corrected.

Eating, breathing, speech and psychological problems are some of the difficulties confronted by the child with a cleft lip or palate. To correct the condition, you are likely to work with a team involving a plastic surgeon, maxillofacial surgeon, otolaryngologist (ear, nose and throat specialist), general dentist, orthodontist and oral surgeon.

The doctor who delivers your baby will probably be able to tell right away if he or she has a cleft lip or palate. A cleft lip is easy enough to see. A cleft palate can vary in size from a small crack to a large hole in the roof of the mouth, and will become apparent soon after birth, if not immediately. When a baby with a cleft palate tries to feed, liquids or food may come out if its nose. This can be addressed with special bottles and extra care until the baby is old enough to undergo surgery.

Surgically closing a cleft lip is simpler than repairing a cleft palate. The procedure is usually performed within 3-4 months after birth, and the scar usually fades as the child gets older.

With a cleft palate, surgery is delayed until the child is 1-2 years old, when the upper jaw has reached normal growth. If the damage is extensive, surgery may be put off until the child is aged 5-7 to prevent structural problems. In some cases, surgery is not possible or may not totally close the opening. In this case, a denture-like appliance called an obturator, is made to cover the opening and allow normal eating.

Depending on the severity of the cleft palate, multiple surgical procedures may be required over an extended period of time. A plastic maxillofacial surgeon performs corrective surgery on the face, while a general dentist, oral surgeon, otolaryngologist or orthodontist make appliances to correct any defects.

Your healthcare team will provide guidance and encouragement during the difficult time from birth to treatment. With the advances in surgical techniques and corrective appliances, the outlook for children born with cleft lips and palates is excellent. As the child gets older, little sign of the cleft should remain.