BCOH Cleft Lip & Palate Repair

Cleft lip and cleft palate are birth defects that affect about one in every 700 newborns. These developmental deformities occur in the first trimester of a woman’s pregnancy; cleft lip in week seven and cleft palate in week nine. Cleft lip and cleft palate occur simultaneously in about half of all cases.

A cleft lip is essentially a separation of the two sides of the lip. In many cases, this separation will include the bone and gum of the upper jaw. A cleft palate occurs when the sides of the palate fail to “fuse” as the fetus is developing, which results in an opening in the roof of the mouth.

Cleft deformities are categorized according to their location in the mouth and the size of the defect.

• Unilateral incomplete: A cleft on only one side of the mouth that does not extend as far as the nostril
• Unilateral complete: A cleft on only one side of the mouth that extends into the corresponding nostril
• Bilateral complete: A larger cleft that affects both sides of the mouth and extends as far as the nostril
• Microform cleft: A mild case of cleft lip that may simply form a bump on the lip or a small scar line extending toward the nostril

What are the reasons for getting cleft lip and cleft palate repair?

Cleft lip and cleft palate are highly treatable deformities, though it may take a whole team of different specialists to fully treat the condition. The prognosis for patients who receive corrective treatment is excellent — medically, physically, and emotionally. However, there are a series of risks for those who do not receive corrective treatment:

• Speech: Children born with either cleft deformity are likely to experience speech problems unless treatment is sought. Speech problems are detrimental to a child’s social and emotional development.
• Feeding: Babies with a cleft palate or a complete cleft lip have difficulty drinking milk. The gap means that liquids can pass from the mouth to the nasal cavity. This can be dangerous unless the child is fed sitting upright.
• Hearing loss & frequent ear infections: A cleft palate can cause the eustachian tubes (connecting the throat to the ear) to be incorrectly positioned. The fluid build up which results from this poor positioning can lead to painful middle ear infections. Severe and prolonged ear infections can lead to complete hearing loss.
• Dental issues: Abnormalities in the upper jaw, gum or arch can cause teeth to become impacted (unable to erupt) or absent completely. The shape of the mouth might not permit proper brushing which can lead to periodontal disease and tooth decay.

What does getting cleft lip and cleft palate surgery involve?

Initially, surgeons will work to close the cleft openings in the first six months of the child’s life. Unfortunately, this does not cure the dental problems that occur as a result of cleft lip and cleft palate defects. One of our Boston dentists will perform a thorough examination of the teeth surrounding the deformity. Panoramic X-rays will generally be taken to allow the dentist to determine the best course of treatment.

The dentist may implant teeth to fill resulting gaps and/or place braces on the teeth in order to correctly align the upper arch. These treatments will restore functionality to the jaw and improve the aesthetic appearance of the smile. Dental restorations can generally be performed under local anesthesia and will not require an overnight stay.