About Cleft Palate/Cleft Lip
Cleft palate and cleft lip are forms of birth defects or congenital deformities that occur when the upper lip and the tissue that forms the roof of the mouth do not join together before the birth of the child; the defects usually occur during the early stages of a mother’s pregnancy. The gap formed by a cleft lip or cleft palate (also called harelip) can be as small as a slight space on the lip; the space can also be bigger, and can run all the way into the roof of the nose or the mouth.
A cleft lip refers to the gap or cleft that does not affect the mouth’s palate structure; a cleft palate, on the other hand, refers to the condition when the two plates of the skull that form the roof of the mouth (called the hard palate) are not fully joined together.
Causes of Cleft Lip/Cleft Palate
Although the exact causes of a cleft palate or cleft lip are unknown, the following factors may affect the occurrences of these congenital defects:
- Genetic and environmental factors
- Medications taken by the mother during pregnancy
- Exposure to chemicals or viruses during the child’s developmental stage inside the womb
- Other medical conditions
Problems Associated with a Cleft Palate/Cleft Lip
Speech Problems – Children who have a cleft lip or a cleft palate may experience difficulties in speaking, as their voices and enunciation will be affected by the cleft; most of the time, the voice and words come out as nasal-sounding and can be hard to understand. Surgery to close the gap, as well as speech pathology, can address these speech problems.
Eating Problems – The space in the palate resulting from the cleft can pose eating and drinking problems, as the food and beverages can pass unintentionally from the mouth back to through the nose. There are specially-designed feeding bottles and nipples for babies with cleft palate or cleft lip; these nipples and baby feeding bottles work to ensure that the liquids are kept flowing downwards, to avoid going back through the nose.
Hearing Loss/Ear Infections – Children who have a cleft lip or a cleft palate have a higher risk of fluid build-up in the middle ear area, which in turn makes them more susceptible to ear infections; these infections can lead to the loss of hearing if left undiagnosed and untreated. There are special tubes that can be placed in the eardrums of children to help in the drainage of excess fluid, so infections can be prevented. Children who have a cleft lip or a cleft palate should be checked for hearing problems every year, to make sure that no infections or problems can develop.
Dental Problems – Children who have clefts have a higher risk of developing cavities, and are more prone to malformed, displaced, missing or extra teeth. A cleft palate or cleft lip can also result to an alveolar ridge defect, which can lead to: improper alveolar ridge formation, problems with the appearance of permanent teeth, and the tipping/rotation/displacement of permanent teeth. Orthodontic treatments and oral surgery by dentists are done to address these dental problems.
Treatment for Cleft Lip/Cleft Palate
The initial treatment for a cleft palate can be started when the baby is as young as three months old; depending on the severity of the cleft, the treatment may involve one or two surgeries.
A cleft palate usually requires multiple surgeries in the course of 18 years, with the first one done when the baby is between six to 12 months old. This initial surgery is done to create a functional palate, helps in the proper development of facial bones and teeth, and reduces the risk of fluid build-up in the middle ear.
A bone graft can be done when a child with a cleft palate is eight years old; the bone graft is necessary to support permanent teeth and to stabilize the upper jaw. Some of the children with a cleft palate may still need further surgeries to help in speech improvement, and orthodontic braces may be needed to straighten permanent teeth.
Other surgical procedures may be done to close the space between the nose and the mouth area; the surgeries will also help improve the appearance of the nose and the lip area, and can help stabilize the jaw and assist the child with normal breathing.
Modern science has made it possible for children with a cleft palate or a cleft lip to have the quality of lives they deserve. Although the treatments may need to be done over the course of a number of years to address the problems associated with a cleft lip or a cleft palate, most of the children who get these treatments are able to conquer the speech, eating and appearance issues that have previously been a hindrance to their leading normal lives.
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