Two of the most common birth defects are cleft palates and cleft lips, affecting thousands of children every year in the United States. The conditions vary in severity, ranging from simply altered appearance to speaking, feeding and even breathing difficulties. Cleft lips and palates almost always require surgical solutions, and a team approach from many different specialties yields the best results.
Surgical Cleft Treatment
Surgical treatment for cleft lips and palates is typically performed in a hospital setting, usually when an infant is between 6 and 12 weeks old. The child is properly anesthetized and then incisions are made on either side of the cleft, creating “flaps” of tissue which are then sutured together to close the gap. Generally speaking, great care is taken to follow the contours of the face and mouth so that surgical scars are as minimal and unobtrusive as possible.
Cleft palate surgery also involves rebuilding soft tissue and bone structures, which occur usually between 6 and 18 months. Because of the specialized and comprehensive techniques involved, the child may need to wear specialized appliances or mouthpieces to ensure tissues and bones stay in their new intended position.
The Orthodontist’s Role in Cleft Treatment
The orthodontist plays a major role in the treatment of the cleft patient. Many of the appliances that may be needed to help the cleft patient either in feeding or speech can be constructed by the orthodontist.
Palatal Expanders
Expanders play an important role in cleft lip and palate treatment. Quite often, the malformed palate is constricted to the point that the orthodontist can place an expander to widen the palate. Then, once the new width is achieved, a surgical procedure called an “alveolar bone graft” can be considered. The orthodontist and surgeon work closely together to get this part of the treatment plan fulfilled.
Follow-Ups
Depending on the severity and complexity of treatment, follow-up appointments may be required after surgical cleft lip or palate surgery. These could include anything from regular examination appointments to additional procedures such as tissue or bone grafts.
While cleft lips and palates are challenging for parents and caregivers, it is important to remember that it is a common and very treatable condition.