Cleft lip and cleft palate is quite a common birth defect that occurs alone or as part of a genetic condition or Syndrome. Cleft lip and cleft palate results when facial structures that are developing, in an unborn baby, don’t close completely. The lip forms between the 4th to the 7th week of pregnancy. As the baby develops, during pregnancy, body tissue and special cells from each side of the head grows towards the Centre of the face and join. A cleft lip occurs if the tissue that makes up the lip doesn’t join. Cleft lip can be on one side or on both sides of the lip.
Sometimes, children with cleft lip also have a cleft palate Cleft palate happens if the tissue that makes up the roof of the mouth does not join together completely during pregnancy. Despite the numerous clinical and experimental investigations, the causes of cleft lip and cleft palate in human beings are still largely unknown. Most probable causes would be genetic and other environmental risk factors.
Physiologic, emotional or traumatic stress may play a significant role.
Other factors suggested were;
- Lack of Prenatal nutritional supplements.
- or a defective vascular supply to the area involved.
- or circulating substances such as alcohol, certain drugs and toxins.
- or a mechanical disturbance, in which, the size of the tongue can prevent the union of body tissue
- Another cause could be lack of inherent force. Several risk factors, like having diabetes and being obese during pregnancy also contribute to having cleft lip n palate.
- It has been researched however that heredity is probably the most important single factor.
There are a number of problems associated with this condition
- Difficulty in feeding: eating and drinking gets difficult because of regurgitation of food and liquid through the nose.
- Speaking with a nasal twang is sometimes so severe as to cause an increase in mental trauma to patient with social implications.
- Babies with cleft palate are especially at risk of developing middle ear fluid and hearing loss.
- If the cleft extends through the upper gum, tooth development may be affected.
- Children with clefts may face social, emotional and behavioral challenges due to differences in appearance and the stress of intensive medical care.’
Diagnosis: Cleft lip with or without cleft palate can be diagnosed during pregnancy by a routine ultrasound, beginning around 13th week of pregnancy.
Treatment: Most cases of cleft lip can be surgically repaired with excellent cosmetic and functional results.
Surgeries are typically performed in this order.
- Cleft lip repair-within first 3 to 6 months of age or when the baby has gained sufficient weight
- Cleft palate repair-by age of 12 months or earlier if possible.
- Follow up surgeries-between age 2 years and late teen years.
Subsequently, children born with cleft lip may require other types of treatment and services such as special dental or orthodontic care or speech therapy, hearing aids and therapy with psychologist to help cope with stress of repeated medical procedures.
With treatment most children with clefts do well and lead a healthy life.
Dr. Siena Pacheco
Dental surgeon