Cleft Lip and Palate

During early pregnancy, separate areas of the face develop individually and then join together, including the left and right sides of the roof of the mouth and lips. If the left and right sides do not join together properly, the result is a cleft. This can occur in the lip, or palate (roof of the mouth), or both. Sometimes various other deformities of the face or other organs of the body may be involved.

A completely formed lip is important not only for a normal facial appearance, but also for sucking and to form certain sounds made during speech. A cleft lip is a condition that creates an opening in the upper lip and skin between the mouth and the nose. It can range from a slight notch in the upper lip to a complete separation in one or both sides of the lip extending up and into the nose. A cleft on one side is called a unilateral cleft. If a cleft occurs on both sides, it is called a bilateral cleft. A cleft in the gum may occur in association with a cleft lip. This may range from a small notch in the gum to a complete division of the gum into separate parts. A similar defect in the palate is called a cleft palate.

The palate is made of bone and muscle and is covered by a thin, wet skin that forms the covering inside of the mouth. Its purpose is to separate your nose from your mouth. The palate has an extremely important role during speech because when you talk, it prevents air from blowing out of your nose instead of your mouth and it prevents food and liquids from going up into the nose. The back of the palate is called the soft palate and the front is known as the hard palate. A cleft palate can range from just an opening at the back of the soft palate to a nearly complete separation of the hard and soft palate.

Children born with a cleft lip and/or palate need the skills of several professionals to manage the problems associated with the defect such as feeding, speech, hearing, and psychological development. This is managed in a team approach where all aspects of care are coordinated. In most cases, surgery is recommended and can be quite positive.

Cleft lip surgery is usually performed when the baby is about 10 weeks old. The goal of the surgery is to close the separation, restore muscle function, and provide a normal shape to the mouth. A cleft palate is initially treated with surgery safely when the child is between 7 and 18 months old. This restores the separation between the mouth and the nose. The cleft of the alveolus (tooth-bearing portion of the hard palate) is normally repaired between the ages of 8 to 12 when the cuspid teeth begin to develop. The procedure involves placement of bone, often taken from the hip, into the bony defect, and closure of the hole from the nose to the gum tissue layers. Other surgeries are timed and required based on an individual basis.

The doctors at The Center would be glad to speak with you about any aspect of cleft lip and palate treatment and, if necessary, can help you find a cleft team for care management.