Cleft lip and cleft palate: Causes, treatment, and speech

Cleft lip and cleft palate are congenital anomalies that occur in the face during fetal development. A cleft can be visible and can lead to medical, behavioral, and social difficulties.

Modern medicine has developed surgical corrections for cleft lip and palette.

Natural structures form in the body and fuse together while a fetus develops in the womb. If they do not fuse, a gap results called a cleft.

The Centers for Disease Control and Prevention (CDC) estimate that, in the United States, around 2,650 infants are born annually with a cleft palate. Around 4,440 babies develop a cleft lip each year, which might occur with or without a cleft palate.

Among the 15 types of clefting that might occur in the mouth and face, cleft lip and cleft palate account for between 50 and 80 percent of these congenital anomalies, and it is one of the most common in the U.S.

What is a cleft?

[cleft]
A child may develop speech problems if they do not receive treatment for their cleft.

A cleft is a fissure or gap.

The cleft in the lip may be small, or partial, and look like an indentation on the lip. A complete cleft can extend to the nose.

A unilateral cleft occurs on either the right or left side of the upper lip. A bilateral cleft affects both sides.

A cleft palate occurs when the two parts of the skull that form the hard palate do not fuse together. The soft palate also has a gap, or cleft.

A person with a complete cleft palate may also have a gap in the jaw, while an incomplete cleft palate looks like a hole in the roof of the mouth.

With modern surgery, most cases can be corrected with minimal scarring.

If not corrected, a cleft lip or palate can lead to:

dental problems

ear infections and possible hearing loss

feeding difficulties

low self-confidence

speech problems

A team of specialists, from the family physician to a speech therapist, will work to help a child with a cleft, because it can cause a range of developmental issues.

Causes

During the first 12 weeks of pregnancy, the skull of the fetus is developing.

Two separate plates of bone and tissue form and gradually move towards each other. At this point, they join, or fuse, at the mouth and nose to form the skull.

Incomplete fusion will result in a cleft.

[cleft surgery]
Surgery can close a cleft lip, enabling the child to speak and eat without difficulties.

A range of interventions is available for children born with a cleft.

An orthodontist may start to repair the palate and bring the lips together within a week of birth.

This treatment, called nasoalveolar molding (NAM) aims to prepare the infant for future surgery.

Surgery to close the cleft lip may take place within 3 to 6 months of birth. An infant will generally receive treatment for a cleft palate between the ages of 9 and 18 months.

This should enable the child to speak and eat without further difficulties.

Corrective surgery can help realign the jaw.

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