Each year, approximately 2,600 babies are born with a cleft palate, and an additional 1,800 are born with a cleft lip. These fall under the term “orofacial clefts,” which are characterized by an underdeveloped mouth or lip, sometimes extending into the nasal cavity. Children with an orofacial cleft often have difficulty latching, breastfeeding, and speaking clearly, and they can experience an increased risk of an ear infection if left untreated.
Treatment for an orofacial cleft varies depending on the severity and other associated syndromes. From surgery to orthodontia, modern healthcare is tailored to each child’s specific condition and needs. These individuals and their parents need to create a good relationship with an orthopedic doctor specializing in managing and treating orofacial clefts.
With National Cleft and Craniofacial Awareness and Prevention Month upon us, it’s the perfect time to raise awareness and improve the understanding of orofacial clefts. From development to causes and treatment, we’ve got the insider scoop on everything to do with orofacial clefts.
Causes and Risk Factors
A cleft lip often develops between the fourth and seventh weeks of pregnancy. As a baby matures inside the womb, body tissue and special cells grow towards the center of the head, forming the face, including the eyes, nose, mouth, and lips. A cleft lip happens when the tissues that shape the mouth don’t come together, leaving an opening in the upper lip. This opening can be small or extend into the lower nasal cavity on the right side, left side, both, or middle.
A cleft palate is similar, developing between the sixth and ninth week of pregnancy when the tissues that form the roof of the mouth don’t join together. This leaves an opening, small or large, in the front, back, or middle of the mouth.
The exact cause of a cleft lip and palate remains uncertain. Doctors believe the condition may result from changes in the genetic makeup of a developing fetus. It may also be influenced by the mother’s environment, what she consumes throughout pregnancy, smoking, diabetes, and chronic use of medication. The CDC continues to fund the study of congenital disabilities to determine other possible causes and risk factors.
Management and Treatment
For children born with an orofacial cleft, there are several treatment options available. Surgery to repair a cleft lip is highly recommended in the first 12 months of life—18 months for a cleft palate. It is important to note that most children will require additional surgical treatments later on during development. Surgery may improve the look and appearance of a child’s mouth and result in improved speech, hearing, and breathing.
Children with orofacial clefts might also require orthopedic braces to assist in developing their jaw and airway. It is essential to connect with an orthodontist in the early stages of life, as these doctors can closely monitor the child’s condition and handle any issues that may arise. The type of orthodontic treatment largely depends on whether or not the child’s orofacial cleft affects the alveolus, the bony sockets in the jaw where the adult teeth sit. This condition often requires more extensive orthodontic treatment, such as an alveolar bone graft, to fill in the gap in the gums before a child’s adult teeth grow in.
Other treatments are more geared towards managing the symptoms associated with an orofacial cleft. For babies, an opening in the palate can make it difficult to breastfeed as liquids can pass from the mouth back through the nose. That said, some specially designed bottles and nipples can eliminate this problem, ensuring the liquid moves down into the stomach.
Children may also experience an increased risk of ear infections, as fluid can accumulate in the middle ear, causing discomfort and possible hearing loss. Doctors often recommend annual checkups to access fluid levels and manually drain the ears if necessary.
Another common symptom of an orofacial cleft is difficulty with speech. The sound may be distorted, difficult to understand, or considered nasally. While surgery is often the prescribed solution, individuals may also work with a speech pathologist to improve their symptoms.
National Cleft and Craniofacial Awareness and Prevention Month is the perfect opportunity to raise awareness and improve the understanding of orofacial clefts. By making ourselves aware of the potential causes and treatment options available, we can continue to expand our knowledge with the hopes of providing better treatment and prevention in the future.