Lesson 16

CHILDREN’S
DENTISTRY
LESSON 16; CLEFT LIP AND PALATE
BY
AYIZIRE BORIS MPEEKA
Cleft Lip and Palate
Definition
• Cleft lip and cleft palate are birth defects that occur when a baby’s lip or
mouth do not form properly during pregnancy.
• Together, these birth defects commonly are called “orofacial clefts”

• They are openings or splits in the roof of the mouth and lip.
Causes
• The causes of orofacial clefts among most infants are unknown

• Cleft lip and cleft palate are thought to be caused by a combination of
genes and other factors, such as things the mother comes in contact with
in her environment, or what the mother eats or drinks, or certain
medications she uses during pregnancy.
Risk Factors
• Smoking―Women who smoke during pregnancy are more likely to have a
baby with an orofacial cleft
• Diabetes―Women with diabetes diagnosed before pregnancy have an
increased risk of having a child with a cleft lip with or without cleft palate,
• Use of certain medicines―Women who used certain medicines to treat
epilepsy, such as valproic acid, during the first trimester (the first 3 months)
of pregnancy have an increased risk of having a baby with cleft lip with or
without cleft palate.
Diagnosis
• Orofacial clefts, especially cleft lip with or without cleft palate, can be
diagnosed during pregnancy by a routine ultrasound.
• They can also be diagnosed after the baby is born, especially cleft palate.
Oral Manifestations of CL/P include;
• Supernumerary teeth and hypodontia in the lines of the cleft

• Restricted dento-facial growth in the maxilla in the anterior/ posterior,
vertical and lateral directions.
• The oral treatment and management provided to an affected child by the
craniofacial Team will include:
Types / Classification
1. Unilateral Cleft Lip
• The gap is only on the side of the lip under either the left or right nostril
and might extend into the nose. The noses of babies with unilateral cleft
lip may look tilted and flat on one side.
2. Bilateral cleft Lip
• Babies with bilateral cleft lip have a gap on both sides of the lip and they
may have deep spilt in the lip that extends into both nostrils.
Unilateral and Bilateral
Types / Classification
3. Partial Cleft
Cleft lip is formed in the top of the lip as either a small gap or an indentation
in the lip
4.Complete Cleft
Continues into the nose (complete cleft).
Partial and Complete Clefts
Management
• Most kids born with this condition can have reconstructive surgery within
the first 12 to 18 months of life to correct the defect and significantly
improve facial appearance.
• The three common kinds of clefts are;
• Cleft lip without cleft palate
• Cleft palate without cleft lip
Mgt
• Cleft lip and palate together.
• Cleft can occur on one side of the mouth (unilateral clefting) or can occur
on both sides of the mouth (bilateral clefting).
• Because clefting causes specific visible symptoms it’s easy to diagnose.
Mgt
• Reconstructive surgery can repair cleft lips and palates and in severe case, plastic
surgery can address specific appearance related concerns. A child with oral clefting
will see a variety of specialists who will work as a team to treat the condition.
• Treatment usually begins in the first few months of life depending on the health of
the infant and the extent of the cleft.
• Surgery ill usually be performed during the first 3 to 6 months to repair the cleft lip
and between 9 to 14 months to repair the cleft palate. Both types of surgery are
performed in the hospital under general anesthesia.
Mgt
• The specialist will evaluate the child’s progress regularly and monitor
hearing, speech, nutrition, teeth and emotional state.
• In addition to treating the cleft, the specialists will work with the child on
issues related to feeding, social problems, speech and your approach to the
condition.
• They will provide feedback and recommendations to help you through the
phases of your child’s growth and treatment.
Complications
• Kids with a cleft lip or palate tend to be more susceptible to middle ear
fluid collection, hearing loss and speech defects.
• Dental problems such as mission extra malformed or displaced teeth and
cavities also are common in kids born with cleft palate.
Complications
• Many children with clefts are especially vulnerable to ear infections
because their Eustachian tubes don’t drain fluid properly from the middle
ear into the throat.
• Fluid accumulates, pressure builds in the ears and infection may set in.
• Feeding can be another complication for an infant with a cleft lip or
palate. A cleft lip can make it more difficult for a child to suck on a nipple
while a cleft palate may cause formula or breast milk to be accidentally
taken up into the nasal cavity.
Cleft Lip Team
• Members of the cleft lip and palate treatment team usually include:
• Plastic Surgeon
• An era, nose and throat physician (Otolaryngologist)
• An oral surgeon
• An orthodontist
• A dentist
• A speech pathologist (often called speech therapist)
• An audiologist
• A nurse coordinator
• A social worker and /or a Psychologist.
Prevention
• Pregnant women may reduce the risk of cleft lip and / or palate in their
babies by;
• Obtaining early and regular prenatal care
• Avoiding alcohol and cigarettes
• Avoiding medications which cause clefts
• Avoiding infections
• Adequate folic acid suppliments.
Thank You

Lesson 16

Uploaded by

Copyright:

Available Formats

Lesson 16

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Lesson 16

Uploaded by

Copyright:

Available Formats

CHILDREN’S

• Together, these birth defects commonly are called “orofacial clefts”

• The causes of orofacial clefts among most infants are unknown

• Supernumerary teeth and hypodontia in the lines of the cleft

You might also like