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When I graduated from McGill Dentistry in 1988, I was fortunate to do a Dental Residency at the Montreal Children’s Hospital.
Along with providing dental treatment to underprivileged children, there was also a great Cleft Palate program which I was able to partake in.
What is Cleft Lip and Palate?
A cleft lip is when there is a gap present in the upper lip when the child is born. Sometimes this gap continues up to and through the palate…this is called a Cleft Palate. There are varying degrees to which this can occur.
In the early stages when the fetus is developing in utero, the lips and palate are supposed to fuse (or seal) together. This is supposed to happen at an exact time during the developmental process. A cleft lip or palate arises when this fusion does not occur when it is programmed to. For instance, if portions of the lip are meant to fuse together on day five of development, and they do not, then the upper lip remains split.
If the palatal portions (called palatal shelves) are meant to fuse on day six and they do not, then there will be a split in the palate.
Certain events are ‘programmed’ to occur in fetal development and cleft lip and palate happen early in this process.
It may be genetic or due to certain environmental influences that the mother may have been exposed to while pregnant.
The most common place to see a cleft lip is in the area of the upper lateral incisor (near the nostril of the nose). It may be either unilateral or bilateral.
If you would like to have an image of cleft lip or palate, then you can see many illustrations by going to Google Images.
Difficulties that arise due to a Cleft Lip and Palate
Aside from physically altering the appearance of the face, a cleft:
1) Makes it difficult to eat.
2) Difficult to speak.
3) Results in teeth that are out of alignment (usually severe).
4) Ear infections due to Eustachian Tube dysfunction.
Treatment is usually at an early age (3-6 months) of age. Surgery is necessary and many times, multiple surgeries depending on the severity of the cleft.
Successful treatment usually involves a team effort I.e. Orthodontist, Plastic Surgeon and General Dentist.
It can be very upsetting for any parent to have to deal with an issue like cleft lip or palate. But through collective efforts of the cleft palate ‘team’, your child’s functioning and appearance will come to resemble that of a child without; however, some work may be required to get there.
Until next time,
Dr. Robert Axelrad, Brampton Dentist