According to the center of disease control and prevention, cleft lip is the most common type of birth defect in the United States. The rate of this congenital disability is increasing every year and is becoming a topic of concern for the new parents. Many factors including a positive family history affect the development of the child and may cause the development of a cleft lip/palate.
A cleft lip is seen as a split commonly on the upper lip and a cleft palate is formed when tissues that make the roof of the mouth don’t close together. They are formed due to failure in the closure of facial structures during development. Cleft lip and palate often present as an isolated defect but are also associated with many genetic syndromes and disorders.
Oral problems that occur as a result of cleft lip and palate affect the teeth and basic functions of the mouth like swallowing, speaking and breathing. Continue reading the article to look at the causes, symptoms and the importance of consulting a doctor to timely treat cleft lip and palate.
What are cleft lip and palate?
Cleft lip and palate are clinically termed as orofacial clefts. These are a group of oral defects that may occur individually as a cleft lip, cleft palate or together as a conjoined defect. A cleft lip is characterized by a split or opening usually found on the upper lip which may extend to the nose. The separation may be unilateral or bilateral or may be present in the midline.
A cleft palate is characterized as an opening between the roof of the mouth and the nasal cavity. Cleft palate is commonly associated with genetic syndromes. Cleft lip and palate occurs in one or two out of 1000 births in the developed countries. (1)
What causes cleft lip and palate?
The exact cause of the formation of cleft lip and palate is still unknown. But certain genetic and environmental factors may increase the prevalence of developing cleft lip and palate in newborn babies.
- A positive family history of cleft lip or cleft palate will increase the risk of development in the newborn. Sometimes, the genes along with environmental triggers worsen the condition and interfere with the healthy development of orofacial structures. (2)
- An environmental cause for example smoking and drinking alcohol can have a negative influence on the development of the baby during pregnancy.
- Anti-convulsant medications taken to treat epilepsy during the first trimester may interfere and cause clefting of the lip and palate.
- Another set of medications taken to treat arthritis, acne or psoriasis during the first three months of pregnancy may increase the risk of developing this congenital disability.
- A diabetic pregnant mother may increase the likelihood of her baby to develop a cleft lip.
Whatever the case may be, the first three months of pregnancy are crucial for the development of the baby. Thus, extensive care should be taken during this time. Consult your doctor to stop or change the medications for any health condition that might influence the development of the baby.
What are the signs and symptoms?
Clinically, a cleft lip involves the upper lip and extends up to the nose. A cleft palate involves the alveolar bone and the hard palate that form the roof of the mouth. Soft palate and the muscles of the back and throat are generally not affected. The orofacial tissues are typically involved in cleft lip and palate and they may interfere with the following functions of the mouth –
- Difficulty with feeding after birth
- Difficulty in swallowing
- Any food or liquid swallowed by the baby might come out of the nose
- Difficulty in speaking, the child may develop a nasal tone
- Development of chronic ear infections
- Missing, impacted or malformed front teeth (3)
- Increased susceptibility to dental caries and oral infections
Who is at risk?
Male babies have double the chances of developing cleft and palate as compared to female babies. Statistically, cleft lip and palate are more prevalent among the Asian population. Also, parental diabetes and obesity have significant effects on the development of this orofacial defect.
When is a good time to consult a doctor?
Cleft lip and palate are easily noticed during birth. But with advancement in technology, a cleft lip and palate can be detected during a prenatal ultrasound check. Whenever the defect is identified, a doctor must start planning the treatment. A holistic approach is made by forming a team of doctors, dentists, speech therapists, nutritionists, and other medical professionals.
The treatment depends on the severity of the cleft. It may include the following options –
- Surgeries – A lip repair surgery may be planned to correct the cleft lip. Similarly, palate repair surgery is done to close the roof of the floor and separate the oral cavity from the nose. Additional surgeries to improve the shape of the nose, augment the maxillary bone and to improve the appearance of the lip and palate may be planned. (4)
- Prosthetic treatment – Sometimes, to temporarily close the palatal defect, a prosthetic appliance made from acrylic, is used to help the baby during feeding. Specialized feeding bottles with a large nipple are used to increase the feeding efficiency of a baby with cleft palate.
- Maintenance of oral hygiene, treatment of dental cavities and initiation of orthodontic treatment may be planned out by a dentist once the surgical intervention is complete. (5)
- Speech therapists keep a routine check on the improvement of speech of the child until they are fully grown.
Take away message
Growing up with a cleft lip or a cleft palate can be very challenging. But proper treatment and guidance will solve maximum problems and bring back the confidence in the child. The risk of developing a cleft lip and palate can be genetic. Consultation with a doctor before planning a child and discussing the genetic and environmental influences can help to be aware and prevent the risks.
Right information and precautionary measures will help to keep a check on avoiding the risk of development of orofacial defects from the beginning. Cleft lip and palate can be very mentally disturbing for your child. Be informed and provide better development and health to your baby.