Cleft Lip & Palate Repair

Online Dental Education Library

Ones healthy smile depends on simple dental care habits, such as brushing and flossing. Please follow these steps to protect you and your loved ones oral health.

Brushing for proper oral health

Consider these brushing basics from the American Dental Association:

Brush your teeth at least twice a day. When you brush, don’t rush. Take enough time to do a thorough job.

Use the proper equipment. Use a fluoride toothpaste and a soft-bristled toothbrush that fits your mouth comfortably. Consider using an electric or battery-operated toothbrush, especially if you have arthritis or other problems that make it difficult to brush effectively.

Practice good technique. Hold your toothbrush at a slight angle against your teeth and brush with short back-and-forth motions. Remember to brush the inside and chewing surfaces of your teeth, as well as your tongue. Avoid vigorous or harsh scrubbing, which can irritate your gums.

Keep your equipment clean. Always rinse your toothbrush with water after brushing. Store your toothbrush in an upright position, if possible, and allow it to air dry until using it again. Don’t routinely cover toothbrushes or store them in closed containers, which can encourage the growth of bacteria.

Know when to replace your toothbrush. Invest in a new toothbrush or a replacement head for your electric or battery-operated toothbrush every three to four months — or sooner if the bristles become frayed.

Flossing for proper oral health

You can’t reach the tight spaces between your teeth or under your gumline with a toothbrush. That’s why daily flossing is important. When you floss:

Don’t skimp. Break off about 18 inches (46 centimeters) of dental floss. Wind most of the floss around the middle finger on one hand, and the rest around the middle finger on the other hand — leaving about 1 inch (3 centimeters) to floss your first tooth.

Take it one tooth at a time. Use your thumbs and forefingers to gently pull the floss from the gumline to the top of the tooth to scrape off plaque. Rub the floss against all sides of the tooth. Unwind to fresh floss as you progress to the next tooth.

Keep it up. If you have trouble getting floss through your teeth, try the waxed variety. If it’s hard to manipulate the floss, use a floss holder or an interdental cleaner — such as a dental pick or stick designed to clean between the teeth.

Cleft lip and cleft palate.Cleft lip and cleft palate are among the most common birth defects, estimated to affect around one in 700-800 babies born in North America. Both problems result from the incomplete formation of anatomical structures (the lips and the palate, or “roof of the mouth”) which develop during early pregnancy. These conditions may occur separately or together, and they can have a wide variation in severity. With proper treatment, however, in most cases the child has an excellent chance of leading a healthy, normal life.

Besides the noticeable irregularity in appearance, a cleft lip or palate can cause difficulties with feeding and speech. Both conditions are also associated with ear infections, hearing loss and dental problems. To fully address these problems, a child may require several surgical procedures, performed at different times. That's why a team approach is often used to treat this complex condition. Members of the medical team may include an oral surgeon, a pediatric dentist, an orthodontist, a plastic surgeon, and other specialists.

In general, the first goal of treatment is to repair or “close” the gap in the lip and/or palate as soon as it is practical for the child — as early as 2 to 9 months of age. Follow-up treatment may be needed to restore the appropriate form and function of the lips, teeth, and jaws (for proper speech, eating, etc) and to correct hearing problems. These procedures may include plastic surgery, orthodontics, orthognathic (jaw) surgery and speech therapy.

Surgical Treatment for Cleft Lip or Palate

Cleft lip or palate surgery is usually performed in a hospital setting, and may be done when an infant is 6 to 12 weeks old. Intravenous sedation or general anesthesia is used, so your child won't experience any pain. In cleft lip surgery, an incision is typically made on each side of the cleft. This creates several “flaps” of tissue, which are then sutured (stitched) together to close the gap. Suture lines are generally planned to follow the facial contours, so that the surgical scar will be as unobtrusive as possible.

Cleft palate treatment involves rebuilding the roof of the mouth, including soft tissue, muscle and bone. The initial surgery is often performed between the ages of 6 and 18 months. Like cleft lip surgery, it relies on specialized “flap” techniques to reposition soft tissues and close the gap. Before or after surgery, your child may need to wear a special appliance such as an obdurator (artificial palate) or a nasal alveolar molding device (NAM), a type of retainer.

Follow-Up Treatment

Depending on how complex the child's condition is, additional procedures may be required after the initial treatment to fully correct any defects. A child's treatment plan will often include pediatric dental examinations beginning around age one. Bone grafts to repair the hard palate may be recommended at age 8-11 years, when the cuspid teeth are developing. To correct problems with the alignment of teeth, orthodontic care may be needed beginning around age 12. In some situations, orthognathic surgery is recommended to address more severe jaw problems.

Handling a child's cleft lip or palate can be a challenge for caregivers and family members — but it's important to keep in mind that this relatively common birth defect can be successfully treated. Many who have this condition have gone on to become well-known performers, politicians, sports stars… as well as moms and dads, friends and neighbors.

Related Articles

Dentistry and Oral Health for Children - Dear Doctor Magazine

Dentistry and Oral Health for Children Dear Doctor magazine brings you this wide-ranging overview of milestones and transitions in your child's dental development. Learn how to protect your children from tooth decay, dental injuries, and unhealthy habits while getting them started on the road to a lifetime of oral health and general well-being... Read Article

Oral Health - Dear Doctor Magazine

How to Help Your Child Develop the Best Habits for Oral Health Proper oral health habits are easy to learn — and lead to behaviors that result in lifelong dental health. And the time to begin is as soon as your child's first baby teeth appear. From toothbrushing for your toddler to helping your teenager stay away from tobacco, Dear Doctor magazine offers the most important tips for healthy habit formation through childhood and beyond... Read Article

Top 10 Tips for Children - Dear Doctor Magazine

Top 10 Oral Health Tips for Children There's no need to wait until your baby actually has teeth to lay the foundations for good oral or general health. In fact, good nutrition and oral hygiene can start right away. It is up to you to develop the routines that will help protect your child from tooth decay and other oral health problems. So let's get started... Read Article