Cleft lip and palate is a congenital deformity that affects approximately 1 in every 600 live births in Singapore. Affected individuals may present with an isolated cleft of the lip or palate alone, or a combination of both. When just one side of the lip is affected, it is called a unilateral cleft. A bilateral cleft affects both sides of the lips.
What causes cleft lip and palate?
During pregnancy, the face of the developing foetus is formed by the fusion of protuberances that emanate from the embryonic spinal cord. Disturbances that interfere with this phenomenon may lead to incomplete fusion, presenting itself as a cleft (gap) in the oral and/or nasal area.
Cleft lip and palate can occur due to genetic inheritance or from environmental influence such as maternal smoking, alcohol consumption or folate deficiency.
What are the issues associated with cleft lip and palate?
Parents are often alarmed when they are initially informed of the condition. These feelings are even more acute when they see their baby for the first time, wondering if the disfigurement will be lifelong. It is good to know that modern surgical and dental care has been demonstrated to be very successful in the treatment of cleft patients. Conversely, untreated cleft patients may end up suffering from a lifetime of dental problems, recurrent ear infections (which may lead to hearing loss), feeding difficulties, speech problems and low self-esteem.
Management of cleft lip and palate.
The treatment of cleft lip and palate hinges on timed interventions to restore appearance, normal feeding, speech and allow for the normal eruption of teeth and ultimately facial growth. Due to the complex nature of the condition, the patient is often cared for by a multidisciplinary team of specialists and therapists throughout his/her first two decades of life.
Nasoalveolar moulding, cleft lip and palate repair is usually performed during the first 2 years to restore the infant’s appearance, ability to feed normally and facilitate speech development.
During the toddler years, speech therapy and periodic visits with the ear, nose and throat surgeon may be needed to manage ear infections or facilitate the placement of grommets that help keep the Eustachian tubes open. The child should also be introduced to regular preventive dental care at this stage.
From the age of between 6 and 12 years, periodic visits with the orthodontist are needed to prepare the child for grafting of jaw bone defects in order to facilitate the normal eruption of the permanent dentition.
During late adolescence/early adulthood, jaw surgery, nasal surgery and lip revision (if required) may be performed to correct residual dentofacial deformities.
What is the dental team's role?
The dental team plays an essential and critical role throughout the patients lifetime due to the location of the defect. Access to comprehensive dental care has been proven to significantly improve treatment outcomes and the patient’s quality of life in the longer term. We provide the following services at Parkway Dental Practice.
- Nasoalveolar Molding
- Orthodontic (Braces) Treatment
- Alveolar Bone Grafting
- Corrective Jaw Surgery
- A wide range of preventive dental care
Can cleft lip and palate be prevented?
Recent advances in ultrasound technology can diagnose oral and facial clefts while the foetus is still developing in the womb. Folate therapy in the presence of maternal folate deficiency and abstinence from alcohol consumption and smoking can reduce your baby’s risk.