Cleft Lip and Cleft Palate – The Facts

Although the cause is often unknown, most scientists believe clefts are due to a combination of genetic and environmental factors.

Another potential cause is medication a mother may have taken during her pregnancy. Some drugs may cause the conditions, among them: anti- seizure/ anticonvulsant drugs, acne drugs containing Accutane, and Methotrexate, a drug commonly used for treating cancer, arthritis, and psoriasis.

The condition may also be caused by exposure to viruses or chemicals while the fetus is developing in the womb.

Problems Associated With Cleft Lip and/or Palate

  • Eating problems. With a separation or opening in the palate, food and liquids can pass from the mouth back through the nose. Fortunately, specially designed baby bottles and nipples that help keep fluids flowing downward toward the stomach are available. Children may need to wear a man-made palate to help them eat properly and ensure that they are receiving adequate nutrition until surgical treatment is provided.
  • Ear infections/hearing loss. There is an increased risk of ear infections due to fluid build-up in the middle ear. If left untreated, ear infections can cause hearing loss. Children with cleft palate usually need special tubes placed in the eardrums to aid fluid drainage, and their hearing needs to be checked once a year.
  • Speech problems. The child’s voice doesn’t carry well and may sound nasal, causing the speech to be difficult to understand. Not all children have these problems and surgery may fix these problems entirely for some. For others, a speech pathologist, can work with the child to resolve speech difficulties.
  • Dental Problems. Children with clefts are more prone to a larger than average number of cavities and often have missing, extra, malformed, or displaced teeth requiring dental and orthodontic treatments. These children often have a defect in the alveolar ridge – the bony upper gum that contains teeth. A defect in the alveolus can (1) displace, tip, or rotate permanent teeth, (2) prevent permanent teeth from appearing, and (3) prevent the alveolar ridge from forming. These problems can usually be repaired through oral surgery.


Treating Children with Cleft Lip and/or Palate

Due to the number of oral health and medical problems associated with a cleft lip or cleft palate, a team of doctors and other specialists is usually involved in the care of these children. These typically include:

  • Plastic surgeon to evaluate and perform necessary surgeries
  • An otolaryngologist to evaluate hearing problems and consider treatment options
  • An oral surgeon to reposition segments of the upper jaw when needed, improve function and appearance and repair the cleft of the gum
  • An orthodontist to straighten and reposition teeth
  • A dentist to perform routine dental care
  • A prosthodontist to make artificial teeth and dental appliances to improve appearance and meet functional requirements for eating and speaking
  • A speech pathologist to assess speech and feeding problems
  • A speech therapist to improve speech
  • An audiologist to assess and monitor hearing
  • A nurse coordinator to provide ongoing supervision of the child’s health
  • A social worker/psychologist to support the family and assess any adjustment problems
  • A geneticist to help parents and adult patients understand the chances of having more children with these conditions


Does your child have a cleft lip or palate? Give us a call, our team is here to help.