Cleft Palate

What is a cleft palate?

Cleft Palate is a treatable birth defect. It happens when the roof of the baby’s mouth (palate) doesn’t develop normally during pregnancy, leaving an opening (cleft) in the palate that may go through to the nasal cavity. A cleft can form on any part of the palate, including the front part of the roof of the mouth (hard palate) or the small flap of tissue that hangs down from the soft palate (uvula). It may appear by itself or along with other birth defects of the face and skull, such as a cleft lip

What is the cause of a cleft plate?

Doctors aren’t sure what causes it. But your baby may be more likely to have cleft palate if you:

  • Use certain medicines while you’re pregnant.
  • Use alcohol or illegal drugs while you’re pregnant.
  • Smoke while you’re pregnant.
  • Are exposed to radiation or infections while you’re pregnant.
  • Have a family history of cleft palate.

It’s important to take good care of yourself before and during your pregnancy so that your baby will be as healthy as possible.

What problems are associated with a cleft palate and/or cleft lip?

  • 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 with a cleft palate may need to wear a man-made palate to help them eat properly and ensure that they are receiving adequatenutrition until surgical treatment is provided.
  • Ear infections/hearing loss: Children with cleft palate are at increased risk of ear infections since they are more prone to fluid build-up in the middle ear. If left untreated, ear infections can cause hearing loss. To prevent this from happening, 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: Children with cleft lip or cleft palate may also have trouble speaking. These children’s voices don’t carry well, the voice may take on a nasal sound, and the speech may be difficult to understand. Not all children have these problems and surgery may fix these problems entirely for some. For others, a special doctor, called speech pathologist, will 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. In addition, children with cleft palate often have an alveolar ridge defect. The alveolus is the bony upper gum that contains teeth. A defect in the alveolus can…
    • displace, tip, or rotate permanent teeth
    • prevent permanent teeth from appearing,
    • prevent the alveolar ridge from forming.

These problems can usually be repaired

What are the treatment options for a cleft palate?

  • A cleft lip may require one or two surgeries depending on the extent of the repair needed. The initial surgery is usually performed by the time a baby is 3 months old.
  • cleft palate often requires multiple surgeries over the course of 18 years. The first surgery to repair the palate usually occurs when the baby is between 6 and 12 months old. The initial surgery creates a functional palate, reduces the chances that fluid will develop in the middle ears, and aids in the proper development of the teeth and facial bones. Children with a cleft palate may also need a bone graft when they are about 8 years old to fill in the upper gum line so that it can support permanent teeth and stabilize the upper jaw. About 20% of children with a cleft palate require further surgeries to help improve their speech. Once the permanent teeth grow in, braces are often needed to straighten the teeth. Additional surgeries may be performed to improve the appearance of the lip and nose, close openings between the mouth and nose, help breathing, and stabilize and realign the jaw. Final repairs of the scars left by the initial surgery will probably not be performed until adolescence, when the facial structure is more fully developed.

What is the prognosis for children born with a cleft palate?

Although treatment for a cleft lip and/or cleft palate may extend over several years and require several surgeries depending upon the involvement, most children affected by this condition can achieve normal appearance, speech, and eating.

Call the office of Dr. Walter D. Gracia M.D., P.A. at (817) 336-9450 to schedule your consultation…

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