Craniofacial Orthodontics

Cleft Lip and Cleft Palate Treatment in Buffalo, NY

Was your child born with a cleft lip or palate? You are probably searching for ways to help improve the quality of their life as they grow. We can help. 

Craniofacial orthodontics is a specialized area of orthodontics that focuses on treating cleft lips and palates, as well as other birth defects that affect the development of the teeth and jaws. Specialists in the field do not work on their own. Rather, they most often partner with other patients including speech therapists, oral surgeons and plastic surgeons who specialize in craniofacial repairs. Craniofacial orthodontics handles the non-surgical portion of treating cleft lip and palate.

What is a Cleft Lip and a Cleft Palate?

craniofacial-orthodontics-cleft-lip-and-palate-treatmentCleft lips and cleft palates are birth defects. They are facial and oral malformations. The condition develops in utero during an extremely early part of the pregnancy. A cleft signifies that there is not enough tissue in the mouth or around the lip. Therefore, the areas do not join together as they should.

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A cleft lip means that the lip is split into two parts instead of being one. It causes a gap to appear between the two parts of the lip. It can even extend beyond the base of the child’s nose. Because of the lack of tissue, the split in the lip can also mean that there is less bone and gum tissue in the mouth. The area behind your upper top teeth is known as your palate. A cleft palate is when there is a split in the palate like in the lip. It can happen at the front of the palate in the bony area or it can occur toward the back of the palate in the softer area.

Cleft lips and palates can be an extremely serious condition. They can affect only one side of the lip and palate or both sides. A cleft palate is the fourth most common birth defect in the United States. It occurs in around 1 of every 700 births.

Clefting is something that is quite obvious at birth. That makes diagnosing a cleft lip and palate easier than other types of birth defects. Often, it can even be diagnosed through ultrasound before the baby is born. This is important because there are times when a cleft lip and palate may be indicators of other abnormalities.

Treatment for Cleft Lip and Palate

Generally, treatment for cleft lip and palate requires surgical correction. Craniofacial orthodontists specialize in the treatment of this condition. However, it can be rather challenging to estimate the number of surgeries that could be required to correct it. Naturally, treatment depends on the severity of the disorder. The optimal time for treatment of cleft lip and palate is between three and six months of age.

The first surgery is designed to repair the palate. The goal of this surgery is to minimize the likelihood of liquids to develop in the ears. This surgery will also help the child’s jaws and teeth grow into the right places.

Often, children undergo another surgery for cleft lip and palate when they are around 8 years old. The goal of this surgery is to perform a bone graft (although this isn’t always needed). The bone graft supports the permanent teeth and may also be used to fill in the upper gums.

Further surgeries for cleft lip and palate that occur from this point are often done to help the child improve their speech. Generally, future surgeries are only needed by around 1/5 of the children diagnosed with cleft lip and palate.

Sometimes, the additional surgeries do not serve the sole purpose of improving speech only. There are times when future surgeries are needed for functional and/or functional reasons. Some children need surgery to help them improve the way that they are able to open and close their mouths. Or they may need surgery simply to improve the appearance of the skin. In other cases, they may need surgery to help improve breathing.

Complications from Cleft Lip and Palate

Thankfully, when cleft lips and cleft palatea are treated using craniofacial orthodontics at an early enough age, they could very well achieve a normal appearance, giving the patient normal speech patterns and the ability to eat without issues. When children with cleft lips and cleft palates are not treated, serious complications can occur including:

  • Difficulty feeding as babies
  • Difficulty eating as they get older
  • Ear infections as a result of fluid build-up
  • Hearing loss
  • Future dental problems
  • Speech difficulties
  • Low self-esteem

Treatment Plan for Cleft Lip and Palate

If your child is born with cleft lip and palate, you should consult with a craniofacial orthodontist. One of the keys to successfully treating clefting is early dental intervention. Your craniofacial orthodontist will show you the proper way to care for your child’s mouth. If your child’s mouth and teeth cannot be properly cleaned with a soft bristled toothbrush, your child’s craniofacial orthodontist can recommend a tool known as a toothette. Your child’s routine dental care (check-ups, cleanings, and fluoride treatment) should begin around their first birthday.

Craniofacial orthodontics should begin before your child’s teeth begin to emerge from the gums. Early surgical intervention usually occurs around three to six months of age. This is crucial for future oral development. The other benefit to early contact with an orthodontist is having an expert who can answer your questions. Your child’s facial development will be assessed and a plan will be made to best treat your child’s cleft lip and/or cleft palate. Additionally, after your child’s permanent teeth have come, the orthodontist can help align the teeth.

Post-care may include speech, plastic surgery and the use of dental appliances to help make up for any missing teeth. Your child may also need a palate lift or a speech bulb. The craniofacial orthodontist will work directly with the speech therapist if your child requires either of these dental appliances to help normalize their speech.

If your child was diagnosed with cleft lip and palate, contact Orthodontists Associates of Western New York for a free screening.

Frequently Asked Questions:

How Is Cleft Lip and Palate Treated?

There are many goals for those who have cleft lip and palate. There are many on board when looking at the team of individuals who help with treatment. You have surgeons, more specifically ENTs and plastic surgeons, along with oral surgeons. You also have orthodontists, nurses, genetic counselors, speech therapists, psychologists and social workers. Treatment requires surgery to repair the issue, then it is the job of the therapists to help with any other conditions afterwards.

What Causes A Cleft Palate During Pregnancy?

There is not a particular reason on why cleft palates occur. They say it could be due to factors such as genes. Other factors that could play a part would be due to environmental aspects. They think certain medications the mother uses during pregnancy could also be related.

How Long Does A Cleft Palate Repair Take to Heal?

Usually the surgery is done between the ages of 9-12 months. It usually takes an average of 3-4 weeks for the incision from the surgery to heal. There will definitely be some pain and swelling after the first few days. Each individual is different and will heal and a different pace. If the surgery was done on a child, they may need arm restraints for the first few days after the surgery, so they do not irritate their mouth.

Does Folic Acid Prevent Cleft Palate?

There are new studies shown that say women who take folic acid during their pregnancy can reduce the risk of their baby developing cleft palate. Research was done by the National Institute of Environmental Health Sciences, they found that women who had 0.4mg per day of folic acid they were reducing the risk by one third.

What Heart Problems Are Associated with Cleft Palate?

The two most common defects are ventricular septal defect along with isolated atrial septal defect. These presented in 21% and 23% of all patients within the study that was completed. The appearance of congenital heart disease in those who have cleft palate was around 5.4%. The most common abnormalities are more so within the skeletal and nervous system.

Is Cleft Palate Genetic?

Researchers have found to believe that a lot of cleft palate cases are due to environmental and genetic factors. Either the father or mother can pass down genes they can cause cleft palate whether that be a part of genetics or not. If a child is born with a cleft palate, they are more at risk for developing a learning or intellectual disability.

How Does Cleft Palate Affect Speech?

A cleft palate has the capability to affect speech is many different ways. It is not really known how a cleft palate affects a child speech until they start speaking. A child may sound more nasally if the cleft affects their soft palate. This is due to the soft palate not being capable of closing off the mouth from the nose while the child is speaking.

Can cleft palate be detected by amniocentesis?

Any cleft abnormalities are not able to be detected during amniocentesis. Usually ultrasounds are done during the time of amniocentesis and are usually able to detect any cleft abnormalities. The ultrasound may be able to pick up the abnormality as early as the 13th week of pregnancy. The longer the fetus continues to grow the easier it may be to diagnose.

Can Cleft Palate Cause Death?

According to Dr. William Magee, nine in ten children who have a cleft palate or lip can die if they do not have surgery. A lot of deaths happen due to not being able to afford or even have the chance to consider surgery due to financial issues. There are many doctors around the world who will travel to other countries to perform the procedure on those in need.

Does Medicaid Cover Cleft Lip Surgery?

If you are a resident of the United States, cleft lip is usually covered under private insurance. It can also be a part of federal or state programs, like Medicaid. There are other programs available to help pay for surgery and any other expenses that are related.

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Orthodontists Associates of Western New York is proud to offer craniofacial orthodontics for cleft lip and palate throughout Buffalo, LancasterOleanHamburgOrchard Park, and Dunkirk, New York. If you are considering orthodontic care for yourself or a loved one, please contact one of our 5 convenient orthodontic offices to arrange a free consultation.

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