Written by Siri Dasari
Edited by Cayla Xue
Published on 06/30/2021
Description
Orofacial cleft, the blanket term for a cleft palate and cleft lip, occurs when an unborn baby does not develop enough tissue to completely form their upper lip or roof of their mouth, sometimes facing issues in both. As a result, the child is born with an opening in their upper lip and roof of their mouth.
Signs and Symptoms
Cleft palate and cleft lip are easy to identify due to the physical traits exhibited by the affected individuals. These traits involve the opening in the palate and/or lip. A cleft lip is often easier to identify than a cleft palate because a split can clearly be seen on the individual’s face, whereas individuals with cleft palate can exhibit a split only inside their mouth without any impacts on their face.
Cleft palates & lips may occur independently or together. They may also occur on one (unilateral cleft) or both (bilateral cleft) sides of the mouth, and can be complete or incomplete. A complete cleft palate extends through the entire length of the palate, and a complete cleft lip extends from the lip to the nose. An incomplete cleft palate is only at the back part of the palate, and an incomplete cleft lip does not extend to the nose.
Many people are not aware that cleft palates and lips do not just affect a patient’s appearance, but may also lead to many challenges that can greatly impact a patient’s quality of life. All of these complications vary depending on how severe the cleft is and what type(s) of cleft a patient is affected by.
Some complications include:
Difficulty eating/feeding; Babies with cleft palates often have difficulty with breast-feeding and sucking.
Ear infections and hearing loss/difficulties; Babies with cleft palates have a higher risk of developing hearing loss and buildup of fluid in the middle ear, due to ear infections.
Dental development issues; Tooth development may be impaired if the cleft extends into the upper gum.
Speech difficulties; Cleft palates can impair speech development, since the palate is used to form sounds. Also, a patient’s speech may sound more nasal.
Stress & emotional challenges; Children with clefts can have a hard time with social and emotional issues due to how cleft palates affect their appearances, quality of life, and need for medical care.
A less common form of cleft palate is when it is found exclusively in the submucous cleft palate, or the muscles of the soft palate. This submucous cleft palate is less easy to diagnose, as it is not easily identified at birth, and may be diagnosed only after signs develop later in life. Some signs and symptoms of submucous cleft palate are:
Difficulty eating/feeding
Dysphagia (difficulty swallowing); foods or liquids may even come out of the nose
Speaking voice sounds “nasal”
Disposition for ear infections
Etiology
Cleft palate and cleft lip are common birth defects, resulting from family history, substance abuse during pregnancy, diabetes, or obesity. Although they are usually inherited as isolated defects, they are also often associated with certain genetic conditions.
Diagnosis
A cleft palate or cleft lip can be immediately diagnosed at birth, due to the physical split on the affected individual's face. However, it is also possible to diagnose a cleft palate or cleft lip during prenatal ultrasounds, where anomalies can be detected. The diagnosis is relatively reliable when identified during a prenatal screening, but it is nearly completely accurate once observed at birth due to the more obvious physical aspects. Nonetheless, both diagnosis methods are simple to conduct.
Treatments
Surgeries can be easily performed to revert the palate and lip to a more “normal” appearance and correct any physical impairments. However, these surgeries are expensive and many families struggle to afford these treatments, with about more than 170,000 children born every year with clefts in the developing world. Organizations like Smile Train help fund these surgeries and help support medical professionals and hospitals as well, in order to get children the treatment they need and deserve.
Furthermore, children with cleft palates often require further therapies to help them recover and live a healthy life. This may include psychological support, nutritional care, and orthodontic or dental care. All of this care can ensure that a child recovers fully and can really thrive after their surgery.
Rarity
A cleft palate or cleft lip are relatively common birth defects, but they are still very rare. Furthermore, the cases are technically even less rare once some of the previously affected individuals undergo surgery to correct the physical symptoms of the condition.
Some statistics on cleft lips/palates in the United States:
About 1 in every 1,600 babies is born with cleft lip with cleft palate in the U.S.
About 1 in every 2,800 babies is born with only a cleft lip in the U.S.
About 1 in every 1,700 babies is born with cleft palate in the U.S.
Resources
If you know that you have a family history of cleft palate or cleft lip, it is recommended that you visit a genetic counselor to try to prevent the risk of having a child with the condition. Some other recommended methods to prevent having a child with a cleft pate or cleft lip are to take prenatal vitamins, avoid alcohol and tobacco, and be safe during pregnancy.
Organizations:
Facebook Groups:
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References:
CDC. “Facts about Cleft Lip and Cleft Palate.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 28 Dec. 2020, www.cdc.gov/ncbddd/birthdefects/cleftlip.html#:~:text=About%201%20in%20every%201%2C600,palate%20in%20the%20United%20States.
Mayo Clinic Staff. “Cleft Lip and Cleft Palate.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 22 May 2018, www.mayoclinic.org/diseases-conditions/cleft-palate/symptoms-causes/syc-20370985#:~:text=A%20cleft%20palate%20is%20an,occur%20without%20affecting%20the%20lip.
Smile Train. “About Us.” About | World's Largest Cleft Charity | Smile Train, www.smiletrain.org/about-us.
Image References:
SickKids staff. “Cleft Lip and Palate.” AboutKidsHealth, 10 Sept. 2009, SickKids staff. “Cleft Lip and Cleft Palate in Babies.” AboutKidsHealth, 10 Sept. 2009, www.aboutkidshealth.ca/Article?contentid=380&language=English.
Transforming Faces. “Types of Cleft Lips and Palates.” Transforming Faces, 11 May 2012, transformingfaces.org/stories/cleft-lip-and-palate-awareness-week-2012/.