BACKGROUND: The optimal management of cleft lip-cleft palate patients presents a formidable challenge to the cleft surgeon. [ncbi.nlm.nih.gov]

• Dentist

  Abstract The pediatric dentist plays a crucial role in the treatment and management of infants born with cleft deformities of the lip, alveolus, and palate. [ncbi.nlm.nih.gov]

  Children with a cleft should be seen by a dentist shortly after their first teeth come through. It is important to see a dentist experienced in the care of people with clefts. It is important that your child's teeth are looked after carefully. [rch.org.au]

  This team may include a surgeon who specializes in these defects, hearing specialist, dentist, orthodontist (dentist who straightens teeth), and speech-language specialist (for both speech and feeding problems). [spectrumhealth.org]

  Regular visits with a pediatric dentist who specializes in cleft lip and palate are important. The dentist will check a child's mouth growth and development, identify any problems, and make treatments when needed. [kidshealth.org]

• Surgical Procedure

  One or two surgical procedures may be necessary to achieve both effective lip function and cosmetic repair. [medicinenet.com]

  A septoplasty, a surgical procedure that straightens the septum, can help restore the nasal airway. [chop.edu]

  The Pin retention surgery is a same-day surgical procedure that helps to align the bony structures along the gums. This may be done 3 to 6 weeks after the repair of the cleft lip. [news-medical.net]

  Your child's surgeon will explain your child's surgical plan to you. Your child will usually only need to stay in hospital for one to three days for surgical procedures. [rch.org.au]

  Because of risks of anesthesia, it may be appropriate to combine surgical procedures in these children. 3) Laryngomalacia or tracheomalacia is common in CHARGE and can result in surgical or anesthetic complications. 4) Cranial nerve palsies complicate [chargesyndrome.org]

• Feeding Difficulties

  Bottle Feeding Potential Problems or Feeding Difficulties in Cleft Lip and/or Palate: Because of the opening between the mouth and nose, an infant with a cleft may have difficulty creating the necessary suction to pull milk from the bottle or breast. [adoptionnutrition.org]

  Beyond the cosmetic abnormality, there are other possible complications that may be associated with cleft lip and cleft palate, including the following: Feeding difficulties occur more with cleft palate abnormalities. [stanfordhealthcare.org]

  Health Problems Related to Cleft Lip and Palate Feeding Feeding difficulties may occur in newborns with cleft lip and/or palate as the normal anatomy of the mouth is disrupted. Each baby is different in their ability to feed. [chla.org]

  Cleft Lip and Palate Symptoms Beyond the cosmetic abnormality, other possible complications that may be associated with cleft lip and cleft palate include: Feeding difficulties. Feeding difficulties occur more with cleft palate abnormalities. [hopkinsmedicine.org]

  Feeding Difficulties A child with a cleft palate can have difficulty feeding through a regular nipple due to the gap in the roof of the mouth and cannot generate enough suck to breast-feed. [beaumont.org]

• Epilepsy

  Other risk factors that the CDC reports increase the chance to have a baby with an orofacial cleft are smoking, diabetes, and use of certain medications to treat epilepsy during the first trimester of pregnancy. [colgate.com]

  Epilepsy is a seizure disorder that affects how the nerve cells in your brain work. A seizure is when the whole body or parts of the body move without control. Being obese during pregnancy. [marchofdimes.org]

  If you have epilepsy and are taking antiepileptic medicine then, if possible, you should talk to your specialist about your medication before you try to get pregnant. [patient.info]

  Mothers who are taking medications for epilepsy may also be at a higher risk of giving birth to babies with a cleft lip and/or palate. This includes drugs like: Phenytoin, Phenobarbital, sodium valproate, benzodiazepines etc. [news-medical.net]

  Certain medication use —There are certain medications, such as those to treat epilepsy (like topiramate or valproic acid), that if taken during the first trimester of pregnancy (first 3 months) increase the risk for having a baby with a cleft lip accompanied [craniofacialteamtexas.com]

• Malnutrition

  Babies can have difficulty with feeding, which in some parts of the world can lead to malnutrition, or even starvation. Ear infections can occur — and recurring ear infections can lead to hearing loss. Dental development can be affected. [operationsmile.org]

  Secondly, other conditions or health problems (such as malnutrition) may prevent children from getting the treatment they need. Many charitable organizations exist to provide surgeries for children in need. [adoptionnutrition.org]

  In extreme cases a baby born with a cleft palate may suffer severe malnutrition. Later, speech difficulties develop. [britannica.com]

• Hearing Problem

  Children with cleft palates may have special dental problems and need to learn good dental habits early in life. Hearing. Babies with cleft palates need to have their hearing tested by the time they are 3 months old. [myhealth.alberta.ca]

  […] missing teeth, especially when cleft lip extends to the upper gum area Symptoms of middle ear infections Hearing problems Symptoms of sleep-disordered breathing Online Cleft Resources Learn more about cleft palate and cleft lip. [childrens.uvahealth.com]

  Babies born with a cleft lip, cleft palate or both may have feeding problems, which can affect weight gain and development. They also are more prone to speech delays, ear infections, hearing problems and dental issues. [barnesjewish.org]

  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. [webmd.com]

  Hearing problems are often associated and require corrective procedures and/or therapy. [austinsmiles.org]

• Hearing Impairment

  impairment); 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 [webmd.com]

  Cleft lip/cleft palate can present a number of obstacles for a child, including possible: feeding issues dental and orthodontic problems speech and language difficulties hearing impairment social and self-esteem challenges Because cleft lip/cleft palate [childrenshospital.org]

• No Speech Development

  A cleft palate interferes with feeding and speech development and increases the risk of ear infections. Goals of treatment are to ensure normal feeding, speech, and maxillofacial growth and to avoid formation of fistulas. [msdmanuals.com]

  Repair of the cleft lip repair is done at 3 months of age and of cleft palate at 6 months of age with the aim of optimizing feeding and speech development without interrupting normal maxillofacial growth. [amboss.com]

  The speech therapist will regularly assess speech development and will arrange for speech therapy in the community if necessary. [chla.org]

  Other surgery may also be needed to: Correct bite alignment Improve appearance and function Cleft Complications Complications include: Feeding problems, especially for a child with cleft palate Problems with speech development Dental problems, including [childrens.uvahealth.com]

  The repair is then stitched closed, usually in the middle of the roof of the mouth, so that normal feeding and speech development can occur and growth can continue throughout the child’s life. [luriechildrens.org]

Early in life a thorough examination should be performed by a pediatrician to make sure there are no other anomalies that require workup. [reidhealth.org]

BACKGROUND: The treatment of patients affected by unilateral cleft lip-cleft palate is based on a multistage procedure of surgical and nonsurgical treatments in accordance with the different types of deformity. [ncbi.nlm.nih.gov]

treatment before turning 22, and be under the age of 28 when receiving treatment Prescribed dental patient certification From 1 December 2015, when providing treatment under the scheme, you must certify that your patient meets all of the eligibility [humanservices.gov.au]

Your child’s individualized treatment plan and surgical timeline extend into young adulthood. We use the latest research to offer the most current treatment options for cleft lip and cleft palate. [dukehealth.org]

Throughout the discussion of growth and treatment concepts, the importance of differential diagnosis in treatment planning is underscored. [euro-libris.ro]

Type-specific sonographic features include: type III: may be seen as a premaxillary echogenic mass 8 Ancillary sonographic features there can be polyhydramnios if the defect is severe and impairs swallowing Treatment and prognosis The overall prognosis [radiopaedia.org]

Regardless, it is still unclear as to the nature of the genetic and environmental components of the etiology as well as the nature of the relevant pathogenetic mechanisms. [ncbi.nlm.nih.gov]

It is important to recognize that the risk of occurrence for ICP and CL/CP is very different (see etiology) with CL/CP being far more common. [kidsplastsurg.com]

Embryology Etiology The development of CLP is dependent on the interaction of environmental factors and genetic predisposition References: [5] [6] [7] [8] Clinical features Subtypes and variants Diagnostics Treatment References: [11] [12] [13] [14] [15 [amboss.com]

Likewise, obesity, which is increasingly common in children and teenagers, may worsen obstructive sleep apnea of anatomic etiology, leading to adverse health and school performance issues. [pediatrics.aappublications.org]

More research is needed to study the risk of developing clefts among the various groups that exhibit different epidemiologic behavior for each race. [ncbi.nlm.nih.gov]

Epidemiology References: [1] [2] [3] [4] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

Epidemiology 2007;18:226–33. Yazdy MM, Autry AR, Honein MA, Frias JL. Use of special education services by children with orofacial clefts. Birth Defects Research (Part A): Clinical and Molecular Teratology 2008;82:147-54. [cdc.gov]

Epidemiology and Etiology of CL/P CL/P is one of the most frequently observed congenital anomalies, occurring in approximately 1 in 600 to 700 births in the United States ( Table 2 ). 8 The Centers for Disease Control and Prevention recently estimated [pediatrics.aappublications.org]

It is important that they are reassured that they did nothing wrong to cause the child’s birth defect. (1-7) Cleft lip and palate pathophysiology Normally the tissues of the face develop from either side and fuse in the middle. [news-medical.net]

CDC funds the Centers for Birth Defects Research and Prevention, which collaborate on large studies such as the National Birth Defects Prevention Study (NBDPS; births 1997-2011) and the Birth Defects Study To Evaluate Pregnancy exposureS (BD-STEPS; began [cdc.gov]

Prevention of middle ear fluid collection Prevention of middle ear fluid collection, infections and hearing loss can be done using a tube equalizes the pressure. Pressure-equalizing tubes help prevent fluid from building up in the ear. [news-medical.net]

Potential Solutions: Feed the baby in a more upright position to prevent milk from coming out of the nose. Upright feeding also helps prevent ear infections. Try using specialized bottles, such as the Haberman Feeder or Pigeon nipple. [adoptionnutrition.org]

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. [webmd.com]

Preventing Oral-Facial Clefts Pregnant women and women who are likely to become pregnant can do the following to help prevent oral-facial clefts in their unborn children: Consume 400 micrograms of folic acid every day and eat foods containing folic acid [childrens.uvahealth.com]