Cleft Palate and Cleft Lip (cont.)
Who Treats 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. Members of a cleft lip
and palate team typically include:
- Plastic surgeon to evaluate
and perform necessary surgeries on the lip and/or palate
- An otolaryngologist (an
ear, nose, and throat doctor) to evaluate hearing problems and consider
treatment options for hearing problems
- An oral surgeon to
reposition segments of the upper jaw when needed, to improve function and
appearance and to 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 the appearance and to meet
functional requirements for eating and speaking
- A speech pathologist to
assess speech and feeding problems
- A speech therapist to work
with child to improve speech
- An audiologist (a
specialist in communication disorders stemming from a hearing 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
understand the chances of having more children with these conditions
These healthcare team members work together to develop a plan of care
to meet the individual needs of each patient. Treatment usually begins
in infancy and often continues through early adulthood.
How Are Cleft Lip and Palate Treated?
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.
Repair of a 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.
Next: What Is the Outlook for Children With Cleft Lip or Clef Palate? »
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