How Cleft Lip Affects the Hard and Soft Palate

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A cleft lip or cleft palate diagnosis in a newborn can be confusing for parents, but these birth conditions are very familiar to doctors. A cleft is a minor opening that may or may not be visible on the infant's face. Most clefts, however, part the upper lip and can even affect the appearance of the nose. It may just appear inside of the mouth, dividing the roof or palate into two parts that should have joined in utero. Luckily, a baby with a cleft isn't in any pain.

Hard palate and soft palate

The palate is an important oral structure, stretching from behind the front teeth to the back of the mouth. The hard and soft palate both form the roof of the mouth, separating it from the nasal cavity and the oropharynx, which is the cavity at the back of the mouth. According to professor Ronan O'Rahilly, MD and others of Dartmouth Medical School, the first two thirds of this roof comprise the hard palate, a firm, fixed structure closer to the upper lip. The remaining third is the soft palate, which is soft, muscular, mobile and further back toward the throat.

Cleft lip and cleft palate

Cleft lip and cleft palate can occur together or independently. Either opening appears when the lips or palate fail to close properly as the fetus develops. The University of Michigan Medical Center (UMMC) explains that the lips come together in the sixth week of pregnancy, whereas the palate closes at the end of the first trimester.

Any child may be born with a cleft lip or palate, though the nature and risk of the defect depends on a few factors. The American Academy of Otolaryngology–Head and Neck Surgery suggests 50 percent of babies born with a cleft condition carry it in both their lip and palate, while 30 percent have just cleft palate and 20 percent have cleft lip. Male babies are more likely to have cleft lip and palate, and female babies are more likely to have just cleft palate. Both the hard and soft palate can be affected in the event of a cleft, according to the UMMC, but it may also be isolated to one or the other.

How they affect development

The palate plays important roles in speech, hearing, facial growth, eating and tooth alignment. As described by the University of Missouri Children's Hospital, cleft palate affects some of these functions more than others. The muscle function of the soft palate is essential to speech development and drainage from the middle ear, and if the cleft palate is not repaired by the age of 18 months, normal speech cannot develop. Infants without an intact, properly functioning palate are also more likely to suffer fluid buildup in the middle ear and ear infections, which affect hearing. Infants with cleft palate are often fitted with ear tubes to help drain the ears, and without surgical correction, the upper jaw may fail to grow properly.

The American Dental Association adds that cleft palate can cause eating problems, as well as tooth misalignment between the upper and lower jaw.

Parents are sometimes concerned about how to provide good oral care for babies with cleft lip or palate. The Cleft Palate Foundation explains that regular brushing with a soft-bristled infant toothbrush, such as Colgate® My First® Toothbrush, and an infant's toothpaste helps to keep the teeth clean the same as any growing child. Dentists can advise on other preventative care depending on the severity of your baby's condition.