Between the sixth and ninth weeks of fetal development, the roof of the mouth starts to form. But if the two halves of the tissue don't fuse together properly, the baby will be born with a cleft palate.
The Centers for Disease Control and Prevention notes that a cleft palate is one of the most common birth defects in the U.S., affecting approximately 2,650 babies every year. But not all cleft palates are alike; in fact, there are three types of cleft palate conditions. If your baby is born with a cleft palate, there are treatment options that can close the gap on the roof of the mouth.
Hard Palate Versus Soft Palate
To understand the different types of cleft palate conditions, it helps to know the difference between the hard palate and the soft palate in the roof of the mouth. If you run your tongue or finger from the front of your mouth to the back, you can feel where the hard, bony palate at the front of your mouth becomes the soft, fleshy palate in the back.
The hard palate separates the mouth from the nose and prevents food and air from entering the nasal cavity. It also plays an important role in speech.
The soft palate pushes food to the back of the throat when swallowing. Eating can be very difficult for a newborn if the soft palate is not properly formed.
1. Complete Cleft Palate
A baby born with a complete cleft palate has an opening in the roof of their mouth that runs across both the soft and hard palates. It extends from the uvula, the part of the palate that hangs down in the back, to the alveolar ridge, the bone in the front of the mouth that supports the teeth. This type of cleft can be unilateral, occurring only on one side of the mouth, or bilateral, occurring on both sides of the mouth.
2. Incomplete Cleft Palate
Incomplete cleft palates start in the back of the mouth at the uvula and extend forward, but do not reach the alveolar ridge. They vary in length, with some clefts stopping before or at the junction of the soft and hard palates. Regardless of the length, the cleft palate will affect speech and the ability to feed. A cleft or notch only in the uvula does not usually pose problems, though it may indicate the presence of a submucous cleft.
3. Submucous Cleft Palate
A submucous cleft palate is a type of partial cleft where the baby's palate appears normal because there is no opening in the tissue covering the roof of the mouth. This type of defect is not always apparent or diagnosed at birth. However, sometimes a doctor is able to detect it by feeling the roof of the baby's mouth with their fingertip.
If the cleft is not immediately identified and the baby doesn't have trouble feeding, the submucous cleft might not be diagnosed until the child begins speaking. Submucous clefts often result in abnormal speech due to air entering the nasal cavity.
Since cleft palates range in size and severity, treatment needs also differ. Additional factors affecting treatment are the presence of other birth defects and the child's age.
Usually the surgical repair of a cleft palate is completed when the infant is between 3 and 6 months old, according to theChildren's Hospital Los Angeles. During treatment, the surgeon will close the gap on the roof of the mouth and reestablish muscular function of the soft palate. Additional surgeries may or may not be needed as the child grows. As the child gets older, their speech development and hearing ability will be monitored closely. Your family dentist will also watch for proper tooth development and eruption.
Thanks to the advances in surgical procedures and specialized teams of surgeons, nurses, speech therapists and dentists, babies born with a cleft palate can receive proper treatment and live a happy, healthy life. If you're concerned about your child's cleft palate, speak with your family doctor or dentist.