Good oral care with cleft palate or cleft lip before and after surgery helps provide the best possible outcome for children. Cleft conditions create a gap in the lips, the palate or both, all of which can result in dental problems. It can also affect speech, hearing and facial development, according to the University of Missouri Children's Hospital. A craniofacial medical team provides professional medical care for cleft conditions, but parents can help too. Parents can start by cleaning newly erupted teeth and then caring for their infant after surgery.
Cleft conditions can result in poorly aligned or missing teeth. Primarily, it affects the lateral incisors, also know as the front teeth that sit next to the eyeteeth, reports the Cleft Palate Foundation. It can cause a poorly formed incisor, an incisor facing the wrong way or even a tooth that's extraneous or missing entirely. These issues can occur in both baby and permanent teeth, too.
Parents should help their children with cleft palate and lip brush their teeth regularly before and after the surgery and while the wound heals to help keep teeth clean and healthy. The Cleft Palate Foundation recommends brushing twice a day as soon as the cleft appears, using a soft-bristled toothbrush, such as Colgate® My First® Toothbrush. Infants with clefts should visit a dentist with experience treating patients with these conditions by the infant's first birthday, or sooner if they experience severe dental problems.
Preparing for Surgery
Treatments, such as lip taping and lip adhesion, help prepare infants for cleft lip surgery by gently stretching and guiding the lips and mouth into a more natural position, which reduces tension when the lip is repaired. According to the University of Michigan's C.S. Mott Children's Hospital, lip taping should occur daily. Parents are instructed to apply non-irritating adhesive tapes that stretch over the cleft area, drawing the sides together. The tape must stay in place for most of the day and night.
Lip adhesion requires suturing the sides of the cleft together, describes C.S. Mott Children's Hospital. This treatment is often used with infants who don't respond well to lip taping, infants with the condition on both sides of their mouth and older children who are older than the typical age for surgery. Lip adhesion usually begins at least eight weeks before surgery.
Another surgery preparation method is nasoalveolar molding (NAM), a more invasive option to prompt alignment involving the placement of a intraoral plate or retainer and an additonal structure that connects to the nostrils, according to the University of Missouri Children's Hospital. The pediatric surgeon will guide parents and patients to the most appropriate preparation method based on the infant's particular needs.
Children with cleft conditions undergo at least one surgery. The University of Missouri Children's Hospital says lip repair surgery usually takes place within the first six months after birth, and surgery to repair the palate is performed by 12 to 18 months. Follow-up surgeries occur when the child is seven to nine years old, usually to repair the gumline.
The C.S. Mott Children's Hospital emphasizes the large role parents play in caring for an infant who has received cleft lip or cleft palate surgery. At discharge from hospital, acetaminophen with codeine is often prescribed. But codeine can often cause stomach upset and needs to be given with food. Parents, however, are encouraged to give over-the-counter acetaminophen a try first, as well as plenty of physical comfort like rocking and cuddling. Parents must also put arm restraints on infants to prevent them from touching the wound.
Lip repair patients must not suck or use a pacifier. Mom, dad or another caregiver should clean around the bandaging covering the wound with a cotton tip gently dipped in a solution provided by the surgeon, according to MedlinePlus. The sutures are usually removed after five to seven days.
Cleft repair patients can only drink from a cup with no top and when eating, the spoon must not go deep in the mouth according to the C.S. Mott Children's Hospital. For at least the first three weeks after surgery, their diet must be soft, so parents should stock up on a child's favorite juice and soft foods such as scrambled eggs or applesauce.
Loving care for infants with cleft palate or cleft lip before and after surgery helps them pass through a difficult period with the least stress and most comfort. Good care also helps surgical wounds heal well and makes cleft operations complete successes.