When Your Infant Needs Cleft Palate Surgery

dentist with little girl teaching how to brush

Cleft palate is an orofacial birth defect wherein the palate (or roof of the mouth) splits as it forms. This condition can occur separately or along with a cleft lip, and inhibits a baby's ability to suck immediately after birth. There are different degrees of cleft palate, and depending upon other conditions or birth defects, cleft palate surgery should be performed within 18 months of birth – or earlier if possible. According to the American Dental Association (ADA), cleft palate usually affects your infant's ability to eat and speak properly. It may also contribute to incorrect tooth alignment and an increase in ear infections.

A baby's face forms early in pregnancy, with the palate forming no later than the ninth week. Specialized tissue and cells from the head fuse together to form the mouth. When this bone does not form completely, it can fail to join together, leaving a cleft that can appear fully or partially open. This condition can be discovered with a routine ultrasound during pregnancy or after birth.

Occurrence and Causes

The Centers for Disease Control and Prevention (CDC) estimates that 2,650 babies are born each year in the U.S. with some form of cleft palate. Orofacial defects that happen without other major birth defects are the most common birth condition in the United States. Some people are born with a partial cleft palate, while others have a complete opening that may include the uvula at the back of the throat.

Although the causes of cleft palate are mostly unknown, the connection is understood to be either genetic or from what the mother is exposed to during pregnancy. These environmental factors can include food, drink or medications. Recently, the CDC reported data that recognizes other Influences that may contribute to the defect as well. They include:

  • Smoking during pregnancy
  • Women who are diabetic before pregnancy
  • Anti-seizure medicines taken in the first trimester

Treatment and Operation Smile

Cleft palate surgery is the best and only treatment for this defect, and should be done before the infant is 18 months of age – earlier if there are no other health problems to address. Treatment usually requires several surgeries as a child grows and should be performed by a qualified surgical team recognized by the American Cleft Palate-Craniofacial Association. The use of these "specialized" teams will ensure a smooth transition from infancy to adulthood focusing on all aspects of treatment, from surgery to therapy dedicated to speech, occupation and cognition.

Outside of the U.S., members of these specialized teams volunteer their time and resources for Operation Smile, a not-for-profit that provides low- to middle-income countries cleft surgery and other free support services, including advocacy, education and research. Unfortunately, these children often remain sick and hidden from their communities until corrective treatment becomes available. Operation Smile consistently provides services that allow these children to live with a healthy smile.

Cleft palate surgery improves the appearance and function of the mouth, but it's only the beginning. The journey will also include speech therapy, orthodontics or braces and other dental treatment provided by similar specialists. Additionally, children who are being treated for a cleft palate may be self-conscious about their appearance. Lending your own guidance and encouragement can mean so much to a child who experiences low self-esteem.

All parents want a health baby, free from a birth defect that may hinder quality of life. But having a baby born with a cleft palate doesn't mean your child can't lead a normal life. Having completed this corrective treatment, your child will be able to get the most out of a normal oral hygiene regimen with his or her My First Colgate toothbrush, the use of which doesn't depend on the presence or absence of a cleft palate. The condition will most likely be diagnosed early with an ultrasound, and you and your doctor will have time to arrange for the best treatment after birth. Cleft palate surgery can be frightening, but it is necessary to allow your child to properly eat, speak and smile.

About the author: Donna Rounsaville, RDH, BS, has been a dental hygienist in private practice for 31 years. She has used her experience with the prevention of dental problems and the importance of healthy eating to educate children in local schools in her hometown of Flemington, New Jersey. Donna is also passionate about infection control and office safety for dental workers, providing yearly training to her office colleagues. Active with the Girl Scouts as a leader and with children's liturgy at her church, Donna uses her communication and leadership skills to motivate young people in her community. She has been writing for Colgate since 2013.

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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Cleft lip and palate are birth defects that occur because a baby’s lip or mouth does not form properly during pregnancy. A cleft lip is an upper lip that is split. It is caused by the failure of the tissue of the lip to join. A cleft palate occurs when the tissue that makes up the roof of the mouth does not come together.