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The palate is formed by joining two sides and one frontal portion during the first trimester of gestation. This process of fusing three structures is not always completed, resulting in an open (“cleft”) palate and possibly a split (“cleft”) lip. This is one of the most common birth defects and occurs in about one of every 1000 children, and can occasionally run in families. In some cases other inherited diseases can also be present. Most kids with cleft palates will have some problems with speech. Some may have feeding difficulties, teeth that are out of place and fluid in their ears that can sometimes cause hearing problems.
In most cases the cleft palate is visible when the child is born – sometimes it can even be seen on an ultrasound before the child is born. Clefts of the palate can be incomplete (appearing in the front or back) or complete on one side (“unilateral”) or both sides (“bilateral”). In rare cases, the cleft is hidden under a thin layer of mucosa (the lining of the mouth). These “submucous” clefts are usually diagnosed later if a child develops certain speech problems as a result of the underlying cleft.
Treatment should be provided by a cleft team that specializes in caring for children with clefts and their families. A Maxillofacial Surgeon can close the gap in the palate and perform other surgeries to help improve speech problems and to aid the work of the dental team. The Pediatrician will look and treat other diseases when these are present. A geneticist can counsel your family. The pediatric dentist and orthodontist will work together to build a smile. The speech and hearing therapists will evaluate each child to offer early diagnosis and help treat hearing or speech problems.
The results of cleft care have improved with better techniques and increased collaboration between the surgeons and other specialists involved in cleft care.
Cleft palates are common birth defects that can be treated by ASMS surgeons in collaboration with cleft team specialists.