Orofacial clefts, also called cleft lip or cleft palate, are one of the most common birth abnormalities in the USA.
Actually, it is estimated that around 2,650 infants are born with a cleft palate each year in America, and about 4,440 are born with a cleft lip. A cleft happens during very early pregnancy while the baby's face is forming. When the parts of the face fall short to combine during pregnancy, a cleft is formed.
Cleft During History
Cleft lips have been documented in case history as early as 390 B.C. In fact, throughout this time, the very first successful cleft lip surgery took place in China. Wey Young-Chi was the initial patient to undertake surgery to mend his cleft lip when he was 18 years old. Afterward, he joined the imperial military where he found acknowledgment and success. He was also documented as believing that he never would have attained a lot in his lifetime if it had not been for the surgery that repaired his cleft.
Cleft Lip Characteristics
A cleft lip occurs when the tissue that creates the lips does not fuse prior to birth, and this leads to an opening in the top lip. The size of the hole can vary between a tiny slit to a large hole that extends from the lip to the nose. There are 3 types of cleft lip: unilateral (takes place on one side), bilateral (occurs on both sides), or complete (meaning that the slit starts at the lip and goes up right into the nose).
Cleft Palate Characteristics
Similar to a cleft lip, a cleft palate happens when the tissue that comprises the roof of the mouth does not link while the mother is pregnant, causing a gap. A child's palate could be interrupted in the soft palate--the area in the back of the mouth--or in the hard palate-- the location closest to the lips-- and sometimes, some infants have gaps in both areas.
The CDC has released its research on some aspects that might raise the possibility that a mom will give birth to a baby who has orofacial clefts. But it needs to be kept in mind that the root causes of this defect are mainly unidentified, and clefts can take place for causes that are not in the person's control.
Females who smoke through their pregnancy, develop diabetic issues before getting pregnant, or use drugs to deal with epilepsy within the very first 3 months of becoming pregnant are at a higher threat of giving birth to a baby with a split lip and/or palate compared to women that do not belong to any of these variables. Some other issues can include family history, excessive weight during pregnancy, and alcohol usage.
Whereas orofacial clefts have the ability to be corrected, the existence of these splits and gaps triggers specific issues for the baby. For instance, among one of the most worrying obstacles when taking care of an infant with a cleft palate is difficult feedings. Due to the fact that the cleft occurs in the palate for some infants, it can trigger issues in the infant's capability to nurse and also swallow. A cleft palate can also put the baby at risk for developing hearing loss as well as fluid in the ear, in addition to interrupting the development of a normal speech pattern and also causing the child to have a nasally tone. Other problems consist of disrupted dental development and social, psychological, and behavioral problems.
Medical Diagnosis and Therapy
Orofacial slits can be spotted and diagnosed while the mother is pregnant by use of a routine ultrasound. Cleft palates, on the other hand, are generally detected soon after birth. Surgical procedures to repair slits is advised to take place within the initial 18 months of life.
In regards to cleft lip surgeries, the doctor will make cuts on each side of the cleft. With the flaps of skin, muscle mass, and intraoral cells, the physician stitches them together in order to shut the slit. With the separation closed, the lip and nose composition can be brought to a more regular structure and feature.
A slit palate needs the medical professional to reconstruct the roof of the mouth. Similar to a slit lip surgery, the doctor will make cuts on either side of the slit. The tissues of the hard, as well as the soft palate, are then rearranged and the cut is stitched back together.
It is normal for children born with a cleft to need more medical care following the preliminary surgery to close the cleft. These extra therapies will assist the baby in building a more powerful speech pattern as well as language growth, along with improving their hearing and breathing. They could need speech treatment or special oral treatment, as well. Despite the surgeries and extra help, a lot of children with orofacial clefts tend to lead typical and balanced lives.
Dr. Sachs has written more articles about the different kinds of dental practices and useful topics for her patients. To read them, you can find Dr. Sachs blog here.