Craniofacial Orthodontics | Cleft Lip and Palate
What Is Craniofacial Orthodontics?
Craniofacial orthodontics is a subspecialty of orthodontics that focuses on the treatment of patients with birth differences such as cleft lip and palate, as well as concerns related to sleep disordered breathing (SDB). In many cases, the orthodontist works as part of a coordinated craniofacial team that may include speech pathologists, oral surgeons, craniofacial plastic surgeons, and ENT specialists.
This team based approach supports treatment planning for cleft lip and palate, airway obstruction, and other jaw and facial growth concerns. As a member of a craniofacial team, a craniofacial orthodontist evaluates tooth and jaw development and growth, provides non surgical guidance for jaw positioning, and supports pre and post operative orthodontic care when jaw surgery is part of treatment. Growth is monitored using diagnostic tools such as X rays and dental models.
What Is a Cleft Lip and Palate?
Cleft lip and cleft palate are facial malformations in which the parts of the face that form the upper lip and mouth remain split instead of sealing together before birth. Similar splits can occur in the roof of the mouth, known as the palate.
Clefting may occur when there is not enough tissue in the lip or mouth area, or when the available tissue does not join together properly. Although the defect occurs early in fetal development, the cause is unknown in most cases. There may be links to genetics and maternal environmental exposures during pregnancy.
How Cleft Lip and Palate Can Affect Health and Development
While cleft lip and palate can involve aesthetic concerns, this condition can also affect health and development in more serious ways:
- Difficulty eating — When there is an opening in the palate, food and liquids can pass from the mouth back through the nose. While waiting for surgery, specially designed prosthetics may be used to help direct fluids downward toward the stomach to support adequate nutrition.
- Speech difficulties — Because the upper lip and palate are not properly formed, children may have difficulty speaking clearly and speech may sound nasal. A speech pathologist may be involved to help resolve these issues.
- Ear infections — Cleft lip and palate can contribute to fluid buildup in the middle ear, increasing the risk of ear infections. Without proper treatment, this may lead to hearing concerns. In some cases, small tubes may be placed in the eardrums to help drain fluid and reduce infections.
- Dental problems — Children with cleft lip and palate often have missing, malformed, or displaced teeth, which can increase the likelihood of cavities and lead to orthodontic concerns.
Treatment
Treatment for cleft lip and palate typically involves surgery, and this is where the craniofacial orthodontist and the team of specialists play an important role. Depending on the severity of the case, more than one surgery may be needed.
In many children, surgery is performed between three and six months of age.