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What Causes Cleft Lip and Palate?
Most of the time, the cause is unknown. Clefts can run in families and be associated with other problems. Some drugs taken during pregnancy are known to cause clefts. Clefts are more common in certain ethnic groups. In most cases, however, there is no identifiable cause or risk factor. In the United States, clefts occur once in every 700 to 1,000 births, making it a common birth defect.
Do Babies With Clefts Have Other Problems?
Most children with clefts do not have other birth defects. Most are normal in intelligence and abilities. Children with clefts do have a higher incidence of a problem called serous otitis media-fluid in the ear. If untreated, frequent ear infections and even hearing loss can result. Many children with clefts have abnormalities of the teeth - this can range from crooked teeth to extra or missing teeth.
What Treatment Is Available for Cleft Lip and Palate?
Children with clefts benefit from specialized team care. Cleft teams consist of specialists in Plastic Surgery, Otolaryngology, Pediatrics, Oral and Maxillofacial Surgery, Genetics, Dentistry, Speech, Pathology, Audiology, Nursing, and Psychology. These teams work with the child's own pediatrician to provide the best care possible. Excellent care is also available outside of cleft teams, but requires more coordination of various specialists by the parents. Most surgeons repair cleft lip when the baby is 6 to 10 weeks old. Most surgeons repair cleft palate at 6 to 12 months of age. The exact age for repair will depend on the size and health of the child and the surgeon's preference.
Many children with clefts involving the gun line will benefit from an operation to put extra bone in the gum. This is called an alveolar bone graft. This allows the permanent teeth to come in better. This operation is done sometime between the ages of 6 and 10, depending on how fast the permanent teeth are developing.
Children with clefts of the lip may need or want touch-up operations to improve the appearance of the scars. As teenagers, some need nasal surgery to improve breathing or appearance.
In some children with clefts, the jaws are not in good alignment. In these cases, surgery can be done to align the bite.