One in 700 babies are born each year with a cleft lip, a cleft palate or both. Besides its devastating emotional and social impact, this common birth defect can also jeopardize a child's long-term health. Fortunately, incredible progress has occurred in the last half century repairing cleft defects. Today's children with these birth defects often enter adulthood with a normal appearance and better overall health.

A cleft is a gap in the mouth or face that typically forms during early pregnancy. It often affects the upper lip, the soft and hard palates, the nose or (rarely) the cheek and eye areas. Clefts can form in one or more structures, on one side of the face or on both. Why they form isn't fully understood, but they seem connected to a mother's vitamin deficiencies or to mother-fetus exposure to toxic substances or infections.

Before the 1950s there was little that could be done to repair clefts. That changed with a monumental discovery by Dr. Ralph Millard, a U.S. Navy surgeon stationed in Korea: Reviewing cleft photos, Dr. Millard realized the “missing” tissue wasn't missing—only misplaced. He developed the first technique to utilize this misplaced tissue to repair the cleft.

Today, skilled surgical teams have improved on Dr. Millard's efforts to not only repair the clefts but also restore balance and symmetry to the face. These teams are composed of various oral and dental specialties, including general dentists who care for the patient's teeth and prevent disease during the long repair process.

Cleft repairs are usually done in stages, beginning with initial lip repair around 3-6 months of age and, if necessary, palate repair around 6-12 months. Depending on the nature and degree of the cleft, subsequent surgeries might be needed throughout childhood to “polish” the original repairs, as well as cosmetic dental work like implants, crowns or bridgework.

In addition to the surgical team's skill and artistry, cleft repair also requires courage, strength and perseverance from patients and their parents, and support from extended family and friends. The end result, though, can be truly amazing and well worth the challenging road to get there.

If you would like more information on repairing cleft birth defects, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Cleft Lip & Cleft Palate.”

About one American baby in 700 is born with some form of lip or palate cleft—and the percentage is even higher in other parts of the world. At one time this kind of birth defect sentenced a child to a lifetime of social stigma and related health issues. But thanks to a surgical breakthrough over sixty years ago, cleft defects are now routinely treated and repaired.

Oral and facial clefts happen because a child’s facial structure fails to develop normally during pregnancy. This causes gaps or “clefts” to occur in various parts of the mouth or face like the upper lip, the palate (roof of the mouth), the nose or (more rarely) in the cheek or eye region. Clefts can have no tissue fusion at all (a “complete” cleft) or a limited amount (an “incomplete” cleft), and can affect only one side of the face (“unilateral”) or both (“bilateral”).

There was little that could be done up until the early 1950s. That’s when a U.S. Navy surgeon, Dr. Ralph Millard, stationed in Korea noticed after reviewing a series of cleft photos that tissue needed to repair a cleft was most often already present but distorted by the defect. From that discovery, he developed techniques that have since been refined in the ensuing decades to release the distorted tissue and move it to its proper location.

This revolutionary breakthrough has evolved into a multi-stage approach for cleft repair that often requires a team effort from several dental and medical professionals, including oral surgeons, orthodontists and general dentists. The approach may involve successive surgeries over several years with dental care front and center to minimize the threat of decay, maintain proper occlusion (the interaction between the upper and lower teeth, or “bite”), or restore missing teeth with  crowns, bridgework or eventually dental implants.

While it’s quite possible this process can span a person’s entire childhood and adolescence, the end result is well worth it. Because of these important surgical advances, a cleft defect is no longer a life sentence of misery.

If you would like more information on treatment for a cleft lip or palate, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Cleft Lip & Cleft Palate.”